Benign Spindel Cell Neoplasam: A Central Myofibroma of Maxilla in Male Child of Seven Years of Age: A Case Report

Abstract

Myofibroma is a rare benign spindle cell neoplasm which occurs predominantly in infants and young children. It can occur as a solitary mass or as a multicentric lesion, consisting of myofibroblasts. In oral cavity, the sites most commonly involved are the mandible, tongue, lips and buccal mucosa however, it rarely involves the maxilla. It has aggressive clinical presentation mimicking malignancies. We report a case of a male child seven years of age presented with intraoral swelling on the left palatal aspect of the maxilla that extended from deciduous upper left second molar to the distal of upper permanent left first molar causing the mobility of these teeth. Radiologically, the lesion was osteolytic causing marked resorption of alveolar bone and displacement of permanent maxillary left second molar. A differential diagnosis of peripheral giant cell granuloma, central giant cell granuloma, fibroma, aggressive fibromatosis, nodular fasciitis, peripheral ossifying fibroma and spindle cell neoplasm was made. After the excluding malignant and vascular involvement, the surgical excision of the lesion was planned and was carried out under general anesthesia. Histologically, benign proliferation of spindle cells was seen giving the diagnosis of benign spindle cell neoplasm. Reports also showed positive immunoreactivity with vimentin and αSMA while non-responsive to desmin, validates the diagnosis of myofibroma. KEYWORDS: spindle cell neoplasm; myofibroma; maxilla