Inflammatory myofibroblastic tumour of the mandible: an enigma unfolded

Inflammatory myofibroblastic tumour (IMT), also known as Inflammatory Myofibroblastoma, is a rare, benign yet aggressive lesion that often mimics malignancy. Histologically, it is composed of spindle-shaped myofibroblasts and chronic inflammatory infiltrates. Immunohistochemistry shows positive staining for smooth muscle actin and anaplastic lymphoma kinase, aiding in diagnosis.Typically found in the lungs, mesentery, and mammary glands, its occurrence in the oro-maxillofacial region is exceedingly rare. We present a case of an early-adolescent female with mandibular IMT, addressing the diagnostic dilemma posed by its radio-histopathological diagnosis through immunohistochemistry, which was pivotal in confirming the diagnosis, elucidating the challenge in treatment planning, demonstrating wide local excision as the gold standard due to the lesion's aggressive and recurrent character, and the importance of long-term follow-up in deciphering this enigma.