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OBJECTIVE: Spindle cell neoplasms of the jaws include a heterogenous cluster that could pose diagnostic difficulty.
CASE REPORT: A 44-year old woman with left maxillary swelling had histology showing monomorphic fusiform to spindle cells and few mildly pleomorphic cells arranged in a vague herringbone, cartwheel and storiform patterns. Also seen were few foci of epithelioid-like cells and ‘staghorn’ pattern of vascular channels. Histology differentials included: Fibrosarcoma (adult type), Malignant Peripheral Nerve Sheet Tumor, Hemangiopericytoma, Spindle-cell type angiosarcoma, Synovial sarcoma, Epithelioid sarcoma and Spindle-cell Malignant Melanoma and storiform Undifferentiated Pleomorphic Sarcoma. Immunohistochemistry was done using the antibodies: CD34, CD45, myogenin, synaptophysin, cytokeratin AE1/AE3, desmin, melan-A and vimentin. Vimentin was positive (++) while all others were negative. The final diagnosis was strongly suggestive of intra-osseous adult-type fibrosarcoma, mostly based on morphological features than immunohistochemical distinction.
CONCLUSION: This case highlights one of the difficulties faced in the process of diagnosis by resource-limited facilities. The patient has not presented for any intervention (due to financial challenges) as at the time of this manuscript documentation and submission.