Intraosseous oral solitary myofibroma: diagnostic challenges and surgical rehabilitation

Abstract

Objective: To report a case of intraosseous oral solitary myofibroma, discussing differential diagnosis and oral rehabilitation applied to the disease. Case report: A 31-year-old male was referred to dental care due a complaint of a swelling in right side of the maxilla. Intraoral examination revealed a slow-growing painless tumor normochromic with gum-like coloration and firm consistency, measuring about 5 cm in diameter. Computed tomography showed hypodense lesion involving the region of upper premolars and molars causing root divergence of premolars. Histopathological examination revealed a neoplasia composed of fusiform cells exhibiting discrete atypia, random arrangement and interspersed by thick collagen bands. Immunohistochemistry showed immunoreactivity for beta-catenin and smooth muscle actin, and negativity for desmin and S-100, leading to the diagnosis of myofibroma. Nine months after the first surgery, rehabilitation was performed with bone graft, titanium screen and dental implants. Conclusion: Intraosseous oral solitary myofibroma of the adult has clinical, radiographic and histological similarities with other benign and malignant lesions and should be considered in the differential diagnosis of maxillofacial intraosseous fusiform cells tumors. Conservative surgical removal is effective, preserves adjacent structures and provides adequate local rehabilitation.