Leiomyoma with Uncommon Localization—Incisive Papilla and Palatal Fibromucosa: A Case Report

Abstract

The current paper presents a case of a 33-year-old female with an uncommon localization of a leiomyoma in the oral cavity—the anterior palatal fibromucosa and the incisive papilla. The patient referred to the Oro-Maxillo-Facial Surgery Clinic of Emergency City Hospital Timisoara, Romania, complaining of a slight discomfort in the act of mastication and the occurrence and persistence of a diastema between the upper central incisors, due to the presence of a nodule located in the anterior palatal mucosa, between the upper central incisors, without any changes of the subjacent bone structure in the anterior hard palate visible on a cone beam computed tomography image (CBCT). The lesion was removed using a surgical excisional biopsy and a histopathological examination was performed using morphological Hematoxylin–Eosin (HE) staining and additional immunohistochemical (IHC) reactions, in order to confirm the diagnosis. On microscopic examination, bundles of spindle cells were found with eosinophilic cytoplasm and vesicular nuclei, with finely granular chromatin. The immunohistochemical reactions were positive for smooth muscle actin (SMA) and desmin and negative for vimentin. The treatment of choice for leiomyoma of the oral cavity is surgical excision with clear margins, followed by periodical clinical monitoring.

Unpredictable Metastasis in the Head and Neck Region: A Diagnostic Immunohistochemical Challenge

“…The presence of a sinonasal or gingival proliferation with clear cells is a diagnostic challenge for the pathologist, especially in the absence of a history of clear cell carcinoma, with differential diagnoses including squamous cell carcinoma with clear cell change, mucoepidermoid carcinoma, salivary clear cell carcinoma, epithelial-myoepithelial carcinoma, achromic melanoma, alveolar rhabdomyosarcoma, and metastatic clear cell variant of follicular thyroid carcinoma [13][14][15][16].…”