a patient referes to you which symptoms in her mouth,describe her situation

The renaming of malignant fibrous histiocytoma to undifferentiated pleomorphic sarcoma by the WHO represents an eventual common pathway in

tumors

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tumours

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progressing to undifferentiated (8). According to

the

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apply

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most studies,

UPS

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shows features of both histiocytic and fibroblastic differentiation (7). Predominant spindle cell

component

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components

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with cytologic and nuclear pleomorphism,

peripheral

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and peripheral

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histiocyte-like cells with storiform

pattern

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patterns

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have been observed. Atypical mitosis and

necrosis

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havenecrosis

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also

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been observed in many

cases

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(9). In the histopathological feature, five subgroups of

this

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tumor

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tumour

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have been identified, including storiform/pleomorphic, myxoid, giant cell, inflammatory and angiomatoid. The giant cell

type

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has more aggressive clinical

behavior

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behaviour

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and poor prognosis. While

,

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the myxoid

type

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is the most common

type

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and its prognosis is better than other types of histology (10). Our

case

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has

gain

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cells

type

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of histology. Maybe,

this

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is one of the reasons for early death and high initial invasion of

this

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tumor

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tumour

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.

This

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tumor

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tumour

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typically demonstrates only vimentin in immunohistochemical staining. Vimentin positivity indicates the mesenchymal origin of the

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tumor

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(6). Like our study, the

cases

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of

the

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most studies tumoral cells have expressed only vimentin with high intensity (2,3,5-7). According to the histopathological view, many differential diagnoses

such

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as carcinosarcoma, leiomyosarcoma, angiosarcoma, Liposarcoma, malignant peripheral nerve sheath

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tumor

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tumour

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, rhabdomyosarcoma, malignant melanoma, malignant lymphoma can be suggested that the negativity of

this

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tumor

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tumour

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for cytokeratin, SMA, CD31, CD34, S100, desmin, HMB45, LCA causes the correct diagnosis (6). In some

cases

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, there has been a variable reaction to CD68 (5,11,12). Like Benites 's study, CD68 was locally positive in our study (5). According to the reported

cases

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, the oral soft tissue is more involved than the jawbone and it is often a nodular mass with or without pain that expands over a few weeks or months (6,7). the mandible alveolar mucosa was involved in 70% of Oral UPSs (5). Only 30% of patients complained of pain in the most reported

of

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UPS

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in

head

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the head

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and neck region.

Although

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, other symptoms

such

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as

trismos

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trismus

trios

, dysphagia and nasal obstruction were observed (13). In our

case

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, the patient has

complaining

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of a rapidly growing painless soft tissue mass from three months ago. Oral

UPS

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is often seen in older adults aged 50 to 70 years and

more

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is more

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affected in males than females (5,6). In

this

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report, we present an oral

UPS

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in an 83 years old female patient which is a rare

case

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. Complete surgical removal of the neoplasm with clear margins is the treatment of choice. regional

metastasis

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or cervical lymph node

metastasis

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are

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is

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rare and has been observed in only 15% of

cases

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.

Then

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, radiotherapy can be recommended in unresectable

cases

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or in

cases

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where a margin may be defined (5,6). But, reported

of

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head and neck UPSs have higher rates of recurrence and distant

metastasis

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(25-35% of

cases

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) to lung, liver, and bone as was observed in our patient, Vivekʼs and Benitesʼs

cases

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(3,5).

Therefore

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, adjuvant chemotherapy might be needed for

the

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tumors

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tumours

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with

history

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a history

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of local recurrence and histologically high-grade (1,6). The prognosis of oral

UPS

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depends on

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tumor

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tumour

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depth, size, primary or recurrent and stage. The 5-year survival rate varies from 30 to 70% (3,7,8). Our

case

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,

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has

not

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no

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lymph node

metastasis

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at the initial examination and before surgery. Eventually, due to delay in referral and lack of complete removal of the lesion, lung

metastasis

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was diagnosed one

months

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after the

first

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surgery.