Juvenile Aggressive Fibromatosis – A Case Report on Diagnostic Approach

Spindle cell lesions are diverse group of heterogeneous disorders affecting the oral cavity and consisting of predominantly spindle-shaped cells in histopathology. It can be either epithelial, mesenchymal or odontogenic in origin and hence the diagnosis of a spindle cell lesion is always challenging. Here, we report a case of a four year old male child who reported to the outpatient department with a chief complaint of pain and swelling in the left side of the jaw with restricted mouth opening for the past two months. Based on the clinical and radiographic features, provisional diagnosis as Odontogenic tumor and Central giant cell granuloma was given. Histopathological and immunohistochemical findings helped us to arrive at a final diagnosis of “Aggressive fibromatosis”, a spindle cell neoplasm of mesenchymal origin. As this lesion has been reported with a high rate of recurrence, it is very crucial to give a definitive diagnosis, and in our case immunohistochemistry served as an adjunct to routine Hematoxylin and Eosin staining in the final reporting.