A SILENT GROWTH: RARE SPINDLE CELL FIBROMA OF THE BUCCAL MUCOSA

Spindle cell neoplasms of the oral cavity represent a rare and diagnostically challenging group of lesions characterized by the proliferation of elongated mesenchymal cells with variable differentiation, including fibroblastic, myofibroblastic, neural, and epithelial lineages. Although these lesions account for less than 1% of oral tumors and approximately 3% of salivary gland neoplasms, their clinical importance lies in their ability to mimic a wide range of benign and malignant conditions, complicating diagnosis and management. Accurate identification requires integration of clinical, radiological, and histopathological findings.We report a case of a 21-year-old male with a two-year history of a painless, slow-growing swelling in the right buccal mucosa, an uncommon site for such lesions. Clinical and imaging evaluation, including ultrasonography, computed tomography, and magnetic resonance imaging, revealed a well-defined soft tissue mass without bone involvement, suggestive of a benign process. Differential diagnoses included fibroma, neurofibroma, schwannoma, and myofibroma. Surgical excision was performed with uneventful healing. Histopathological examination demonstrated spindle-shaped fibroblasts in a collagenous stroma without atypia or mitotic activity, confirming spindle cell fibroma. Immunohistochemistry was not required. Early diagnosis and complete excision ensure excellent prognosis.