A case report of solitary, intraosseous, adult-onset myofibroma of the mandible

Incidental Solitary Myofibroma in a Young Adult Female Patient: A Case Report and Comprehensive Literature Review of Myofibroma in Adults

Myofibroma is a rare mesenchymal tumor typically observed in children, with only a few reported cases in adults. It can be easily mistaken for more common benign lesions, making it essential to include them in the differential diagnosis of soft tissue masses. This case report presents a rare instance of myofibroma in a young adult, and a comprehensive review of the literature presenting case reports and case series of myofibroma cases in the head and neck regions of adult patients aged > 18 years. A 22-year-old woman presented with a gradually enlarging, painless mass on the right side of her neck which had been developing over the course of two years. An ultrasound initially identified a 1×2 cm lipoma; however, during surgery, a fibrous soft tissue mass was discovered extending beneath the sternocleidomastoid muscle. The mass was found to be closely associated with the posterior auricular nerve. Despite its proximity to the nerve, the tumor was successfully excised, while preserving the nerve. Histopathological analysis confirmed a diagnosis of myofibroma. This case highlights the rare occurrence of myofibromas in adults and emphasizes the importance of considering this diagnosis when evaluating soft-tissue masses. Even when imaging suggests a benign lesion, surgical intervention may yield unexpected results. Accurate diagnosis through histopathology is essential, and careful surgical techniques, including nerve preservation, play a critical role in successful management. Long-term follow-up is necessary to ensure the absence of tumor recurrence.

Solitary Myofibroma of the oral and maxillofacial regions in pediatric patients: A clinicopathological analysis of ten patients and review of 75 cases

BACKGROUND

The imaging manifestations of oral and maxillofacial myofibroma/myofibromatosis can vary among patients. Although many clinical cases have been reported, a consensus on the clinicopathological features of and treatment principles for this disease is lacking.

PURPOSE

This study aimed to summarize the clinicopathological features of solitary myofibroma of the oral and maxillofacial regions in pediatric patients.

METHODS

The clinical data, histological features, and immunohistochemical characteristics of ten pediatric patients who underwent surgical removal and subsequent pathological diagnosis of myofibroma were collected and retrospectively and cross-sectionally analyzed.

RESULTS

Seven patients were male, and 3 were female, with ages ranging from 3 months to 6 years (mean: 2.6 years). The patients presented with solitary lesions involving the mandibular gingiva and adjacent mandible (4 patients), mandible (2 patients), oral floor and submandibular area and adjacent mandible (1 patient), gingiva (1 patient), maxilla (1 patient), and oropharynx (1 patient). Light microscopy revealed spindle-shaped tumor cells organized in bundles or vortex patterns, forming a hemangiopericytoma-like perivascular pattern, whereas immunohistochemical staining revealed diffuse smooth muscle actin (SMA) positivity. All patients underwent surgical resection, and none experienced recurrence over the 12- to 82-month follow-up.

CONCLUSIONS

Solitary myofibroma in the oral and maxillofacial regions is predominantly observed in infants and young children, with a higher incidence among males. The prognosis is favorable following localized lesion resection or curettage of jawbone lesions. Accurate recognition of the clinical, radiological, and pathological features of the disease will reduce the misdiagnosis rate.

Myofibroma of the body of mandible: A case report of a solitary lesion

Myofibromas are rare benign lesions and are often found as solitary entities. The treatment of the lesion is complete excision and the recurrence is rare. A 56-year-old female presented to the Oral and Maxillofacial Surgery clinic for further evaluation and management of a solitary lesion of the right body of the mandible that was first noticed incidentally by her referring dentist. An incisional biopsy was first performed in the clinic with the diagnosis of myofibroma. The patient was then treated with complete excision of the lesion and extraction of the adjacent teeth. The final biopsy report confirmed the initial diagnosis of myofibroma. Intraosseous solitary lesion of the mandible is a rare lesion with a handful of reported cases. Uniquely, the diagnosis of myofibroma in this 56-year-old is the oldest reported case of myofibroma. There are distinct histopathological features of the lesion that distinguishes this entity from other closely resembling lesions.

Solitary intramuscular myofibroma in an adult: Case report and MR imaging findings

Myofibroma is a benign, soft tissue neoplasm that predominantly affects infants and young children. Most occur in the skin or subcutaneous tissues, with a predilection for the head and neck regions. We describe the magnetic resonance (MR) imaging and histophathologic findings of a rare case of intramuscular myofibroma of the right deltoid in a healthy 30-year-old male. MR imaging revealed a well-circumscribed intramuscular mass, with isointense signal on T1-weighted images, hyperintense signal on T2-weighed images, and a "target-sign" with peripheral rim enhancement after gadolinium administration. The lesion was surgically excised with no complications, and the histopathologic analysis revealed the typical morphologic and histochemical markers of a myofibroma. We conclude that, although rare, myofibroma can be considered in the differential diagnosis of adults with lesions the above signal characteristics.

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: a case report

BACKGROUND

Infantile myofibromatosis is the most common benign fibrous tumor in infants. Three different types have been reported in the literature. The most commonly affected areas are the head, the neck and the trunk. Our patient showed a very high level of mandibular destruction resistant to all mandibular sparing treatment strategies requiring segmental mandibulectomy and complex reconstruction.

CASE PRESENTATION

We describe a rare case of multicentric infantile myofibromatosis with mandibular bone destruction. The treatment required a succession of chemotherapy, a subtotal transoral resection and a hemi-mandibulectomy. The mandibular reconstruction was staged with initial bridging titanium plate with a submental flap, followed later by a fibula free flap.

CONCLUSION

Mandibular involvement by myofibromatosis is rare, and the extend of bone destruction and reconstruction make this case unique. To our knowledge, this is the only reported case of fibula free flap mandibular reconstruction in a patient with infantile myofibromatosis , as well as one of the youngest reported submental island flaps for any pathology. We describe the clinical presentation and management, including relevant imaging, histopathology, medical and surgical treatment as well as a review of relevant literature.

Solitary Intra-Osseous Myofibroma of the Jaw: A Case Report and Review of Literature

Myofibroma is a rare benign spindle cell neoplasm in children that usually affects both soft tissue and bone in the head and neck region. Approximately one third of these cases are seen within jaw bones as solitary lesions. Solitary intra-osseous myofibroma of the jaw bone shares its clinical, radiographic and histological features with other spindle cell tumors. The rarity of this lesion can make diagnosis difficult for clinicians and pathologists. We report a case of a solitary intra-osseous myofibroma in the mandible of a nine-year-old child.

The spectrum of infantile myofibromatosis includes both non-penetrance and adult recurrence

Infantile myofibromatosis is characterized by benign myofibroblastic tumors within skin, muscle, bone or viscera which have a characteristic staining pattern on immunohistochemistry. The condition typically presents in infancy and the tumors often disappear by the third year of life. Mutations in the PDGFRB gene and NOTCH3 genes have been identified in familial forms of the condition. We present two families with molecularly confirmed germline mutations in the PDGFRB gene, one demonstrating a phenotype ranging from complete non-penetrance to neonatal lethality; and the other illustrating adult recurrence of the tumors.

Solitary, adult-onset, intraosseous myofibroma of the finger: report of a case and review of literature

Myofibroma is a rare benign neoplasm of myofibroblastic origin. It typically occurs in the skin and subcutaneous tissues of the head and neck in infants and young children as multicentric lesions known as infantile myofibromatosis. Intraosseous myofibromas are very rare and are typically destructive lesions that predominantly affect craniofacial bones in the setting of myofibromatosis. Solitary, intraosseous myofibromas in adults are exceedingly rare. Herein, we report a myofibroma involving the middle phalanx of the right index finger in a 58-year-old man who presented with a pathologic fracture. Twelve other cases of adult-onset, intraosseous myofibroma were compiled from the English language literature and integrated with this report.

Myofibroma in the palm presenting with median nerve compression symptoms

SUMMARY

A myofibroma is a benign proliferation of myofibroblasts in the connective tissue. Solitary myofibromas are a rare finding especially in an adult. We report a case of a 23-year-old man presenting with an enlarging mass over his right palm. The patient is an active weight lifter. He reported numbness and tingling in the median nerve distribution. Nerve conduction studies and magnetic resonance imaging scans suggested a tumor involving or compressing the median nerve. The final diagnosis of myofibroma was made only after the histopathological diagnosis.

Solitary myofibroma of the mandible: an immunohistochemical and ultrastructural study with a review of the literature

A solitary myofibroma (MF) is an unusual spindle cell neoplasm that usually arises in the soft tissue, skin, or bone of the head and neck region in infancy. We report an extremely rare case of MF of the mandible in an 18-year-old Japanese woman together with the conventional histologic, immunohistochemical, and electron microscopic findings. The tumor was well circumscribed and composed of fibroblast-like or myofibroblast-like spindle cells. On immunohistochemical evaluation the tumor cells were positive for vimentin, α-smooth muscle actin, HHF-35, and calponin, but negative for neurogenic antigens and markers for vascular endothelial cells. The Ki-67 labeling index was 10 % and the p53 labeling index was 10 %. Ultrastructural examination revealed smooth muscle cell differentiation. The patient was treated by surgical resection and underwent follow-up without any signs of recurrence. MF presents a wide range of differential diagnosis, including benign and malignant neoplasms. Therefore, accurate diagnosis may avoid an unnecessarily aggressive therapy.

Submandibular myofibroma: a case report

PURPOSE

Myofibroma is a rare benign spindle cell neoplasm, and the aim of the present study was to carry out a literature review and present a clinical case of a patient with a myofibroma in the submandibular region and its management.

CONCLUSIONS

Diagnosis of myofibroma can be reached by a histopathologic and immunohistochemical analysis and surgical excision is the treatment of choice.

Solitary myofibroma of the adult mandible: a case report

A 43-year-old woman presented with a swelling in the anterior mandible appearing radiographically as a well-defined radiolucency causing mobility of the anterior teeth. A clinical diagnosis of a radicular cyst led to removal of the lesion and the associated mobile teeth. Postoperative histopathology led to a diagnosis of intraosseous solitary myofibroma of the mandible. Solitary lesions of myofibroma are exceedingly rare in adult jaws, with only 3 previously documented cases.