MAXILLARY OBTURATOR IN 3-DIMENSIONAL ADAPTED DURING MAXILLECTOMY IN A PEDIATRIC PATIENT WITH MYOFIBROMA DIAGNOSIS: A CASE REPORT

The parents of a 4-year-old boy reported a lesion in his mouth with approximately 4-month evolution. Extraoral physical examination revealed left facial asymmetry. Intraoral examination showed expansive ulcerated lesion on the ipsilateral hard palate, rigid to palpation and painless. Computed tomography evidenced solid expansive formation, infiltrative not limited, invading the maxillary sinus and the nasal fossa with bone erosion. Incisional biopsy was performed, and histologic slices in hematoxylin and eosin showed mucosa with areas of ulceration and formation of granulation tissue, proliferation of spindle cells with eosinophilic cytoplasm, and vesicular nuclei in the collagenized stroma medium with extravasation of red blood cells and typical mitotic figures. Immunohistochemical analysis revealed muscle actin expression in myofibroblastic pattern, leading to the diagnosis of myofibroma. The patient underwent maxillectomy with immediate adaptation of the palatal obturator, made by 3-dimensional planning and is followed up with good adaptation of the prosthesis.