Leiomyosarcoma of oral cavity: Rare presentation in retromolar trigone

Most of head and neck Leiomyosarcoma present with primary lesion in skin and soft tissue, minority are found in mucosal sites, Leiomyosarcoma is derived from vascular smooth muscles or arrector pili muscles of hair follicles, intraoral presentation is extremely rare of which tongue appears to be most common intraoral site followed by palate.We present a case report of large (4.5 cm × 5.5 cm × 3.5 cm) Leiomyosarcoma of retromolar trigone.A 68 years old male patient presented with a history of painless lump in the oral cavity since a period of 4 months. Clinical examination revealed a large nodular growth in the left retro molar trigone. Radiological features suggested lingual and buccal extension of the lesion with destruction of mandible. Incision biopsy was suggestive of spindle cell tumour. Metastatic work up was negative for metastasis, following which patient was treated by surgical resection and reconstruction.Final histology was suggestive of high grade leiomyosarcoma based on morphological findings and panel of IHC reports. Patient was further managed with post operative adjuvant radiotherapy and is under follow up since a period of 6 months.