MYXOFIBROSARCOMA OF THE MAXILLARY GINGIVA MIMICKING A PYOGENIC GRANULOMA: A RARE CASE REPORT.

Aim: to report a rare case of myxofibrosarcoma of the maxillary gingiva mimicking a pyogenic granuloma in a 91-year-old woman. Myxofibrosarcoma is a distinct histotype of adult soft tissue sarcoma, usually reported in the lower extremities and rarely in the abdominal and head-neck areas. These tumors affect patients between 60 and 80 years old, with a slight male predominance. Histological features include incomplete fibrous septa, curvilinear vessels with myxoid stroma and high degree of pleomorphism. Methods: a 91-year-old Caucasian female patient with a no relevant medical history came to our attention to evaluate an intraoral exophytic neoformation, covered by a yellowish pseudomembrane and with no pain, sensory changes or bleeding. Extraorally no asymmetry, cervical lymphadenopathy or trismus were noticed. All the dental elements of the upper left hemimaxillary were present, among these, 2.5 and 2.6 were prosthetically rehabilitated, incorporated by the neoformation but not presented mobility. Results: diagnostic exams and biopsy identified a low-grade myxofibrosarcoma with an extremely rapid growth rate and early metastasis to the pulmonary system. The head-neck CT scan of the facial mass and neck highlighted a cercinate formation localized in the left upper alveolar arch, colliquation and infiltration of the buccinator muscle, reaching the masseter muscle. For patient’s clinical conditions and her age, systemic treatment was not considered, but only a follow-up. Conclusions: careful investigation of all the neoformations is decisive and helpful for diagnosis.