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Solitary myofibroma of the mandible in an adult with magnetic resonance imaging and positron emission tomography findings: a case report.

Tanaka Y, Yamada H, Saito T, Nakaoka K, Kumagai K, Fujihara H, Mishima K, Hamada Y - World J Surg Oncol (2014)

Bottom Line: The tumor was removed by marginal resection of the left mandible under general anesthesia.Histopathological findings revealed that the tumor stroma contained abundant thin-walled vessels.The postoperative course was uneventful, and we found no evidence of recurrence at the postoperative 34-month follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Japan. yamada-hi@tsurumi-u.ac.jp.

ABSTRACT
Myofibroma is a benign tumor composed of myoid spindle cells. The prevalence of myofibroma in the oral cavity is very low, with the mandible being the most common site. This report describes an adult case of myofibroma that arose on the mandible and includes magnetic resonance imaging (MRI) and positron emission tomography (PET) findings. On the MRI T1-weighted images, the tumor appeared with signal iso-intensity and was highly and heterogeneously enhanced with contrast material. On the T2-weighted images, it appeared with increased signal intensity. 18 F-fluorodeoxyglucose (FDG)-PET imaging showed abnormal strong accumulation of FDG in the left mandibular region. The tumor was removed by marginal resection of the left mandible under general anesthesia. Histopathological findings revealed that the tumor stroma contained abundant thin-walled vessels. The postoperative course was uneventful, and we found no evidence of recurrence at the postoperative 34-month follow-up.

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Photomicrographs showing spindle-shaped cells, cytoplasmic immunoreactivity and vascular endothelial cells. (A) Interlacing bundles of spindle-shaped cells (HE stain, original magnification × 100). (B) Spindle-shaped cells with tapered blunt-ended nuclei and pale-staining eosinophilic cytoplasm (HE stain, original magnification × 400). (C) Cytoplasmic positive immunoreactivity for vimentin (original magnification × 400). (D) Cytoplasmic positive immunoreactivity for HHF-35 (original magnification × 400). (E) Cytoplasmic positive immunoreactivity for α-SMA (original magnification × 400). (F) Vascular endothelial cells with cytoplasmic positive immunoreactivity for CD34 (original magnification × 200). HE, hematoxylin and eosin.
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Figure 6: Photomicrographs showing spindle-shaped cells, cytoplasmic immunoreactivity and vascular endothelial cells. (A) Interlacing bundles of spindle-shaped cells (HE stain, original magnification × 100). (B) Spindle-shaped cells with tapered blunt-ended nuclei and pale-staining eosinophilic cytoplasm (HE stain, original magnification × 400). (C) Cytoplasmic positive immunoreactivity for vimentin (original magnification × 400). (D) Cytoplasmic positive immunoreactivity for HHF-35 (original magnification × 400). (E) Cytoplasmic positive immunoreactivity for α-SMA (original magnification × 400). (F) Vascular endothelial cells with cytoplasmic positive immunoreactivity for CD34 (original magnification × 200). HE, hematoxylin and eosin.

Mentions: Pathological examination of hematoxylin and eosin (HE)-stained sections revealed that the tumor was composed of interlacing bundles of spindle-shaped cells. The tumor cells had tapered blunt-ended nuclei with pale-staining eosinophilic cytoplasm. The spindle-shaped cells did not show either cellular atypism or polymegethism. Mitoses were sometimes observed. The stroma contained abundant thin-walled vessels (Figure 6A,B). Immunohistochemical staining was performed using an avidin-biotin method. Immunoreactivity for vimentin (mouse anti-vimentin monoclonal antibody, clone V9; DakoCytomation, Glostrup, Denmark), muscle actin (mouse anti-human muscle actin monoclonal antibody, clone HHF35; DakoCytomation), and α-smooth muscle actin (mouse anti-human alpha smooth muscle actin monoclonal antibody, clone 1A4; Daco, Carpinteria, CA, USA) were positive in the tumor cells. Conversely, S-100 protein (rabbit anti-human S-100 polyclonal antibody, clone MOC32; Nichirei, Tokyo, Japan), desmin (mouse anti-human desmin monoclonal antibody, clone D33; Daco, Kyoto, Japan), and CD34 (mouse anti-human CD34 monoclonal antibody, clone NU-4A1; Nichirei, Tokyo, Japan) were negative. Thin-walled vessels were positive for CD34 (Figure 6C,D,E). These findings were consistent with the diagnosis of myofibroma.


Solitary myofibroma of the mandible in an adult with magnetic resonance imaging and positron emission tomography findings: a case report.

Tanaka Y, Yamada H, Saito T, Nakaoka K, Kumagai K, Fujihara H, Mishima K, Hamada Y - World J Surg Oncol (2014)

Photomicrographs showing spindle-shaped cells, cytoplasmic immunoreactivity and vascular endothelial cells. (A) Interlacing bundles of spindle-shaped cells (HE stain, original magnification × 100). (B) Spindle-shaped cells with tapered blunt-ended nuclei and pale-staining eosinophilic cytoplasm (HE stain, original magnification × 400). (C) Cytoplasmic positive immunoreactivity for vimentin (original magnification × 400). (D) Cytoplasmic positive immunoreactivity for HHF-35 (original magnification × 400). (E) Cytoplasmic positive immunoreactivity for α-SMA (original magnification × 400). (F) Vascular endothelial cells with cytoplasmic positive immunoreactivity for CD34 (original magnification × 200). HE, hematoxylin and eosin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230239&req=5

Figure 6: Photomicrographs showing spindle-shaped cells, cytoplasmic immunoreactivity and vascular endothelial cells. (A) Interlacing bundles of spindle-shaped cells (HE stain, original magnification × 100). (B) Spindle-shaped cells with tapered blunt-ended nuclei and pale-staining eosinophilic cytoplasm (HE stain, original magnification × 400). (C) Cytoplasmic positive immunoreactivity for vimentin (original magnification × 400). (D) Cytoplasmic positive immunoreactivity for HHF-35 (original magnification × 400). (E) Cytoplasmic positive immunoreactivity for α-SMA (original magnification × 400). (F) Vascular endothelial cells with cytoplasmic positive immunoreactivity for CD34 (original magnification × 200). HE, hematoxylin and eosin.
Mentions: Pathological examination of hematoxylin and eosin (HE)-stained sections revealed that the tumor was composed of interlacing bundles of spindle-shaped cells. The tumor cells had tapered blunt-ended nuclei with pale-staining eosinophilic cytoplasm. The spindle-shaped cells did not show either cellular atypism or polymegethism. Mitoses were sometimes observed. The stroma contained abundant thin-walled vessels (Figure 6A,B). Immunohistochemical staining was performed using an avidin-biotin method. Immunoreactivity for vimentin (mouse anti-vimentin monoclonal antibody, clone V9; DakoCytomation, Glostrup, Denmark), muscle actin (mouse anti-human muscle actin monoclonal antibody, clone HHF35; DakoCytomation), and α-smooth muscle actin (mouse anti-human alpha smooth muscle actin monoclonal antibody, clone 1A4; Daco, Carpinteria, CA, USA) were positive in the tumor cells. Conversely, S-100 protein (rabbit anti-human S-100 polyclonal antibody, clone MOC32; Nichirei, Tokyo, Japan), desmin (mouse anti-human desmin monoclonal antibody, clone D33; Daco, Kyoto, Japan), and CD34 (mouse anti-human CD34 monoclonal antibody, clone NU-4A1; Nichirei, Tokyo, Japan) were negative. Thin-walled vessels were positive for CD34 (Figure 6C,D,E). These findings were consistent with the diagnosis of myofibroma.

Bottom Line: The tumor was removed by marginal resection of the left mandible under general anesthesia.Histopathological findings revealed that the tumor stroma contained abundant thin-walled vessels.The postoperative course was uneventful, and we found no evidence of recurrence at the postoperative 34-month follow-up.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, Japan. yamada-hi@tsurumi-u.ac.jp.

ABSTRACT
Myofibroma is a benign tumor composed of myoid spindle cells. The prevalence of myofibroma in the oral cavity is very low, with the mandible being the most common site. This report describes an adult case of myofibroma that arose on the mandible and includes magnetic resonance imaging (MRI) and positron emission tomography (PET) findings. On the MRI T1-weighted images, the tumor appeared with signal iso-intensity and was highly and heterogeneously enhanced with contrast material. On the T2-weighted images, it appeared with increased signal intensity. 18 F-fluorodeoxyglucose (FDG)-PET imaging showed abnormal strong accumulation of FDG in the left mandibular region. The tumor was removed by marginal resection of the left mandible under general anesthesia. Histopathological findings revealed that the tumor stroma contained abundant thin-walled vessels. The postoperative course was uneventful, and we found no evidence of recurrence at the postoperative 34-month follow-up.

Show MeSH
Related in: MedlinePlus