Solitary Myofibroma of the Mandible in a Six-Year Old-Child: Diagnosis of a Rare Lesion

Intraosseous myofibroma mimicking an odontogenic lesion: case report, literature review, and differential diagnosis

BACKGROUND

Intraosseous myofibroma of the jaw is a rare neoplasm of mesenchymal origin with limited comprehensive understanding. It typically affects patients in the first two decades of life with a male predilection.

CASE PRESENTATION

This study presents a rare case of myofibroma mimicking an odontogenic lesion in a 2-year-old boy. The patient presented with an incidental finding of a painless swelling of the right mandibular ramus of unknown etiology. Imaging analysis revealed a solid, expansile lesion adjacent to the germinal zone of the right mandibular first molar. Histopathologic analysis and immunohistochemistry after incisional biopsy suggested a possible central odontogenic fibroma, and the patient underwent total enucleation, leading to the final diagnosis of intraosseous myofibroma. Follow-up examinations showed no evidence of recurrence.

CONCLUSIONS

This report contributes to the understanding of myofibroma in pediatric patients and underscores the critical role of meticulous histopathologic examination for effective surgical planning and optimal patient outcomes.

Solitary Intraosseous Myofibroma of the Mandible in a Nine-Year-Old Child: A Case Report and Literature Review

Myofibroma (MF) is a benign neoplasm derived from myofibroblasts. While they are infrequent, these tumors are predominantly found in the pediatric group and seldom manifest as intraosseous mandibular tumors. Herein, we present a 9-year-old female with a radiolucent lesion in the left mandible associated with malposed left lower canine and 1st premolar teeth. Clinical examination revealed a slightly tender 5×4 cm firm mass resulting in an expansion of the buccal and lingual aspects of the mandible in the canine and first premolar region. An incisional biopsy revealed a benign tumor consisting of spindle cells organized in fascicles, alongside dispersed thin-walled blood vessels. Tumor cells tested positive for α-smooth muscle actin (SMA) and vimentin. Given these findings, a diagnosis of MF was established. To the best of our knowledge, only 45 cases of solitary MF of the mandible have been reported in the pediatric age group in the literature. We describe one additional case and provide a review of the 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.