Large myofibroma in the mandible of an adult woman: a case report

The myofibroma is a benign mesenchymal neoplasm of perivascular myoid cells that forms a spectrum with myopericytoma. We report the case of a 39-year-old woman with a unilocular radiolucent lesion in the mandible, extending from the mesial of the left first molar to near the incisura. Computed tomography showed a well-defined hypodense lesion. Incisional biopsy revealed a biphasic proliferation of round to spindle-shaped cells, with various fascicular patterns and narrow blood vessels surrounded by tumor cells. The stroma was predominantly myxoid, with low mitotic activity. Adjacent to the lesion, densely collagenized fibrous connective tissue, peripheral nerve fibers, and fragments of mucoserous acini from salivary glands were observed. Immunohistochemistry was positive for SMA and podoplanin. The diagnosis of myofibroma was established, highlighting its histological morphology and adjacent characteristics. Intraosseous myofibroma requires meticulous clinical-histological-radiological investigation, combined with an immunohistochemical marker panel, aiding in its diagnosis. The patient is awaiting tumor removal.