Odontogenic myxoma: A clinical and ultrastructural study

doi:10.1016/0030-4220(75)90111-5

Oral Surgery, Oral Medicine, Oral Pathology

Volume 39, Issue 6, June 1975, Pages 901-917

Oral Surgery, Oral M...

https://doi.org/10.1016/0030-4220(75)90111-5 Get rights and content

Abstract

The odontogenic myxoma is an uncommon neoplasm of the jaws that is believed to arise from the primitive, mesenchymal portion of the tooth germ. This study surveys nine cases of odontogenic myxoma of the jaws. Analysis of the clinical material revealed that the myxoma occurred most frequently in the posterior regions of the mandible and will recur if initial therapy is too conservative. The average age of the patients in this series was 26.5 years. Five cases involved females and four involved males. Electron microscope findings revealed that the tumor cells are probably responsible for the secretion of the myxomatous intercellular material of the neoplasm.

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Citation Excerpt :
Nevertheless, transdifferentiation mediators of MF in myxomas remains obscure. The EM features of most cells studied in our series closely resembled actively secreting fibroblasts, similar to what have been described by previous authors.16,17,20 However, as mentioned before, one of our cases showed MF characterized by the presence of myofilaments and well-developed fibronexi.
The aim of this study was to analyze the clinico-pathological and immunohistochemical features of 62 cases of odontogenic myxoma (OM) diagnosed in three Oral Pathology Diagnostic Services in Latin America, as well as to describe the ultrastructural features of three of these cases. OM showed a wide age range (9–71 years), with a mean of 27.97 yr (SD: 11.01) and a male to female ratio of 1:2.2. Mandible was affected in 37 cases (59.6%) and maxilla in 25 (40.4%), with 61.3% located in the posterior region. Thirty-nine cases (62.9%) were multilocular and 23 (37.1%) unilocular. Size ranged from 1 to 13 cm, (mean: 5.2 cm). Thirty-seven multilocular (54.8%) and 6 unilocular lesions (26%) were larger than 4 cm (p < 0.05). Epithelial islands were identified in 5 cases (8%) on H&E stained sections, but AE1/AE3 and CK14 disclosed these structures in 15 cases each (24.2%); CK5 was positive in 8 (12.9%); CK7 in 2 (3.2%) and CK19 in only 3 cases (4.8%). All cases were negative for CKs 8 and 18, S-100 protein, NSE and CD68, and showed a low index of expression of Bcl2 and ki-67 proteins (<1%). Mast cell antibodies showed these cells in 45 cases (72.6%). Myofibroblastic differentiation evidenced by myofilaments and fibronexi was found in one case out of the three studied by TEM and 29 cases (46.7%) were positive by immunohistochemistry for alpha actin. In conclusion, only a minority of OM had epithelial islands, and only 3 cases expressed CK 19, indicating an odontogenic epithelium origin. Immunohistochemical and ultrastructural findings suggest that OM is a mesenchymal neoplasm in which several factors may contribute to its pathogenesis, including myofibroblastic differentiation and the participation of mast cell products. However, further investigations are needed to better understand the participation of these elements in this particular neoplasm.
Myxomatous lesions of the maxilla in children: A case series and review of management
2004, International Journal of Pediatric Otorhinolaryngology
A paucity of data exists in the literature regarding the pediatric bony myxoma. Controversy exists regarding both its histopathologic origins and surgical management. The purpose of this study was to report on our experience in managing these patients, including diagnostic work-up, histopathologic findings and an evaluation of surgical treatment outcomes.
A retrospective review was undertaken of all consecutive cases of pediatric bony myxoma treated between 1988 and 2001. Tumors were analyzed in terms of clinical data, imaging studies, histopathology and surgical treatment. A selective review of the literature regarding management of the bony myxoma is also presented.
Five lesions were identified, all of which occurred in the maxillary bone. Histopathologically our cases did not show a strong association with odontogenic epithelium. All cases were treated by surgical resection with conservative margins. No recurrences were documented over a mean follow-up period of 8.5 years.
The bony myxoma is a rare lesion in the pediatric population, and initial clinical or radiological misdiagnoses are not uncommon. The presupposed odontogenic origin of these tumors may need reassessment. Conservative resection with narrow margins is a safe and effective therapy for myxomas of the pediatric maxilla.
Central odontogenic fibroma, myxoma (odontogenic myxoma, fibromyxoma), and central odontogenic granular cell tumor
2004, Oral and Maxillofacial Surgery Clinics of North America
Odontogenic myxoma: A clinicopathological study of 33 cases
2004, International Journal of Oral and Maxillofacial Surgery
Odontogenic myxoma, a rare tumour that occurs in the jaws, has been reported to be the second commonest odontogenic tumour in many countries. Few studies, however, provide detailed clinicopathological findings of a large series of cases and no study so far has attempted to calculate the incidence of this condition. Retrospective and prospective studies were carried out in Tanzania from 1982 to 1998 (16 years) and 1999 to 2002 (4 years), respectively. A total of 33 cases of myxomas were found with a male:female ratio of 1:1.83. Most of the tumours were located in the mandible compared to the maxilla and were predominantly multilocular. Pain, diasthesia, ulceration, invasion of the soft tissues and tooth mobility were among the symptoms that patients presented with although the majority had no clinical signs or symptoms.
Based on the prospective study only, an annual incidence of 0.07 per million can be ascertained.
Late reporting was a common feature in this group of patients. Radical surgery with resection of the tumour with a safe margin is advocated.

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^☆: Supported in part by Grant No. T12 CA08144-06 from The National Cancer Institute, National Institutes of Health, Bethesda, Md.

^∗: Assistant Professor, Department of Pathology.

^∗∗: Professor and Chairman, Department of Oral Surgery.

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Odontogenic myxoma: A clinical and ultrastructural study☆

Abstract

Lancet

Oral Surg

Br. J. Oral Surg

Arch. Oral Biol

Oral Surg

Am. J. Orthod

A Textbook of Oral Pathology

Central Tumors of the Jaws

Radiology

Myxomata of the Jaw and Pharynx

Trans. Am. Laryngol. Rhinol. Otol. Soc

Un Caso de Fibro-mixoma do Maxilar superior

Rev. Port. Estomatol

Central Myxoma of the Jaw

Am. J. Orthod

Myxoma, the Tumor of Primitive Mesenchyme

Ann. Surg

Odontogenic Tumors; Classification, Histopathology and Clinical Behavior in Man and Domesticated Animals

Cancer

The Myxoma in Childhood

Cancer

Mixoma de los Maxilaries

Antioquia Med