Myofibroma and Myofibromatosis of the Oral Mucosa: Clinico-pathologic Correlations

Objectives: Myofibroma (MFoma) is a solitary benign tumor of myofibroblasts. Myofibromatosis (MFtosis) describes multiple such lesions that occur simultaneously at different sites in various organs. The present study analyzed clinico-pathologic correlations of MFoma/MFtosis confined to the oral mucosa. Methods: A total of 41 cases of MFoma and 12 cases of MFtosis involving the oral mucosa were found in the English literature. Three new cases of MFoma were added. Results: Mean age of patients with oral mucosa MFoma was 21.5 years, which is considerable higher than the remaining of the body. Forty-three percent of these lesions occurred during the first decade, only about half of them in the first year of life. The male-to-female ratio was 1:1.44, in contrast to the male predominance in the rest of the body. The most common sites were the tongue (34%) and cheek (18%). Patients were usually cured by local excision; four patients were treated by wide excision and two by surgery and chemotherapy. Oral mucosa involvement in MFtosis was diagnosed during the first year of life in 11 (91.7%) patients and only one (8.3%) patient was a young adult. The male-to-female ratio was 2:1. The tongue was the most involved oral site (50%). Half of patients died of disseminated disease within a few days from birth. Three patients were cured by partial or complete excision and other 3 patients experienced spontaneous regression. Histologically, oral mucosa MFoma/MFtosis appearance was in accordance to the findings in the literature. Conclusions: MFoma should be included in the clinical differential diagnosis of oral mucosa masses, especially in the tongue and cheek of children and teenagers. Histological differential diagnosis includes benign and malignant spindle-shaped lesions. Usually, local excision is curable. Study was supported by the Ed and Herb Stein Chair in Oral Pathology, Tel Aviv University.