Abstract
We present a rare case of primary oral leiomyosarcoma (LMS) occurring at maxilla pterygoid plate area. The patient had symptom of pain and swelling for more than 10 months over left pre-auricular area. The patient went to see the neurologist for help and was diagnosed as trigeminal neuralgia after checking computed tomography (CT) without any finding. Medication was prescribed at first but without any regressive change. Then, the magnetic resonance imaging (MRI) was arranged and a tumor over left maxillary pterygoid area extending to temporal space was found. The biopsy was arranged under general anesthesia and the result showed compatible with sarcoma. The patient was treated by radical surgery and reconstruction with free anterior lateral thigh flap. The pathology showed leiomyosarcoma and the immunohistochemical examination revealed positive cytologic features of HHF-35, smooth muscle actin and h-Caldesmon. The distant metastasis to thoracic and lumbar spines were found after 6 months of surgery and the patient is still under palliative chemo and radiotherapy.
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