A rare low-grade myofibroblastic sarcoma in lower jaw with the resemblance to benign lesions

Martina C Schwerzmann; Matthias S Dettmer; Daniel Baumhoer; Tateyuki Iizuka; Valerie G A Suter

doi:10.1186/s12903-022-02381-1

A rare low-grade myofibroblastic sarcoma in lower jaw with the resemblance to benign lesions

BMC Oral Health. 2022 Sep 5;22(1):380. doi: 10.1186/s12903-022-02381-1.

Authors

Martina C Schwerzmann^{1

2}, Matthias S Dettmer^{3

4}, Daniel Baumhoer⁵, Tateyuki Iizuka⁶, Valerie G A Suter⁷

Affiliations

¹ Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
² Clinic for Oral and Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland.
³ Institute of Pathology, University Bern, Bern, Switzerland.
⁴ Institute of Pathology, Klinikum Stuttgart, Stuttgart, Germany.
⁵ Bone Tumour Reference Center at the Institute of Pathology, University and University Hospital Basel, Basel, Switzerland.
⁶ Department of Cranio-Maxillofacial Surgery, Bern University Hospital, Inselspital, Bern, Switzerland.
⁷ Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland. valerie.suter@zmk.unibe.ch.

Abstract

Background: Low-grade myofibroblastic sarcoma (LGMS) is a rare solid infiltrative soft tissue tumor with a predilection for the head and neck region.

Case presentation: We report the diagnostic steps of a fast-growing lesion of the lower left jaw in a 45-year-old otherwise healthy woman. A first biopsy and subsequent histopathological examination showed potential differentials of a benign myofibroma, benign nodular fasciitis or an LGMS. This diagnostic overlap was a challenge for the decision of the further treatment approach. The treatment consisted of a segmental en bloc resection of the mandible including the second premolar, first and second molar. Histopathological examination of the resected tumor confirmed an LGMS.

Conclusion: The histopathologic resemblance of LGMS to a range of benign and reactive tumors may lead to misdiagnosis and mistreatment. The rarity of LGMS explains the lack of established treatment protocols. This case shows the importance of adequate clinical decisions, expertise in the histopathology of rare tumors and interdisciplinary exchange to achieve state-of-the-art patient management.

Keywords: Diagnostic challenge; Low-grade-myofibroblastic sarcoma; Malignant spindle cell tumor; Myofibroma.

Publication types

Case Reports

MeSH terms

Female
Fibrosarcoma* / diagnosis
Fibrosarcoma* / surgery
Humans
Mandible / pathology
Middle Aged
Soft Tissue Neoplasms*