Metastatic leiomyosarcoma in the oral cavity: case report with protein expression profiles.
Leiomyosarcoma (LMS) is a relatively uncommon malignant tumour derived from smooth muscle cells that rapidly metastasizes to distant regions. It rarely reaches oral tissues in which smooth muscle tissues are absent. We report the case of a 56-year-old woman who presented with LMS in the maxilla that had metastasized from a primary tumour in her uterus, received a total hysterectomy with bilateral salpingo-oophorectomy 9 months earlier. To reveal the poor prognosis of metastatic LMS, a total of 26 antibodies against different factors related to the proliferation, apoptosis, necrosis, and angiogenesis were simultaneously applied on the immunohistochemistry and immuno-blot detection in order to screen for expression n of different proteins in the metastatic LMS. Compared with the immunoreactions of primary uterine LMS, the different antibodies for cellular proliferation, i.e., proliferating cell nuclear antigen (PCNA), multiple primary neoplasm-2 (MPN-2), Max, p21, CDK4, p53, Rb-1, Bad, Bcl-2, epidermal growth factor receptor (EGF-R), hepatocyte growth factor (HGF), C-erbb2, Maspin, and DMBT-1, and those for angiogenesis, i.e., vWF, CD31, and Angiogenin, were more intensely expressed, while Bax, p16, Wnt-1, E-cadherin, and APC were relatively weakly expressed. In particular, beta-catenin was densely localized to the nuclei of tumour cells. These data suggest that rapid proliferation of the tumour cells is related to over-expression of different oncogenes, and that the infiltrative growth and early distant metastasis of these tumour cells are related to over-expression of angiogenesis factors. A total of seven cases of metastatic LMS to the oral cavity that had been published in the English literature were reviewed, and the reason for the poor prognosis in the metastatic LMS is suggested in this case report.
Kim
Soung Min
SM
Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Republic of Korea.
Myoung
Hoon
H
Choung
Pill Hoon
PH
Kim
Myung Jin
MJ
Lee
Suk Keun
SK
Lee
Jong Ho
JH
D002135:Calcium-Binding Proteins; D051358:Cyclin-Dependent Kinase 4 / Q000032:analysis; D050759:Cyclin-Dependent Kinase Inhibitor p21 / Q000032:analysis; D004268:DNA-Binding Proteins; D066246:ErbB Receptors / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D005887:Gingival Neoplasms / Q000556:secondary*; D017228:Hepatocyte Growth Factor / Q000032:analysis; D006801:Humans; D007890:Leiomyosarcoma / Q000556:secondary*; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000032:analysis; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis; D018809:Proliferating Cell Nuclear Antigen / Q000032:analysis; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000032:analysis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011956:Receptors, Cell Surface / Q000032:analysis; D016160:Retinoblastoma Protein / Q000032:analysis; D012259:Ribonuclease, Pancreatic / Q000032:analysis; D015843:Serpins / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D025521:Tumor Suppressor Proteins; D014594:Uterine Neoplasms / Q000473:pathology*; D051025:bcl-Associated Death Protein / Q000032:analysis; D051176:beta Catenin / Q000032:analysis; D014841:von Willebrand Factor / Q000032:analysis
D002135:Calcium-Binding Proteins; D051358:Cyclin-Dependent Kinase 4; D050759:Cyclin-Dependent Kinase Inhibitor p21; D004268:DNA-Binding Proteins; D066246:ErbB Receptors; D017228:Hepatocyte Growth Factor; D009363:Neoplasm Proteins; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D018809:Proliferating Cell Nuclear Antigen; D019253:Proto-Oncogene Proteins c-bcl-2; D018719:Erb-b2 Receptor Tyrosine Kinases; D011956:Receptors, Cell Surface; D016160:Retinoblastoma Protein; D012259:Ribonuclease, Pancreatic; D015843:Serpins; D016159:Tumor Suppressor Protein p53; D025521:Tumor Suppressor Proteins; D051025:bcl-Associated Death Protein; D051176:beta Catenin; D014841:von Willebrand Factor; C494819:BAD protein, human; C493956:CDKN1A protein, human; C495270:CTNNB1 protein, human; C108174:DMBT1 protein, human; C085344:SERPIN-B5; C495900:CDK4 protein, human; C046366:angiogenin