A Rare Case of Intraosseous Myofibroma of the Mandible in a Three Year Old Patient: Clinical Observation

Abstract

Presented here is a unique case of myofibroma involving the mandible in a 3-year-old patient. Clinically it mimicked more like an ameloblastoma and didn’t exhibit any of its classical signs of a myofibroma. The diagnosis could be established only after complete excision of the lesion and histopathological examination. There was no recurrence after a follow-up period of 6 months. Myofibroma and myofibromatosis is a well-recognized spindle cell neoplasm that occurs predominantly in infants and young children. Classically these lesions are described in children younger than two years old, with 2/3 present at birth and rarely in adults. In the oral region, most lesions occur in the lip, buccal mucosa, and tongue; however, the lesions arising in the maxilla and mandible are very rare. These lesions are a benign fibroblast and myofibroblast proliferation containing a biphasic presentation of spindle-shaped cells surrounding a central zone of less differentiated cells focally arranged in a hemangiopericytoma like pattern. Controversy exists as to an autosomal dominant or recessive inheritance or to a sporadic occurrence. The rarity of this disease makes it difficult to diagnose for clinicians, radiation diagnosticians and histopathologists. Myofibroma has an aggressive clinical presentation and is often treated aggressively because of an inappropriate diagnosis.