Treatment

The patient underwent enucleation of the lesion through a buccal corticotomy. Multiple fragments of "fleshy" pink tissue were removed from the site. The surgical defect was curetted and cleaned with a rotary instrumentation. The wound was irrigated with sterile solution and the soft tissues were re-approximated and closed with 3-0 chromic sutures.

Excisional Biopsy

Histologic examination reveals multiple pieces of decalcified hard and soft tissue composed of a neoplasm of spindle-cell origin. This neoplasm is made up of predominant acellular and hyalinized tissue in the center and loose and myxoid tissue at the periphery (Figure 2). The latter is made up of compact and short bundles of spindle shaped cells (Figure 3). By Immunohistochemistry (IHC) stain, the spindle-shaped cells are positive with antibody to S-100 protein (Figure 4). The IHC stain also identified small dendritic type cells. Also present are cells with palisaded nuclear morphology (Figure 3). This neoplasm is surrounded by calcified bone with viable osteocytes.

Figure 2 Low power (x40) H & E stained section illustrates a predominantly acellular and hyalinized tissue in the center and loose and myxoid tissue at the periphery. The latter is made up of compact and short bundles of spindle shaped cells.

Figure 3 Higher power (x100) H & E stained section illustrates at a higher power the compact and short bundles of spindle shaped cells.

Figure 4 Higher power (x100) immunohistochemistry stained section illustrates the spindle-shaped cells to be positive with antibody to S-100 protein.