Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12742
Peer-review started: September 6, 2022
First decision: October 12, 2022
Revised: October 20, 2022
Accepted: October 27, 2022
Article in press: October 27, 2022
Published online: December 6, 2022
Processing time: 86 Days and 19.8 Hours
Oral liposarcoma is an extremely rare lesion that is often clinically misdiagnosed as a benign tumor due to its asymptomatic and indolent clinical course. Here, we report a case of massive low-grade myxoid liposarcoma (MLS) of the floor of the mouth.
A 71-year-old man presented with a huge mass in the left floor of the mouth. A biopsy was performed, and a diagnosis of a myxoid tumor suspicious for low-grade MLS or myxoma was made. Gadolinium-enhanced T1-weighted magnetic resonance imaging showed an intensely enhanced tumor lesion that occupies the left sublingual space and extends to the submandibular space. Submandibular dissection, tumor resection, and reconstruction with a radial forearm flap were performed. The surgical specimen exhibited histologically low-grade MLS. Fused in sarcoma (FUS, also known as TLS) and DNA damage-inducible transcript 3 (DDIT3, also known as CHOP) break-apart was not detected in the fluorescence in situ hybridization analysis. The tumor was completely encapsulated and did not require additional treatment. Furthermore, no recurrence was reported 40 mo after surgery.
We experienced an extremely rare, massive, low-grade MLS emerging from the floor of the mouth. Oftentimes, an MLS of the floor of the mouth lacks significant clinical findings and is often misdiagnosed. Although no FUS-DDIT3 fusion gene was detected, a low-grade MLS was ultimately diagnosed based on the histological findings.
Core Tip: Liposarcoma emerging from the floor of the mouth is extremely rare and often lacks significant clinical findings. This type of liposarcoma is usually misdiagnosed as ranula or benign tumor. In the present case, a definitive diagnosis could not be made preoperatively; however, myxoid liposarcoma was suggested, and complete resection could be achieved with appropriate imaging. A preoperative biopsy can help prevent incomplete resection. Clinical and radiological surveillance is necessary due to the possibility of local recurrence.