title: Inflammatory Myofibroblastic Tumor Mimicking Apical Periodontitis.
abstract: Inflammatory myofibroblastic tumors (IMTs) are rare. IMTs of the head and neck occur in all age groups, from neonates to old age, with the highest incidence occurring in childhood and early adulthood. An IMT has been defined as a histologically distinctive lesion of uncertain behavior. This article describes an unusual case of IMT mimicking apical periodontitis in the mandible of a 42-year-old man. At first presentation, the patient showed spontaneous pain and percussion pain at teeth #28 to 30, which continued after initial endodontic treatment. Panoramic radiography revealed a radiolucent lesion at the site. Cone-beam computed tomographic imaging showed osteolytic lesions, suggesting an aggressive neoplasm requiring incisional biopsy. Histopathological examination indicated an IMT. The lesion was removed en bloc under general anesthesia, and the patient manifested no clinical evidence of recurrence for 24 months. Lesions of nonendodontic origin should be included in the differential diagnosis of apical periodontitis. Every available diagnostic tool should be used to confirm the diagnosis. Cone-beam computed tomographic imaging is very helpful for differential diagnosis in IMTs mimicking apical periodontitis.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Asahi University School of Dentistry, Mizuho, Gifu, Japan. Electronic address: madachi_dds_phd@yahoo.co.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Adachi
authors.affiliation: Department of Endodontics, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kiho
authors.affiliation: Department of Endodontics, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Genta
authors.initials: G
authors.lastname: Sekine
authors.affiliation: Department of Oral and Maxillofacial Surgery, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Ohta
authors.affiliation: Department of Oral and Maxillofacial Surgery, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Matsubara
authors.affiliation: Department of Endodontics, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Takakazu
authors.initials: T
authors.lastname: Yoshida
authors.affiliation: Department of Oral Radiology, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Katsumata
authors.affiliation: Department of Oral Pathology, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Tanuma
authors.affiliation: Department of Oral and Maxillofacial Surgery, Asahi University School of Dentistry, Mizuho, Gifu, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Sumitomo
mesh_terms: D000328:Adult; D054893:Cone-Beam Computed Tomography; D003937:Diagnosis, Differential; D006801:Humans; D007573:Jaw Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009379:Neoplasms, Muscle Tissue / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010485:Periapical Periodontitis / Q000175:diagnosis*; D011862:Radiography, Panoramic
keywords: Apical periodontitis; inflammatory myofibroblastic tumor; jaw tumor; mandible