IADR Abstract Archives
Beyond Tooth Extraction: Unmasking a Hidden Rare Oral Neoplasm
Objectives: Inflammatory myofibroblastic tumor is a rare benign mesenchymal neoplasm with variable clinical presentation and unknown etiology. First reported in the lungs, then observed in other locations. However, the oral cavity involvement is an extremely uncommon finding.
We aim through our communication to underline the inflammatory myofibroblastic tumor diagnostic difficulties, expose its clinical and histological aspects as a rare intraoral entity and to describe our therapeutical approach, as only a handful of such cases have been reported so far.
Methods: We hereby report a case of a 36-year-old female, with ptosis and strabismus, who was referred to us for an unexplained total limitation of her mouth opening that had been evolving for three years and appeared six months after the extraction of her lower left wisdom tooth. She had been followed by different services and misdiagnosed for almost two years for post-extraction osteitis related to the wisdom tooth, with no improvement.
Results: Laboratory examinations did not reveal a biological inflammatory syndrome or rhabdomyolysis. The infectious investigations were all negative, as well as the immunological tests. On the facial-computed-tomography-scan, we noted an active reshuffle, a lytic image, a mitted bone appearance in the left mandible ascending branch associated with a horizontal fracture of the left ramus while the extraction-site of the 38 was well-healed. After being put on Dexamedis 4mg/d for 2 days, the patient showed a spectacular improvement in her mouth-opening of up to two cm, which enabled us to perform the biopsy, histological results of the biopsy revealed inflammatory myofibroblastic tumor.
Conclusions: The inflammatory myofibroblastic tumor misdiagnosis, given its rarety comparing to other neoplasms of the oral cavity, is a major problem for dentists. The early diagnosis and excisional biopsy are the mainstay of treatment. Follow-up is crucial to prevent recurrence due to the aggressive nature of this disease.
We aim through our communication to underline the inflammatory myofibroblastic tumor diagnostic difficulties, expose its clinical and histological aspects as a rare intraoral entity and to describe our therapeutical approach, as only a handful of such cases have been reported so far.
Methods: We hereby report a case of a 36-year-old female, with ptosis and strabismus, who was referred to us for an unexplained total limitation of her mouth opening that had been evolving for three years and appeared six months after the extraction of her lower left wisdom tooth. She had been followed by different services and misdiagnosed for almost two years for post-extraction osteitis related to the wisdom tooth, with no improvement.
Results: Laboratory examinations did not reveal a biological inflammatory syndrome or rhabdomyolysis. The infectious investigations were all negative, as well as the immunological tests. On the facial-computed-tomography-scan, we noted an active reshuffle, a lytic image, a mitted bone appearance in the left mandible ascending branch associated with a horizontal fracture of the left ramus while the extraction-site of the 38 was well-healed. After being put on Dexamedis 4mg/d for 2 days, the patient showed a spectacular improvement in her mouth-opening of up to two cm, which enabled us to perform the biopsy, histological results of the biopsy revealed inflammatory myofibroblastic tumor.
Conclusions: The inflammatory myofibroblastic tumor misdiagnosis, given its rarety comparing to other neoplasms of the oral cavity, is a major problem for dentists. The early diagnosis and excisional biopsy are the mainstay of treatment. Follow-up is crucial to prevent recurrence due to the aggressive nature of this disease.