This is a 62-year-old man, partially edentulous and without prosthesis, smoker since he was 12 years old (20 cigarettes a day).
He consulted for a painful tumor of 5 x 3 cm in the tongue of a month of evolution and weight loss of approximately 6 kg in two months.
The tumor was located on the right free edge, extending to the lingual base.
He had an ulcer unrelated to chronic dental trauma or prostrate.
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Biopsy of the ulcerated area was taken and histology raised the differential diagnosis between pseudosarcomatous carcinoma and epithelioid-fusocellular sarcoma.
One month later, lung metastases were found in the chest X-ray, osteolytic images in the dorsolumbar spine and two subcutaneous nodules in the back.
Biopsy of a dorsal nodule shows the same diagnosis as in the tongue.
No treatment was performed and the patient was admitted to Palliative Care and died 6 months later.
Pathological Anatomy: tongue biopsy (hematoxylineosine): proliferation epithelioid and fusocellular with ulcerated mitotic index.
It presents a differential diagnosis between pseudosarcomatous carcinoma and epithelioid and fusocellular sarcoma.
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Immunohistochemistry: negative pankeratin (AE1-AE3), positive vimentin, negative desmin (positive in non-tumoral muscle), negative CD34 and positive actin in fusocellular component (positive intrinsic control in vessels).
Immunohistochemical diagnosis: leiomyosarcoma arising in the tongue.
