A case of odontogenic myxoma treated by two-stage surgery to preserve the form of the mandible

：Odontogenic myxofibroma is a rare and locally invasive benign neoplasm, which is a variant of odontogenic myxomas. Odontogenic myxofibromas contain considerable amounts of collagen fibers, dispersed within a myxoid stroma.The radiographic features of odontogenic myxofibromas are variable, and so it is difficult to diagnose this condition. We present a case of odontogenic myxofibroma in the right maxilla of an 18-year-old woman.An operation was performed to carry out tumor extraction and curettage ; during this procedure, a residual tumor in the pterygopalatine fossa region was noted. This residual tumor was removed during a second surgery via a Le Fort type I osteotomy. The patient has reported no tumor recurrence during the 5 years post-operation. ：odontogenic myxofibroma(歯原性粘液線維腫) ，Le FortⅠosteotomy(Le FortⅠ型骨切り術) ，odontogenic myxoma (歯原性粘液腫) 〔Received Oct. 21, 2016〕歯原性粘液腫は間葉系の良性腫瘍で，中でも膠原線維の多いものを歯原性粘液線維腫といい，比較的まれな疾患である。良性腫瘍であるが局所浸潤性を有し再発が報告されていることから，処置法が問題となることが多い。上顎骨基底部または上顎洞内に進展した腫瘍性病変の摘出は，通常犬歯窩より行われるが病変が比較的大きな場合は十分な視野が得られず完全摘出が困難である。今回われわれは，上顎に広範囲に伸展した腫瘍に対し，犬歯窩より腫瘍摘出，掻爬術を行ったが上顎洞後上方の翼口蓋窩付近に腫瘍の残存を認めたため，Le FortⅠ型骨切術を利用してアプローチ困難な部位の腫瘍の摘出を行い，結果として 2 期的手術となり，経過良好な巨大な上顎歯原性粘液線維腫の 1 例を報告する。患者：18 歳女性。初診：200X 年 9 月下旬。主訴：右上臼歯部歯牙の動揺。既往歴：特記事項なし。家族歴：特記事項なし。現病歴：200X 年 4 月初旬より右上顎大臼歯部の歯牙動揺を自覚するも放置していた。歯牙動揺が増大し，9 月中旬近在歯科へ受診。右上顎臼歯部の骨膨隆，頰部腫脹を指摘され近在病院歯科口腔外科へ紹介された。画像検査にて鳥取県立中央病院歯科口腔外科(主任：木谷憲典部長) ＊鳥取大学医学部口腔顎顔面病態外科学(主任：小谷勇教授)

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A case of oral focal mucinosis of the palate treated long after initial diagnosis

Akimori

Ueda

Takada

et al. 2022

Jpn. J. Oral. Maxillofac. Surg.

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Oral focal mucinosis (OFM) is a rare disease that forms a mass with the production of mucoid substances under the oral mucosa. The details of OFM etiology and pathophysiology are not clear. We report a case that was histopathologically diagnosed as OFM; however, nine years had passed between the diagnosis and the time of the first treatment. The patient was a 64-year-old male found to have a 13 × 9 mm mass in the left palate. Biopsy revealed growth of collagen fibers and mucoid substances containing hyaluronic acid below the epithelium, and OFM was initially diagnosed. His next planned visit to the hospital was interrupted, and nine years following his initial visit, he requested the treatment and was re-examined. The mass had increased to 17 × 12 mm toward the hard palate and was resected under general anesthesia. The mass was surrounded by fibrous tissue and was easily detached from the surrounding tissue, with no exposed bone observed. There was no histopathological change in the tissue structure. No recurrence after resection has been observed.

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A case of odontogenic myxoma treated by two-stage surgery to preserve the form of the mandible

Cited by 4 publications

References 6 publications

Conservative surgical treatment of odontogenic myxoma with preservation of the inferior alveolar nerve

Conservative surgical treatment of odontogenic myxoma with preservation of the inferior alveolar nerve

A Residual Tumor Extracted Using a Le FortⅠOsteotomy in a Patientwith Maxillary Odontogenic Myxofibroma

A case of oral focal mucinosis of the palate treated long after initial diagnosis

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