Well-differentiated liposarcoma of the epiglottis

Liposarcomas of the larynx are very rare. A review of the English literature revealed only 28 published reports of tumours in this anatomical location. Diagnosis requires a high index of suspicion and careful histologic analysis. We present a case of a well-differentiated liposarcoma of the epiglottis, the tenth reported case at this laryngeal subsite. Initial biopsy specimens showed histological characteristics of a liposarcoma, which facilitated provision of optimal surgical treatment after careful analysis of published literature.     

Primary liposarcoma of the pharynx

We describe a rare case of primary pharyngeal liposarcoma in a 64-year-old man who had multiple recurrences. The available literature is reviewed and discussed. Although it is very difficult to assess the prognosis and treatment of pharyngeal liposarcomas, it appears that the histologic characteristics of the individual tumor and its location and resectability determine the outcome of treatment. However, because of its rare occurrence clinically, no single institution has been able to gain enough experience to formulate reliable long-term prognoses and therapeutic guidelines.     

Primary pleomorphic liposarcoma of the larynx

Liposarcoma is a rare tumor in the larynx. A case of such lesion occurring in a 52 year old male patient is described. This is the second case to be reported in the world literature. The patient underwent hemilaryngectomy and later total laryngectomy for a recurrent tumor and is living and well six years after diagnosis.     

Primary parotid liposarcoma

IntroductionPrimary liposarcoma is very rare in the parotid gland. To date, only 8 cases of primary parotid liposarcoma have been reported. The aim of this study is to report on a case of primary parotid liposarcoma highlighting the complexity of its treatment and analyze treatment outcomes of other reported cases.Case summaryWe report a case of parotid liposarcoma arising in the left parotid gland of a 66 year-old man, causing local morbidity, recurrence, repeated surgical treatment and death 5 months after initial treatment.DiscussionParotid liposarcoma is marked by a high probability of local recurrence of up to 70% and is prone to distant metastatic spread, as was the case in our patient. Based on limited experience from published literature, optimal treatment entails radical surgery with negative margins. Postoperative radiotherapy is an option for patients with large high-grade tumors, positive margins and involvement of complex anatomic subsites. High-grade tumors have a worse outcome despite the addition of surgery and postoperative radiotherapy.     

Retro-pharyngeal liposarcoma.

We present a case of extensive recurrence of a retro-pharyngeal liposarcoma following surgical removal 18 years previously. The surgery and pathology are discussed, and management strategies of head and neck liposarcomas are reviewed.     

Laryngeal dedifferentiated liposarcoma

Background  

Soft tissue liposarcomas are quite common in the adult population, whereas liposarcoma of the larynx is exceedingly rare.     

Well-differentiated,pedunculated liposarcoma of the hypopharynx

IntroductionLiposarcoma of the hypopharynx is extremely rare, as only 28 cases have been reported in the literature. The cardinal symptom of liposarcoma is progressively worsening dysphagia.Case reportThe authors report the case of a 71-year-old man who presented with dysphagia, marked weight loss over several weeks and an episode of exteriorization of a solid mass from the mouth during an episode of vomiting. Imaging revealed a fat density intra-oesophageal mass. Panendoscopy and upper gastrointestinal endoscopy visualized the pedunculated tumour in the left piriform sinus, which was able to be exteriorized via the mouth. The tumour was then resected endoscopically at its hypopharyngeal insertion pedicle. Histological examination of the operative specimen concluded on well-differentiated benign liposarcoma.DiscussionWell-differentiated liposarcoma is the most common form of liposarcoma, but is only exceptionally reported in the hypopharynx. The main symptoms are related to compression of adjacent structures. Imaging findings are nonspecific. Only histological examination can distinguish liposarcoma from other benign oesophageal tumours. Standard treatment consists of wide, complete resection, which is not always possible in the neck. Long-term follow-up of these patients is essential in order to rapidly detect recurrence.     

Parotid metastasis of liposarcoma of the lower limbs

Distant metastasis affecting the parotid gland are a rare entity, with origin in most cases from cutaneous tumors of the head and neck, mainly melanoma and epidermoid carcinoma. Other histological types of metastasis and tumors originated from distant organs or sites are very rare and may be a diagnostic and therapeutic challenge, for this reason, we consider it interesting for discussion. In this paper, we present the case of a patient with a metastatic tumor of the parotid gland secondary to a liposarcoma of the leg, extremely rare case, about which we have no found previous references in the literature.     

Leiomyoblastoma of the tongue

Leiomyoma is a benign tumor of smooth muscle origin that is rarely found in oral cavity. We report a case of leiomyoblastoma of the tongue. The interest of this lesion is supported by its location and by the difficulty to determine its biological behavior. About 25% of the oral smooth muscle tumors are malignant, and have been reported "leiomyoma" locally invasive.     

Chondroma of the tongue

Lingual chondromas are rare neoplasms. They are usually seen on the lateral border and dorsum of the tongue. A case of chondroma on the ventral surface of the tongue of a 79-year-old woman is described and the literature reviewed. The possible causes of this unusual neoplasm are discussed.     

Osteochondroma of the tongue

A case is described of osteochondroma of the tongue and the literature on osteomata, chondromata and osteochondromata of the tongue is reviewed. The tendency for these tumours to arise in the region of the foramen caecum has been noted in previous reports as has the female preponderance. It has been suggested that they arise from remnants of branchial arch cartilage. The variation in the duration and age at presentation of the lesion has not been explained and an alternative theory is suggested.     

Neurilemmoma of the tongue

A rare case of benign nerve sheath tumor arising from tongue is being reported. The tumor was excised and has showed no recurrence.     

Reconstruction of the tongue

Subtotal or total glossectomies performed for malignancies or other afflictions of the tongue are fraught with great disabling problems postoperatively. Recently the introduction of myocutaneous flaps has aroused new interest in surgical procedures to reconstruct the tongue following major resections. A new approach to functional reconstruction of the tongue is presented utilizing the sternocleidomastoid myocutaneous flap based superiorly. Neurorrhaphy between the hypoglossal nerve on the resected side of the tongue and the nerve to the sternocleidomastoid muscle is easily achieved without under tension as these nerves are in close proximity. In addition, the sternocleidomastoid myocutaneous flap is an ideal flap in tongue reconstruction as there is no fat between the skin and muscle and it resembles the bulkiness of the tongue muscle itself. A patient with a carcinoma of the tongue treated with subtotal resection and reconstruction using the above principles demonstrated full tongue movements 11 months postoperatively.     

Hamartoma of the tongue

Hamartomas of the tongue are rare. A case of a 6-year-old girl with hamartoma at the base of the tongue is reported. The diagnosis was confirmed by a histopathologic examination of the mass after removal in a wedge fashion by the CO2 laser under general anesthesia. The literature is reviewed and discussed.