Odontogenic myxoma
| Odontogenic myxoma | |
|---|---|
| Synonyms | Myxofibroma |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Swelling, tooth displacement, asymptomatic |
| Complications | Tooth loss, jaw expansion |
| Onset | Typically in young adults |
| Duration | Chronic |
| Types | N/A |
| Causes | Unknown |
| Risks | None specifically identified |
| Diagnosis | Radiograph, biopsy |
| Differential diagnosis | Ameloblastoma, central giant cell granuloma, fibrous dysplasia |
| Prevention | N/A |
| Treatment | Surgical resection |
| Medication | N/A |
| Prognosis | Good with treatment, but recurrence possible |
| Frequency | Rare |
| Deaths | N/A |
Odontogenic myxoma is a rare and benign odontogenic tumor that originates from the mesenchymal tissue of the tooth germ, specifically the dental papilla, dental follicle, or the periodontal ligament. It is characterized by its locally invasive and unencapsulated nature, which can lead to significant bone destruction if left untreated.
Epidemiology
Odontogenic myxomas are rare, accounting for approximately 3-6% of all odontogenic tumors. They are most commonly found in the second and third decades of life, with a slight predilection for females. The tumors are most commonly found in the mandible, particularly in the molar and premolar areas.
Clinical presentation
Patients with odontogenic myxoma often present with a painless swelling of the jaw. The tumor may cause displacement of teeth, and in some cases, it may be associated with an unerupted tooth. On radiographs, the tumor often presents as a multilocular radiolucent lesion with a "soap bubble" or "honeycomb" appearance.
Histopathology
Histologically, odontogenic myxomas are composed of stellate and spindle-shaped cells embedded within a myxoid extracellular matrix. The cells are often loosely arranged, and there is typically a lack of cellular atypia or mitotic figures. The tumor does not contain odontogenic epithelium, which distinguishes it from other odontogenic tumors.
Treatment
The treatment of choice for odontogenic myxoma is surgical excision. Due to the infiltrative nature of the tumor, a wide margin of normal tissue is often removed to prevent recurrence. In some cases, preoperative embolization may be performed to reduce blood loss during surgery. Following surgery, regular follow-up is necessary due to the high recurrence rate of the tumor.
Prognosis
The prognosis for patients with odontogenic myxoma is generally good, as the tumor is benign and does not metastasize. However, the tumor is locally aggressive and can cause significant bone destruction if not treated promptly. The recurrence rate is high, particularly if the tumor is not completely excised.
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Contributors: Prab R. Tumpati, MD