Odontogenic myxoma: a clinicopathologic study of 25 cases

Abstract

Context: Odontogenic myxoma is an uncommon tumor that has the potential for extensive destruction of the jaws.

Objective: To document the clinical, pathologic, and behavioral features of odontogenic myxomas.

Design: Histologic and immunocytochemical examinations were performed on odontogenic myxomas from 25 Chinese patients. Clinical and available follow-up data were analyzed.

Results: In the present series, 13 were male and 12 female. The age at diagnosis ranged from 6 to 66 years, with a mean age of 28.8 years. Twelve tumors involved the mandible and 13 occurred in the maxilla, with a predilection for posterior areas. The posterior maxillary tumors frequently (9/10) involved the maxillary sinus. Of the 23 cases with radiographic records, 22 lesions presented with a multilocular appearance. Although 80% of the mandibular lesions showed a well-defined border, only 33.3% of the maxillary tumors were well-defined. Histologically, odontogenic myxomas were mainly composed of spindled or stellate-shaped cells in a mucoid-rich intercellular matrix. Tumors containing noticeable fibrous components were evident in 13 cases. Apart from 5 cases treated conservatively by enucleation, the remaining 20 cases were treated by relatively radical procedures, including block/segmental resection and partial or total maxillectomy or mandibulectomy. Follow-up data were available on 22 patients and only 1 patient initially treated by enucleation had a recurrence.

Conclusions: Odontogenic myxomas have a very bland histologic appearance that lacks atypia and may easily lead to misdiagnosis. The tumors are infiltrative with no capsulation and may recur after inadequate surgery.