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As'ad A, Al-Shbailat SA, Alhawamleh H, Alsalamat HA. Incidental Solitary Myofibroma in a Young Adult Female Patient: A Case Report and Comprehensive Literature Review of Myofibroma in Adults. Cureus 2024; 16:e72229. [PMID: 39583463 PMCID: PMC11584212 DOI: 10.7759/cureus.72229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2024] [Indexed: 11/26/2024] Open
Abstract
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.
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Affiliation(s)
- Anas As'ad
- General Surgery, Faculty of Medicine, Al-Balqa' Applied University, Al-Salt, JOR
| | | | - Hamza Alhawamleh
- Surgery, Faculty of Medicine, Jordan University of Science and Technology, Irbid, JOR
- Surgery, Tafila Governmental Hospital, Al-Tafila, JOR
| | - Husam A Alsalamat
- General Surgery, Faculty of Medicine, Al-Balqa' Applied University, Al-Salt, JOR
- Biopharmaceutics and Clinical Pharmacy, University of Jordan, Amman, JOR
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El Hafi Z, Habte EA, Hjaouj K, Bencheikh R, Benbouzid MA, Oujilal A, Cherradi N, El Ouazzani H, Essakalli L. Intramasseteric Solitary Myofibroma: A Case Report. EAR, NOSE & THROAT JOURNAL 2024:1455613231223378. [PMID: 38284156 DOI: 10.1177/01455613231223378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Solitary myofibroma or infantile myofibroma is a rare spindle cell neoplasm that generally affects infants before the age of 2 years but cases in young children and adults have been described. Although the location of infantile myofibroma in the oral and maxillofacial region has been described, the intramasseteric location of the lesion is very uncommon. A thorough assessment of histopathological and immunohistochemical characteristics is necessary to have a correct diagnosis. Treatment relies on surgical resection. In this article, we present a rare clinical case of a 15-year-old patient with a myofibroma of the masseteric muscle and its management.
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Affiliation(s)
- Zakaria El Hafi
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Eden Ayele Habte
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Khalil Hjaouj
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Razika Bencheikh
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Mohamed Anas Benbouzid
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Abdelilah Oujilal
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Nadia Cherradi
- Pathology Department, Spécialities Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Hafsa El Ouazzani
- Pathology Department, Spécialities Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
| | - Leila Essakalli
- ENT-HNS Department of Specialties Hospital-CHU Ibn Sina Rabat, Morocco Mohammed V University in Rabat, Rabat, Morocco
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Cannon S, Hammad Y, Schlieve T. Intraosseous myofibroma of the mandible: A case report and review of the literature. ORAL AND MAXILLOFACIAL SURGERY CASES 2021. [DOI: 10.1016/j.omsc.2021.100234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Aggressive Intraosseous Myofibroma of the Maxilla: Report of a Rare Case and Literature Review. Head Neck Pathol 2020; 15:303-310. [PMID: 32335819 PMCID: PMC8010050 DOI: 10.1007/s12105-020-01162-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/09/2020] [Indexed: 01/03/2023]
Abstract
Myofibroma (MF) is a benign mesenchymal myofibroblast-derived tumor, which occurs most frequently in children, and rarely affects the maxilla. We reported a case of an aggressive intraosseous lesion found in the maxilla of a 9-year-old female child. Intraorally, the swelling extended from tooth 12 to 16, causing displacement of teeth 13, 14, and 15. Computed tomography revealed a large osteolytic lesion causing thinning and cortical erosion. Microscopically, the lesion showed a proliferation of spindle-shaped cells, with elongated nuclei and eosinophilic cytoplasm, arranged in interlaced fascicles. The immunohistochemical analysis revealed cytoplasmic positivity for α-SMA and HHF-35, and negativity for desmin, laminin, S-100, β-catenin, and CD34. Ki-67 was positive in 8% of tumor cells. The diagnosis was MF. Herein, we describe an additional case of central MF arising in the maxilla, including clinical, imaging, microscopical, and immunohistochemical features, as well as a review of the literature.
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Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: a case report. J Otolaryngol Head Neck Surg 2019; 48:14. [PMID: 30871614 PMCID: PMC6419343 DOI: 10.1186/s40463-019-0333-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 03/04/2019] [Indexed: 11/10/2022] Open
Abstract
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.
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An update on myofibromas and myofibromatosis affecting the oral regions with report of 24 new cases. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 124:62-75. [DOI: 10.1016/j.oooo.2017.03.051] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/21/2017] [Accepted: 03/26/2017] [Indexed: 01/21/2023]
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Guglielmi G, Guida L, Bacchini P, Lo Muzio L, Bertoni F, Lo Russo L. Imaging study of myofibroma of the jaws: case report and literature review. Oral Radiol 2015. [DOI: 10.1007/s11282-015-0230-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ma Y, Siegal GP, Wei S. Solitary, adult-onset, intraosseous myofibroma of the finger: report of a case and review of literature. Hand (N Y) 2015; 10:550-4. [PMID: 26330794 PMCID: PMC4551629 DOI: 10.1007/s11552-014-9729-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Yihong Ma
- Department of Pathology, The University of Alabama at Birmingham, NP 3542, 619 19th St. South, Birmingham, AL 35249-7331 USA
| | - Gene P. Siegal
- Department of Pathology, The University of Alabama at Birmingham, NP 3542, 619 19th St. South, Birmingham, AL 35249-7331 USA
| | - Shi Wei
- Department of Pathology, The University of Alabama at Birmingham, NP 3542, 619 19th St. South, Birmingham, AL 35249-7331 USA
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Fushimi K, Shiiba M, Kouzu Y, Kasama H, Higo M, Koike H, Kasamatsu A, Sakamoto Y, Ogawara K, Uzawa K, Tanzawa H. Central myofibroma of the maxilla: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY MEDICINE AND PATHOLOGY 2015. [DOI: 10.1016/j.ajoms.2013.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Satomi T, Kohno M, Enomoto A, Abukawa H, Fujikawa K, Koizumi T, Chikazu D, Matsubayashi J, Nagao T. Solitary myofibroma of the mandible: an immunohistochemical and ultrastructural study with a review of the literature. Med Mol Morphol 2014; 47:176-83. [PMID: 24213519 DOI: 10.1007/s00795-013-0062-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/18/2013] [Indexed: 12/01/2022]
Abstract
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.
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Affiliation(s)
- Takafumi Satomi
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan,
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Lee YM, Son SM, Kim KW, Lee OJ. Solitary myofibroma of the adult mandible: a case report and review of literature. KOREAN JOURNAL OF PATHOLOGY 2014; 48:307-10. [PMID: 25214864 PMCID: PMC4160595 DOI: 10.4132/koreanjpathol.2014.48.4.307] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 09/26/2013] [Accepted: 09/27/2013] [Indexed: 11/17/2022]
Affiliation(s)
- Yong-Moon Lee
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Seung-Myoung Son
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Kyoung Won Kim
- Department of Oral and Maxillofacial Surgery, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Ok-Jun Lee
- Department of Pathology, Chungbuk National University College of Medicine, Cheongju, Korea
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Tanaka Y, Yamada H, Saito T, Nakaoka K, Kumagai K, Fujihara H, Mishima K, Hamada Y. Solitary myofibroma of the mandible in an adult with magnetic resonance imaging and positron emission tomography findings: a case report. World J Surg Oncol 2014; 12:69. [PMID: 24678877 PMCID: PMC4230239 DOI: 10.1186/1477-7819-12-69] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 03/15/2014] [Indexed: 11/29/2022] Open
Abstract
Myofibroma is a benign tumor composed of myoid spindle cells. The prevalence of myofibroma in the oral cavity is very low, with the mandible being the most common site. This report describes an adult case of myofibroma that arose on the mandible and includes magnetic resonance imaging (MRI) and positron emission tomography (PET) findings. On the MRI T1-weighted images, the tumor appeared with signal iso-intensity and was highly and heterogeneously enhanced with contrast material. On the T2-weighted images, it appeared with increased signal intensity. 18 F-fluorodeoxyglucose (FDG)-PET imaging showed abnormal strong accumulation of FDG in the left mandibular region. The tumor was removed by marginal resection of the left mandible under general anesthesia. Histopathological findings revealed that the tumor stroma contained abundant thin-walled vessels. The postoperative course was uneventful, and we found no evidence of recurrence at the postoperative 34-month follow-up.
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Affiliation(s)
| | - Hiroyuki Yamada
- Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Japan.
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Heitz C, de Barros Berthold RC, Machado HH, Sant'Ana L, de Oliveira RB. Submandibular myofibroma: a case report. Oral Maxillofac Surg 2014; 18:81-86. [PMID: 23404191 DOI: 10.1007/s10006-013-0388-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2012] [Accepted: 01/01/2013] [Indexed: 06/01/2023]
Abstract
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.
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Affiliation(s)
- Claiton Heitz
- Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil,
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