Prevalence of Head and Neck Sarcoma in a Major Cancer Center in Iran- A 10-Year Study

Document Type: Original


1 Department of Oral and Maxillofacial Pathology, Dental School of Shahid Beheshti University, Tehran, Iran.

2 PhD Iran National Tumor Bank, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.

3 Research Committee, Dental School of Shahid Beheshti University of Medical Sciences, Tehran, Iran.


Sarcomas are rare malignancies with aggressive biological behavior. They are categorized into soft and hard tissue types. The main objective of this study was to analyze the prevalence of head and neck sarcomas (HNS) among the Iranian population.
Materials and Methods:
The pathology files derived from Iran National Tumor Bank of Cancer Institute in Imam Khomeini Hospital, affiliated to Tehran University of Medical Sciences, Tehran, Iran, served as the source of the materials for this study. All cases diagnosed with head and neck sarcoma were included in the study. The recorded data included the patient’s age, gender, tumor location, and rates of recurrence and metastasis.
Investigation of the pathology files of the patients referring to the center under study during a 10-year period resulted in the identification of 183 HNS cases, 96.17% of which were primary. Generally, the prevalence of this disease was at its highest level in patients within the age range of 30-60 years with a male to female ratio of 1.4. The recurrence and metastasis rates of HNS were 32.38% and 5%, respectively. Osteosarcoma was detected as the most common type of sarcoma. Soft tissue sarcomas constituted 69.3% of the lesions with a male predilection. The patients afflicted with this type of sarcoma had a mean age of 45.88 years. Furthermore, hard tissue sarcomas comprised 30.68% of the sarcoma cases with a mean age of 36.22 years and a female predilection. The commonest lesion was osteosarcoma, and the most typical location was the mandible.
In the current study, head and neck sarcomas were most often observed in patients within the age range of 30-60 years with a male predilection. Osteosarcoma was identified as the most common type of sarcoma. Studies addressing rare lesions with a large sample size facilitate the recognition of the demographic data and histopathologic variation which may contribute to a correct diagnosis.


Main Subjects

1. Breakey RW, Crowley TP, Anderson IB, Milner RH, Ragbir M. The surgical management of head and neck sarcoma: The Newcastle experience. J Plast Recontr Aesthet Surg 2017; 70:78-84.

2. Barosa J, Ribeiro J, Afonso L, Fernandes J, Monteiro E. Head and neck sarcoma: analysis of 29 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131: 83-6.

3. Alishahi BKargahi NHomayouni S. Epidemiological Evaluation of Head and Neck Sarcomas in Iran (the Study of 105 Cases Over 13 Years). Iran J Cancer Prev 2015; 8: e3432.

4. Akbari MEAtarbashi Moghadam SAtarbashi Moghadam F, Namdari M, Bastani Z. Epidemiological Evaluation of Palatal Cancers in Iran: A Study on 303 Cases. Int J Cancer Manag. 2018; 11: e61788.

5.Woods RH, Potter JA, Reid JL, Louise J, Bessen T, Farshid G, et al. Patterns of head and neck sarcoma in Australia.ANZ J Surg 2017 May16.

6. Vassiliou LV, Lalabekyan B, Jay A, Liew C, Whelan J, Newman L, et al. Head and neck sarcomas: A single institute series. Oral Oncol 2017; 65: 16-22.

7. Bentz BG, Singh B, Woodruff J, Brennan M, Shah JP, Kraus D. Head and neck soft tissue sarcomas: a multivariate analysis of outcomes. Ann Surg Oncol. 2004; 11: 619-28.

8. Lajer CB, Daugaard S, Hansen HS, Kirkegaard J, Holmgaard S, Christensen ME. Soft tissue sarcomas of the head and neck: a single-centre experience. Clin Otolaryngol 2005;30:176-82.

 9. Stavrakas M, Nixon I, Andi K, Oakley R, Jeannon JP, Lyons A, et al. Head and neck sarcomas: clinical and histopathological presentation, treatment modalities, and outcomes. J Laryngol Otol 2016; 130: 850-9.

10. Tejani MAGalloway TJLango MRidge JAvon Mehren M. Head and neck sarcomas: a comprehensive cancer center experience. Cancers (Basel)  2013; 5(3): 890-900.

11. Tudor-Green B, Gomez R, Brennan PA. Current update on the  diagnosis  and  management of head and neck soft tissue sarcomas. J Oral Pathol Med 2017; 46(9): 674-79.

12. Pandey MChandramohan KThomas G,  Mathew ASebastian PSomanathan T et al. Soft tissue sarcoma of the head and neck region in adults. Int J Oral Maxillofac Surg 2003;32:43-8.

13. Gorsky MEpstein JB. Head and neck and intra-oral soft tissue sarcomas. Oral Oncol 1998; 34:        292-6.

14. Huber GF, Matthews TW, Dort JC. Soft-tissue sarcomas of the head and neck: a retrospective analysis of the Alberta experience 1974 to 1999. Laryngoscope 2006; 116: 780-5.

15. Liuzzi JFDa Cunha MSalas DSiso SGarriga E. Soft-tissue sarcomas in the head and neck:  25 years of experience. Ecancermedicalscience  2017;   11: 740.

16. Chindia ML, Swaleh SM, Godiah PM. Sarcomas of the head and neck at Kenyatta National Hospital. East Afr Med J 2000; 77: 256-9.

17. Akbari MEAtarbashi Moghadam SAtarbashi Moghadam F, Bastani Z, Salehi Zalani S. Primary Malignant Neoplasms of Parotid Gland in Iranian Population. Int J Cancer Manag. 2017; 10: e7485.

18. Tudor-Green B, Fonseca FP, Gomez RS, Brennan PA. Current update on the  diagnosis  and management of head and neck hard tissue sarcomas. J Oral Pathol Med 2017; 46(9): 667-73.

19. Stewart BD, Reith JD, Knapik JA, Chi AC. Bone- and cartilage-forming tumors and Ewing sarcoma: an update with a gnathic emphasis. Head Neck Pathol 2014; 8: 454-62.

20.  Guevara-Canales JO, Sacsaquispe-Contreras SJ, Morales-Vadillo R, Sanchez-Lihon J. Epidemiology of the sarcomas of the jaws in a Pe­ruvian population. Med Oral Patol Oral Cir Bucal 2012; 17: e201–5.

21. Jasnau S, Meyer U, Potratz J, Jundt G, Kevric M, Joos UK, et al. Craniofacial osteosarcoma Experience of the cooperative German-Austrian-Swiss osteosarcoma study group. Oral Oncol 2008; 44: 286-94.

22. Brady JSChung SYMarchiano EEloy JA, Baredes SPark RCW. Pediatric  head  and  neck bone sarcomas: An analysis of 204 cases. int J Pediatr Otorhinolaryngol 2017; 100: 71-6.