Primary leiomyosarcoma of the upper gingiva mimicking epulis: Report of a case and review of the literature

Leiomyosarcoma of the oral cavity is a very rare tumor type associated with aggressive clinical behavior and a low survival rate. However, this tumor may also be encountered as a slow-growing, non-ulcerated, painless mass in its early stage. We report a case of leiomyosarcoma, affecting the gingival mucosa of a 24-year-old male. The tumor mimicked an epulis, because it was encountered as a slow-growing, discreet, firm, non-ulcerated, painless mass without any evidence of resorption of the maxillary bone. Excision of the “epulis” resulted in a histological diagnosis of leiomyosarcoma. The histological findings of a wider excision did not indicate the presence of any tumor cells. The patient has since remained tumor-free for 3 years. A literature review, related to the gingiva of the maxilla or mandible, indicated only a few cases wherein the tumor behavior was similarly mild and benign as it was in this case. Thus, when the tumor is diagnosed at an early stage, while it is small and non-aggressive, successful treatment can lead to a good prognosis.