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Myofibroma is an uncommon spindle cell neoplasm rarely found in oral cavity. Typically, this lesion is seen in neonates and infants with few cases reported in adults patients. In the oral cavity, myofibroma occurs within the submucosal or intramuscular tissue and has a predilection by the tongue, buccal mucosa and lips. Microscopically, a typical biphasic pattern can be observed. Misdiagnosis included benign and malignant spindle cell lesions of nerve tissue or smooth muscle origin, such as neurofibroma, leiomyoma and sarcomas. Thus, immunohistochemical staining is a useful tool to identify the nature of neoplastic cells and to reach an accurate diagnosis. An immunohistochemical panel consisting of antibodies to vimentin, SMA, HHF-35, S-100p and desmin must be achieved. In most cases, positivity for vimentin, SMA and HHF-25 can be observed. Our report describes a solitary myofibroma of the tongue of a 23-year-old man with emphasis in clinical, histopathological and immunohistochemical features of this lesion.
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