Abstract

Myofibroma is a benign, localized or generalized myofibroblast-derived tumor, occurring most frequently in children, and rarely affecting the maxilla. A 9-year-old girl complained of mainly a painless swelling on the right side of the face since 5 months prior. Intraorally, the swelling extended from teeth #11 to #16, causing displacement of teeth #13, #14, and #15. Computed tomography revealed a large osteolytic lesion causing thinning and erosion of the cortical bones. Incisional biopsy revealed proliferation of spindle-shaped cells, with elongated nuclei and eosinophilic cytoplasm, arranged in interlaced fascicles. The immunohistochemical panel showed cytoplasmic positivity for α-SMA and β-catenin. Ki-67 was positive in 1% of the tumor cells. The diagnosis was myofibroma. After surgical excision of the lesion, the patient is under follow-up. Myofibroma is an aggressive lesion often misdiagnosed as a malignant tumor; the establishment of a correct differential diagnosis is crucial for determining an appropriate treatment approach.

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