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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Main Authors: Takayuki Taruya, Takao Hamamoto, Tsutomu Ueda, Nobuyuki Chikuie, Sachio Takeno
Format: Article
Language:English
Published: MDPI AG 2025-04-01
Series:Reports
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Online Access:https://www.mdpi.com/2571-841X/8/2/58
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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
collection DOAJ
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.
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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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AT tsutomuueda transoralvideolaryngoscopicsurgeryforanundifferentiatedpleomorphicsarcomaofthetonguebaseacasereport
AT nobuyukichikuie transoralvideolaryngoscopicsurgeryforanundifferentiatedpleomorphicsarcomaofthetonguebaseacasereport
AT sachiotakeno transoralvideolaryngoscopicsurgeryforanundifferentiatedpleomorphicsarcomaofthetonguebaseacasereport