Tonsillar leiomyoma

Tumors of smooth muscle origin are rare in the oral cavity. To date, only eighty-three cases of oral leiomyomas have been reported. A first case of tonsillar leiomyoma in a 73-year-old male is presented. The theories of origin and the various histologic types of oral leiomyomas are discussed. Leiomyomas can easily be confused with other spindle-cell tumours. Special stains are necessary to reach a correct diagnosis. It is sometimes difficult to differentiate benign leiomyoma from malignant leiomyosarcoma. The use of mitotic figure count to indicate malignant behaviour is not always reliable. The need for wide surgical excision of the tumour, complete sectioning and examination of the specimen and meticulous follow-up of the patient for evidence of recurrence are emphasized.