Mitra Saikat, Jolly Satnam S, Sinha Anindita, Chatterjee Debajyoti
Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Oral and Maxillofacial Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Oral Maxillofac Pathol. 2023 Feb;27(Suppl 1):S10-S14. doi: 10.4103/jomfp.jomfp_256_22. Epub 2023 Feb 4.
Low-grade myofibroblastic sarcoma is a rare and indolent tumour of soft tissue. This tumour is relatively common in the head and neck region followed by extremities. Primary low-grade myofibroblastic sarcoma of the mandible is very rarely reported and the occurrence of this tumour in a child is very unusual. A 7-year-old male child presented with a swelling in right angle of mandible. X-ray and computed tomography scan showed a lytic lesion. The lesion was excised and the tissue was sent for histopathological evaluation, which revealed a cellular spindle cell neoplasm arranged in fascicles. The tumour was partly circumscribed and lobulated. On immunohistochemistry (IHC), these tumour cells showed cytoplasmic positivity for vimentin, and smooth muscle actin showed 'tram-track' pattern of positivity. The case was diagnosed as low-grade myofibroblastic sarcoma. There are no definite clinical features or pathognomonic radiological appearances of this tumour that can differentiate this rare tumour from other commonly encountered gnathic bone tumours, such as osteosarcoma, inflammatory myofibroblastic tumour, etc., Histopathological diagnosis coupled with ancillary investigations such as IHC is important to establish a definite diagnosis and rule out the differentials. The exact biological behaviour of this tumour is not known.
低度恶性肌纤维母细胞肉瘤是一种罕见的软组织惰性肿瘤。该肿瘤在头颈部相对常见,其次是四肢。下颌骨原发性低度恶性肌纤维母细胞肉瘤的报道非常罕见,且在儿童中发生这种肿瘤极为不寻常。一名7岁男童因下颌骨右角肿胀就诊。X线和计算机断层扫描显示有溶骨性病变。病变被切除,组织送去做组织病理学评估,结果显示为一种呈束状排列的细胞性梭形细胞瘤。肿瘤部分边界清晰且呈分叶状。免疫组织化学(IHC)检查显示,这些肿瘤细胞波形蛋白呈胞质阳性,平滑肌肌动蛋白呈“铁轨样”阳性。该病例被诊断为低度恶性肌纤维母细胞肉瘤。这种肿瘤没有明确的临床特征或特征性的影像学表现,无法将这种罕见肿瘤与其他常见的颌骨肿瘤,如骨肉瘤、炎性肌纤维母细胞瘤等区分开来。组织病理学诊断结合免疫组织化学等辅助检查对于明确诊断和排除鉴别诊断很重要。这种肿瘤的确切生物学行为尚不清楚。