SPINDLE CELL TUMOR INVOLVING THE JAW OF A YOUNG PATIENT

Abstract

An 18-year-old male patient without previous comorbidities reported pain in the left side of the jaw. Clinically, 34 and 35 teeth mobility were observed. Radiographic images exhibited a poorly defined board radiolucent lesion extending from tooth 33 to 35 with tooth resorption. Antimicrobial and analgesic therapy were prescribed, and the patient was referred to specialized care. Computed tomography and resonance evaluation confirmed previous image findings bringing the diagnostic hypothesis of lateral periodontal cyst or other neoplasm of odontogenic origin. Lesion curettage was performed, complemented by margins ostectomy and cryotherapy. Teeth 33, 34, and 35 were lost. Histopathologic analysis revealed spindle shaped cells proliferation with wavy nuclei, diagnosing a fusocellular neoplasia suggestive of fibroma and/or neurofibroma. Immunohistochemistry analysis was requested. The results showed positive staining to EMA (weak and focal) and to smooth muscle actin and negative staining to AE1/AE3, desmin, CD34, S100, and ALK1. The final diagnosis was inflammatory myofibroblastic tumor. An 18-year-old male patient without previous comorbidities reported pain in the left side of the jaw. Clinically, 34 and 35 teeth mobility were observed. Radiographic images exhibited a poorly defined board radiolucent lesion extending from tooth 33 to 35 with tooth resorption. Antimicrobial and analgesic therapy were prescribed, and the patient was referred to specialized care. Computed tomography and resonance evaluation confirmed previous image findings bringing the diagnostic hypothesis of lateral periodontal cyst or other neoplasm of odontogenic origin. Lesion curettage was performed, complemented by margins ostectomy and cryotherapy. Teeth 33, 34, and 35 were lost. Histopathologic analysis revealed spindle shaped cells proliferation with wavy nuclei, diagnosing a fusocellular neoplasia suggestive of fibroma and/or neurofibroma. Immunohistochemistry analysis was requested. The results showed positive staining to EMA (weak and focal) and to smooth muscle actin and negative staining to AE1/AE3, desmin, CD34, S100, and ALK1. The final diagnosis was inflammatory myofibroblastic tumor.