Myofibroblastoma of the mandible in a 3-year-old child.
Myofibroblastoma is a rare benign tumor of the head and neck region, which is characterized by a large, rapidly growing, and destructive mass. A 3-year-old boy presented with an 8-week history of a rapidly growing swelling of the right mandible. Examination revealed a firm 13-cm mass occupying the entire right body and ramus of the mandible. The clinical and radiological features were suggestive of a sarcoma. An initial biopsy taken in the referring hospital was inconclusive, and the second biopsy showed a myofibroblastic neoplasm consistent with a desmoplastic fibroma. Progressive tumor growth necessitated a tracheostomy. Right hemimandibulectomy was performed, and the defect was reconstructed with free microvascular fibula flap. Histopathology and immunocytochemistry revealed a myofibroblastoma. This entity differs from other myofibroblasts and fibroblast tumors such as inflammatory myofibroblastic tumor (IMT), myofibroma, and desmoplastic fibroma. The child has been followed up for 2 years.


CONCLUSIONS
Differentiation between myofibroblasts and fibroblastic tumors as well as some malignancies can be challenging. Myofibroblastoma can behave as a malignant neoplasm, and the clinical distinction of this entity lies primarily in its recognition as a benign neoplasm.
Oral and Maxillofacial Surgery, King Faisal Medical City, Abha, Saudi Arabia. hajeri@me.com.
Saad
S
Hajeri
Department of Head and Neck Oncology Surgery, King Fahad Medical City, Riyadh, Saudi Arabia.
Abdulsalam
A
Al Jabab
College of Dentistry, Department of Oral Medicine and Diagnostic Sciences, King Saud University, Riyadh, Saudi Arabia. dr_aljabab@hotmail.com.
Manal
M
Al Sheddi
Department of Head and Neck Oncology Surgery, King Fahad Medical City, Riyadh, Saudi Arabia.
Hanadi
H
Fatani
D001706:Biopsy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology; D008339:Mandibular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D063168:Mandibular Osteotomy; D009379:Neoplasms, Muscle Tissue / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply / Q000601:surgery; D014057:Tomography, X-Ray Computed
Myofibroblastoma