Case Report

Head and Neck Pathology

, Volume 4, Issue 1, pp 44-48

Collagenous Myofibroblastic Tumor of the Mandible: Case Report of a Unique Locally Aggressive Neoplasm

  • Jason W. NashAffiliated withDepartment of Pathology, The University of Texas M.D. Anderson Cancer Center, Unit 85
  • , Amy C. HesselAffiliated withHead and Neck Surgery, The University of Texas M.D. Anderson Cancer Center
  • , Nadarajah VigneswaranAffiliated withDepartment of Diagnostic Sciences, The University of Texas Dental Branch at Houston
  • , Adel K. El-NaggarAffiliated withDepartment of Pathology, The University of Texas M.D. Anderson Cancer Center, Unit 85Head and Neck Surgery, The University of Texas M.D. Anderson Cancer Center Email author 

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Abstract

We report a locally aggressive collagenous myofibroblastic neoplasm of the mandible in an 18-year-old male. Clinically, the lesion presented with rapid growth and irregular mandibular bone destruction. Grossly, the tumor was 10 cm in greatest dimension, light-tan, firm, and involving the posterior one-thirds of the body and inferior half of the left mandibular ramus. Histologically, the lesion was composed of a loose spindle cell proliferation interspersed with periodic dense bands of collagen. The spindle cells reacted positively to smooth muscle actin, calponin, and focally to desmin and were negative for S-100, pan-cytokeratin, CD99, CD34 and caldesmon, supporting myofibroblastic derivation. At our 4 year follow-up, the patient remained free of local recurrence and surgery related complications. The clinicopathologic findings and the differential diagnosis of this lesion is presented and discussed.

Keywords

Mandible Myofibroblastic neoplasm Mesenchymal tumors Odontogenic tumors