Solitary myofibroma of the mandible: an immunohistochemical and ultrastructural study with a review of the literature

Med Mol Morphol. 2014 Sep;47(3):176-83. doi: 10.1007/s00795-013-0062-8. Epub 2013 Nov 9.

Abstract

A solitary myofibroma (MF) is an unusual spindle cell neoplasm that usually arises in the soft tissue, skin, or bone of the head and neck region in infancy. We report an extremely rare case of MF of the mandible in an 18-year-old Japanese woman together with the conventional histologic, immunohistochemical, and electron microscopic findings. The tumor was well circumscribed and composed of fibroblast-like or myofibroblast-like spindle cells. On immunohistochemical evaluation the tumor cells were positive for vimentin, α-smooth muscle actin, HHF-35, and calponin, but negative for neurogenic antigens and markers for vascular endothelial cells. The Ki-67 labeling index was 10 % and the p53 labeling index was 10 %. Ultrastructural examination revealed smooth muscle cell differentiation. The patient was treated by surgical resection and underwent follow-up without any signs of recurrence. MF presents a wide range of differential diagnosis, including benign and malignant neoplasms. Therefore, accurate diagnosis may avoid an unnecessarily aggressive therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Actins / metabolism
  • Adolescent
  • Calcium-Binding Proteins / metabolism
  • Calponins
  • Female
  • Histological Techniques
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / metabolism
  • Mandibular Neoplasms / diagnosis
  • Mandibular Neoplasms / surgery
  • Mandibular Neoplasms / ultrastructure*
  • Microfilament Proteins / metabolism
  • Microscopy, Electron
  • Myofibroma / diagnosis
  • Myofibroma / surgery
  • Myofibroma / ultrastructure*
  • Vimentin / metabolism

Substances

  • Actins
  • Calcium-Binding Proteins
  • Ki-67 Antigen
  • Microfilament Proteins
  • Vimentin