An Unusual Presentation of Ossifying Fibromyxoid Tumor of the Mandible: A Case Report

Abstract

A 13-year-old boy who complained rapid swelling on the left side of mandible is presented. Histopathological examination revealed ossifying fibromyxoid tumor (OFMT). OFMT is a rare soft-tissue neoplasm that occurs usually in the subcutaneous tissue of the extremities. Head and neck involvement is relatively rare. In this case, we present the diagnosis, surgical treatment and long-term follow-up of an OFMT due to its unusual site of occurrence. The precise clinical behavior of atypical and malignant types of OFMTs is still unclear. Thus, histopathology report is important, leading surgeon to decide how often and how long to follow-up patient with OFMT.

Ossifying Fibromyxoid Tumor in the Mandibular Gingiva: Case Report and Review of the Literature

“…Patients commonly present with a painless subcutaneous nodule attached to the underlying tendons, fascia, or skeletal muscle 1,6,9 . OFTs located in the oral cavity can also infiltrate the surrounding subcutaneous tissue and skeletal muscle 10 . However, in the present case, the tumor was exclusively located in the gingiva, without noticeable extension to the adjacent alveolar mucosa, and was clinically indistinguishable from a reactive or neoplastic lesion.…”

“…Involvement of the oral cavity is rare, with only seven cases reported. In the oral cavity, OFTs have been observed in the soft palate, buccal mucosa, and vestibule 3,4,9,10 . Involvement of the gingiva is extremely rare, with the report of only one case 4 …”

“…The trunk, retroperitoneum, mediastinum, and head and neck region can also be affected, but at a lower frequency 4,5,7,8 . OFTs exclusively located in the oral cavity are rare; 3,4,9,10 only one case of OFT arising in the gingiva has been reported 4 …”

Ossifying Fibromyxoid Tumor of Soft Parts—A Clinicopathologic and Immunohistochemical Study of 104 Cases With Long-term Follow-up and a Critical Review of the Literature

“…Other studies have reported 7 OFTs in children. 2,3,8,11,18,26,49 However, it is our impression that some of the cases reported as OFTs in patients below the age of 10 years, are more plausibly explained by alternative diagnoses. Examples include a subcutaneous tumor in the head in a 2-year-old with distinct lesional smooth musclelike elements, 8 and a 25-cm S100 protein-positive retroperitoneal tumor with a corded pattern involving nerve roots, more consistent with an epithelioid peripheral nerve sheath tumor.…”

“…nasal septum, and orbit). 2,5,26,31,42 One of these tumors occurred in a newborn, 2 another in a 13-year-old girl, 26 and 2 in adults. 5,31 Only 1 of the 5 referenced tumors was S100 protein-positive.…”