We report the case of a 54-year-old man who came to our clinic for dysphagia, dyslalia and foreign body sensation in the oral cavity of 2 months duration.
The patient was a regular smoker.
Intraoral examination revealed a large exophytic mass of 7 cm in maximum diameter, fleshy, which seemed pedunculated to soft palate and occupied the oropharynx lumen.
No cervical lymphadenopathies were detected.
The cervicofacial CT showed a large soft tissue lesion with well-defined borders that seemed to originate in the soft palate, growing exophytically and occupying the oropharynx lumen.
No pathological findings were observed.
The rest of the physical examination and CT scan showed no other distant lesions.
An incisional biopsy revealed a fusocellular neoplasm consisting of a population of fibrotic growth habit cells type with a storiform pattern, compatible with malignant fibrotiocytoma.
Due to the rapidly progressive obstruction of the upper airway, the patient required a tracheostomy prior to definitive surgery.
The patient underwent surgery, performing an approach using midline labiomandibulotomy, excision of the lesion with safety margins - which supposed the resection of the totality of the soft palate, left side of the radial fasciocutaneous flap with abutment.
The anatomopathological study of the piece revealed a fusocellular neoplasia constituted by a population of disposed fibrotic zones like this pattern, in nuclei or ovaliforms, confirming the initial growth pattern and epithelial pattern, which alternated with others.
Frequent figures of mitosis were identified, some of them due to episodes of psychosis.
The staining for vimentin and CD68 protein were positive.
The tumor largely respected surgical resection margins.
Given the large size of the lesion, radiotherapy was administered.
The patient remains free of local recurrence or distant recurrence to date and has an excellent aesthetic and functional outcome, with normal occlusion.
