Intraosseous myofibroma of the mandible: A case report and review of the literature

Soft tissue myofibromas of the head and neck are relatively common lesions diagnosed within the first two decades of life; however, these myofibromas are rarely found to affect the jaw bones. Myofibromas that do develop within the bone are referred to as intraosseous myofibromas (IM). A thorough search and review of the literature has found only five cases of IM impacting the mandible of an adult patient. The current case report describes a myofibroma impacting the right posterior mandible in a 44-year-old male patient with no previous history of pathology or surgery within the affected area. Histologic examination of the incisional biopsy specimen revealed a proliferation of spindle cells, and the spindle cells showed positivity for SMA on immunohistochemical staining supporting the diagnosis of myofibroma. The final pathology results of the subsequent composite resection of the lesion yielded a 1.5cm myofibroma that was < 1mm from the nearest bone/soft tissue edge; the resection margin was uninvolved by tumor. The purpose of this case report is to present the sixth case of IM of the mandible of an adult patient and to review the pertinent radiographic and clinical features, and necessary methods for diagnosis and treatment of this rare entity.