Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report
<b>Background and Clinical Significance:</b> Undifferentiated pleomorphic sarcoma (UPS) is a highly malignant soft tissue tumor formerly known as malignant fibrous histiocytoma. In the fifth edition of the WHO classification (2020), UPS is classified as an undifferentiated/unclassifiable...
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2025-04-01
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| author | Takayuki Taruya Takao Hamamoto Tsutomu Ueda Nobuyuki Chikuie Sachio Takeno |
| author_facet | Takayuki Taruya Takao Hamamoto Tsutomu Ueda Nobuyuki Chikuie Sachio Takeno |
| author_sort | Takayuki Taruya |
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| description | <b>Background and Clinical Significance:</b> Undifferentiated pleomorphic sarcoma (UPS) is a highly malignant soft tissue tumor formerly known as malignant fibrous histiocytoma. In the fifth edition of the WHO classification (2020), UPS is classified as an undifferentiated/unclassifiable sarcoma diagnosed via exclusion. While UPS commonly occurs in the extremities, its incidence in the head and neck region is rare (3%), with only a few reported cases in the oropharynx. Surgical resection is the primary treatment; however, tumors at the tongue base pose significant challenges due to the complex anatomy and the presence of critical neurovascular structures. This case highlights a rare instance of tongue-base UPS successfully treated with transoral videolaryngoscopic surgery (TOVS), demonstrating its feasibility as a minimally invasive approach. <b>Case Presentation:</b> A 68-year-old male presented with pharyngeal discomfort, dysphagia, and nocturnal dyspnea. Clinical examination revealed a pedunculated tumor originating from the left tongue base, occupying the pharyngeal cavity. Imaging studies showed a 5 cm mass without lymph node metastasis. A biopsy confirmed UPS (cT3N0M0). Given the tumor’s characteristics, TOVS was performed using an FK-WO TORS laryngo-pharyngoscope retractor. The tumor was resected with a ≥10 mm margin, achieving complete histological resection. The patient’s dyspnea resolved immediately, and oral intake resumed the next day. No adjuvant radiotherapy was administered, and no recurrence was observed for 50 months. <b>Conclusions:</b> This is the first reported case of UPS of the tongue base successfully resected using TOVS. This minimally invasive approach provides a safe and effective alternative for managing oropharyngeal UPS. |
| format | Article |
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| institution | Kabale University |
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| spelling | doaj-art-94889fe653734661a7ea12d9c8ac17dc2025-08-20T03:29:39ZengMDPI AGReports2571-841X2025-04-01825810.3390/reports8020058Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case ReportTakayuki Taruya0Takao Hamamoto1Tsutomu Ueda2Nobuyuki Chikuie3Sachio Takeno4Department of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, JapanDepartment of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, JapanDepartment of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, JapanDepartment of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, JapanDepartment of Otorhinolaryngology, Head and Neck Surgery, Hiroshima University Hospital, 1-2-3, Kasumi, Minami-ku, Hiroshima 734-8551, Japan<b>Background and Clinical Significance:</b> Undifferentiated pleomorphic sarcoma (UPS) is a highly malignant soft tissue tumor formerly known as malignant fibrous histiocytoma. In the fifth edition of the WHO classification (2020), UPS is classified as an undifferentiated/unclassifiable sarcoma diagnosed via exclusion. While UPS commonly occurs in the extremities, its incidence in the head and neck region is rare (3%), with only a few reported cases in the oropharynx. Surgical resection is the primary treatment; however, tumors at the tongue base pose significant challenges due to the complex anatomy and the presence of critical neurovascular structures. This case highlights a rare instance of tongue-base UPS successfully treated with transoral videolaryngoscopic surgery (TOVS), demonstrating its feasibility as a minimally invasive approach. <b>Case Presentation:</b> A 68-year-old male presented with pharyngeal discomfort, dysphagia, and nocturnal dyspnea. Clinical examination revealed a pedunculated tumor originating from the left tongue base, occupying the pharyngeal cavity. Imaging studies showed a 5 cm mass without lymph node metastasis. A biopsy confirmed UPS (cT3N0M0). Given the tumor’s characteristics, TOVS was performed using an FK-WO TORS laryngo-pharyngoscope retractor. The tumor was resected with a ≥10 mm margin, achieving complete histological resection. The patient’s dyspnea resolved immediately, and oral intake resumed the next day. No adjuvant radiotherapy was administered, and no recurrence was observed for 50 months. <b>Conclusions:</b> This is the first reported case of UPS of the tongue base successfully resected using TOVS. This minimally invasive approach provides a safe and effective alternative for managing oropharyngeal UPS.https://www.mdpi.com/2571-841X/8/2/58undifferentiated pleomorphic sarcomamalignant fibrous histiocytomaundifferentiated sarcomatongue baseoropharynxtransoral endoscopic surgery |
| spellingShingle | Takayuki Taruya Takao Hamamoto Tsutomu Ueda Nobuyuki Chikuie Sachio Takeno Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report Reports undifferentiated pleomorphic sarcoma malignant fibrous histiocytoma undifferentiated sarcoma tongue base oropharynx transoral endoscopic surgery |
| title | Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report |
| title_full | Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report |
| title_fullStr | Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report |
| title_full_unstemmed | Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report |
| title_short | Transoral Videolaryngoscopic Surgery for an Undifferentiated Pleomorphic Sarcoma of the Tongue Base: A Case Report |
| title_sort | transoral videolaryngoscopic surgery for an undifferentiated pleomorphic sarcoma of the tongue base a case report |
| topic | undifferentiated pleomorphic sarcoma malignant fibrous histiocytoma undifferentiated sarcoma tongue base oropharynx transoral endoscopic surgery |
| url | https://www.mdpi.com/2571-841X/8/2/58 |
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