Multiple fibromyxomas of the jaws: A case report

Abstract

Fibromyxoma of the jaw is a rare benign mesenchymal odontogenic tumor with locally aggressive behavior. In the present report, a 13-year-old female patient presented to our university hospital with delayed eruption of some of her teeth. A panoramic radiograph taken at the initial examination revealed four pericoronal radiolucencies related to the four third molars. Thereafter, a magnetic resonance imaging (MRI) examination was performed. After the surgical removal of these molars, the microscopic examination diagnosed the four lesions as fibromyxomas. Here, we have discussed the clinical, panoramic radiography, MRI, and histopathological findings of the case.

Keywords: Fibroma, Jaw; Magnetic Resonance Imaging.

Fig. 1

Intra-oral photograph shows absence of multiple teeth in the mandible.

Fig. 2

Panoramic radiograph shows four pericoronal radiolucencies related to unerupted third molars as well as multiple impacted teeth with delayed development.

Fig. 3

A. Axial T2-weighted magnetic resonance (MR) image shows bilateral pericoronal lesions with a slightly hyper-intense heterogeneous signal and a black void representing the impacted tooth on the right side as well as the buccal and lingual expansion of the ramus cortices. B. Axial T1-weighted MR image shows bilateral pericoronal lesions with an intermediate signal invaginating the maxillary sinus. C. Coronal T2-weighted MR image shows bilateral pericoronal lesions with a slightly hyper-intense heterogeneous signal with the invagination of both maxillary sinuses.

Fig. 4

A. Axial colored relative enhancement map of magnetic resonance imaging (MRI) shows a strong heterogeneous enhancement of the mandibular lesions. B. Time-intensity curves of both mandibular lesions show the same behavior: a rapid initial rise in the first few seconds that continues at a relatively slow rate to reach its maximum enhancement at 360 s. Then, it shows a gradual washout in the delayed phase (10 min) and another at a relatively slow rate in the super-delayed phase (15 min).

Fig. 5

Microphotographs show (A) a hypocellular tumor with a focally collagenous background (hematoxylin and eosin (H&E) stain, 10 ×) and (B) spindle and stellate cells with bland nuclear features arranged in a myxoid background (H&E stain, 40×).