A Rare Case of Myofibroma of the Mandible Complicated by Traumatic Neuroma Arising After a Conservative Surgical Approach.

Abstract

Myofibroma (MF) is an uncommon benign mesenchymal neoplasm composed of myofibroblasts. Traumatic neuroma (TN) is a non-neoplastic proliferative disorder of the nerve sheath in response to injury or surgery. Both are uncommon in the jaws. We present a case of a 39-year-old Afro-descendant woman with a unilocular radiolucent lesion in the posterior mandible, showing mild expansion and cortical disruption. Biopsy revealed proliferation of fascicularly arranged spindle cells strongly positive for α-SMA and podoplanin, with low Ki-67 (<5%), and the final diagnosis was central MF. Ten months after enucleation and curettage, persistent pain led to a second biopsy, which revealed proliferation of multiple hyperplastic nerve fascicles consistent with TN. The postoperative course was uneventful with 14-month follow-up. A discussion on the clinicopathological criteria for differential diagnosis of MF and other spindle cell tumors as well as the rare occurrence of post-surgical TN is also provided. Key words:Mouth neoplasms, differential diagnosis, mandible, oral pathology.