Central Myxoma / Myxofibroma of the Jaws: A Clinico-Epidemiologic Review

Abstract

Introduction: Myxomas are a group of benign rare tumors of connective-tissue origin that occur in both hard (central) and soft tissues of the body. The aim of this study is to highlight our experience in the management of central myxoma of the jaw, with emphasis on its clinic-epidemiologic features as seen in our environment.

Materials and methods: All patients who were managed for central myxoma of the jaw at the Oral and Maxillofacial Surgery department of a regional University Teaching Hospital between September 1997 and October 2015 were retrospectively studied. Details sourced included age, sex, site of tumor, duration, signs/symptoms, treatment given, and complications. Data were analyzed using Statistical Package for Social Sciences (SPSS) version 16 (SPSS Inc., Chicago, IL, USA) and Microsoft Excel 2007 (Microsoft, Redmond, WA, USA). Results from descriptive statistics were represented in the form of tables and charts, with a test for significance (ρ) using Pearson Chi-square (χ²) set at 0.05.

Results: A total of 16 patients were managed within the period reviewed, consisting of 10 (62.5%) females and six (37.5%) males, giving a male-to-female ratio of 1:1.7. The ages of patients ranged from 5 to 70 years, with a mean of 27.06±15.45 years. The mandible accounted for nine (56.3%) cases and the maxilla for six (37.5%) cases, while a combination of the maxilla and the zygoma were involved in one (6.3%) case. Bucco-lingual or bucco-palatal expansion were the most common presentation (six [46.2%] cases each). Histological assessment of tissue specimens showed that fibromyxoma accounted for seven (43.8%) cases, while the remaining nine (56.3%) cases were diagnosed as myxoma. All patients had jaw resections, and these consisted of mandibulectomies in nine (60.0%) patients and maxillectomies in six (40.0%) patients. The duration of hospital stay ranged from 5 to 29 days, with a mean of 17.86±7.68 days. Complications were noted in three patients, and all were surgical wound infections.

Conclusion: Most patients in our environment present late with large tumors and are usually not compliant with follow-up review. Thus, a radical approach is favored in most patients.

Keywords: Jaw; Myxofibroma; Odontogenic Myxoma.

Fig 1:

Age range of patients

Fig 2

Facial bones involved in myxoma

Fig 3

Photomicrograph of fibromyxoma showing proliferation of spindle and stellate cells in a myxoid stroma (white arrow) with fibrous tissue (black arrow). H&E ×200

Fig 4

Photomicrograph shows proliferation of spindle and stellate cells (black arrow) in a myxoid stroma (white arrow). H&E ×400

Fig 5

Massive central myxoma of the jaws

Fig 6

Central myxoma of the jaw in a child. (a) Preoperative view. (b) Postoperative appearance following jaw resection