Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
Clinic for Oral and Maxillofacial Surgery, University Hospital Zurich, Zurich, Switzerland.
BMC Oral Health. 2022 Sep 5;22(1):380. doi: 10.1186/s12903-022-02381-1.
Low-grade myofibroblastic sarcoma (LGMS) is a rare solid infiltrative soft tissue tumor with a predilection for the head and neck region.
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.
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.
低度恶性肌纤维母细胞瘤(LGMS)是一种罕见的具有头颈部偏好的低度浸润性软组织肿瘤。
我们报告了一位 45 岁健康女性左下颚快速生长病变的诊断步骤。第一次活检和随后的组织病理学检查显示良性肌纤维瘤、良性结节性筋膜炎或 LGMS 的潜在差异。这种诊断上的重叠给进一步治疗方案的决策带来了挑战。治疗包括下颌骨包括第二前磨牙、第一和第二磨牙的节段性整块切除术。切除肿瘤的组织病理学检查证实为 LGMS。
LGMS 在组织病理学上与一系列良性和反应性肿瘤相似,可能导致误诊和误治。LGMS 的罕见性解释了缺乏既定治疗方案的原因。本病例表明,充分的临床决策、对罕见肿瘤的组织病理学专业知识和跨学科交流对于实现先进的患者管理至关重要。