Aggressive leiomyosarcoma of the oral cavity: a rare case report.

Leiomyosarcoma is a rare malignant tumor of smooth muscle, typically found in the uterus and gastrointestinal tract. Its occurrence in the oral cavity is extremely rare due to limited smooth muscle presence. Diagnosis relies on histopathology, and treatment involves wide surgical resection with adjuvant therapy. A 41-year-old male presented with a progressive gingivomandibular swelling for 1 year. He had previously undergone excision of a gingival lesion diagnosed as leiomyoma, which recurred after 1 year. Examination revealed a firm, non-bleeding mass from teeth 37 to 44, with hypoesthesia in the left labiomental region and mobility of the incisivocanine complex. Imaging showed aggressive features, including cortical bone lysis at the symphysis, suggesting malignancy. A biopsy confirmed leiomyosarcoma, and further imaging ruled out metastases or another primary tumor. This case underscores the importance of early diagnosis and aggressive treatment for optimal prognosis.