Problems concerning Clinical and Histologic Diagnosis of Oral Sarcomas

¹ Universitätsklinik und Poliklinik für Zahn-, Mund-, und Kieferkrankheiten Nordwestdeutsche Kieferklinik, Hamburg, Germany

Eighty-two sarcomas (64 oral sarcomas and 18 sarcomas of the face and neck) were analyzed with regard to the problems of clinical and histologic diagnosis. Of the oral sarcomas, 57.8 per cent were first diagnosed and treated as inflammations. Five-year cures were achieved in 33.3 per cent, in comparison with 45.5 per cent among those tumors that were immediately recognized as sarcomas. Among the sarcomas of the face and neck, there was only one case that was mistaken for an inflammation. Five cases that were either histologically misjudged or in which the histologic findings differed from the clinical diagnosis were described: (1) a chondroblastic sarcoma of the articular process that had entered the parotid gland and was first mistaken histologically for a mixed tumor; (2) an osteogenic sarcoma of the maxilla that histologically appeared as an ossifying fibroma and that recurred each time after operative removal; (3) a sarcoma of the sphenomaxillary space with destruction of the base of the skull that microscopically revealed a fibroma containing numerous cells; (4) multiple chondromas that clinically were characterized as sarcomas and by histologic examination were diagnosed as benign chondromas; (5) a polymorphic-cell sarcoma of the mandible that was clinically well marked and therefore appeared comparatively benign but which, from the histologic aspect, showed a considerable loss of differentiation.