Recurrent hard palate lesion in a child

An unusual timing for symptomatic chest pain in an adult chest wall myofibroma: a case report

Introduction

Myofibromas are benign mesenchymal neoplasms that can present as solitary and multicentric lesions. They can occur in several locations and can occur at any age from neonates to elderly patients. However, most of the lesions are found in neonates and babies. It rarely occurs in adults.

Case presentation

A 29-year-old Taiwanese man presented with persistent dull chest pain in his right lateral chest wall for 2 weeks. A chest X-ray showed a faint patchy opacity over the periphery of his right upper lung zone. Computed tomography and magnetic resonance imaging showed a lobulated mass at the intercostal space between his right fifth and sixth ribs with contrast enhancement and bone invasion. Malignancy could not be excluded. A percutaneous needle aspiration biopsy failed due to technique issues, so he underwent a thoracotomy and the tumor was excised with Marlex mesh repairs for the thoracic defect. Pathology confirmed a myofibroma without malignancy. He recovered uneventfully and no local recurrence was detected at the 1-year follow-up examination.

Conclusions

Chest wall myofibroma presenting with chest pain has never been reported in adults. It is a challenge to differentiate myofibroma from malignancy in chest wall preoperatively, such as seen in our patient. To the best of our knowledge, this has not been previously reported in the scientific literature. Although myofibroma rarely occurs in the chest wall and adults, it must be suspected in any chest wall tumor presenting with chest pain.

Unusual hard palate foreign body: a case report

Foreign bodies embedded in the palate are exceedingly rare, and may imitate oral lesions. The majority of cases occur in infants and children. The following report discusses the unique presentation of a foreign body in the hard palate of an infant. This report emphasizes that foreign bodies must be considered in the differential of lesions found in the oral cavity of children.

Clinico-pathologic correlations of myofibroblastic tumors of the oral cavity. II. Myofibroma and myofibromatosis of the oral soft tissues

BACKGROUND

Myofibroma is a solitary benign tumor of myofibroblasts. Myofibromatosis describes multiple, simultaneous myofibromas at different sites in various organs. The clinico-pathologic correlations of myofibroma/myofibromatosis confined only to oral soft tissues were analyzed.

METHODS

In the English language literature, 41 myofibroma and 12 myofibromatosis cases involving the oral soft tissues were found. From our files, three new myofibroma cases were added.

RESULTS

Age at time of diagnosis of oral mucosa myofibroma ranged from birth to 70 years (mean 21.7 years), considerably higher than myofibroma in other parts of the body. Lesions occurred during the first decade (44%) and in the first year of life (17%). Male:female ratio was 1:1.6, contrary to the male predominance in other parts of the body. Common sites were the tongue (32%) and buccal mucosa (18%). Treatment was local excision, either complete (n = 13) or partial (n = 3), wide excision (n = 4), surgery, and chemotherapy (n = 1). Myofibromatosis involving oral soft tissues was diagnosed at birth in nine (75%) patients, within the first year in two, and as a young adult in one. Male:female ratio was 2:1. The tongue was the most common site (50%). Half the patients died of disseminated disease within a few days from birth, three were cured by partial or complete excision, and three experienced spontaneous regression. Histologically, oral mucosa myofibroma/myofibromatosis appearance agreed with findings in the literature.

CONCLUSIONS

Myofibroma should be included in the clinical differential diagnosis of masses of the oral soft tissues, especially in the tongue and buccal mucosa of children and adolescents. Histological differential diagnosis includes benign and malignant spindle-shaped lesions. Treatment of choice is local excision.

Myofibromatosis: A case report with a unique clinical presentation

Myofibroma and myofibromatosis have been described under different names since 1951. These lesions are a benign fibroblastic and myofibroblastic proliferation containing a biphasic presentation of spindle-shaped cells surrounding a central zone of less differentiated cells focally arranged in a hemangiopericytoma-like pattern. Classically, these lesions are described in children younger than 2, with two thirds present at birth, and rarely in adults. The typical clinical presentation shows variable growth pattern of a painless purple to pink soft tissue mass, often showing secondary ulceration. Controversy exists as to an autosomal dominant or recessive inheritance versus sporadic occurrence. Presented here is a unique case of myofibromatosis presenting first as a superficial scalp lesion at age 2, followed by other primary lesions of the right mandibular vestibule, right temple, and left mandibular vestibule at ages 9, 12, and 23, respectively. All were treated with excision, without recurrence at the primary site.