A Case of Odontogenic Myxoma with Unusual Histological Features Mimicking a Fibro-Osseous Process

Abstract

Odontogenic myxoma is a rare benign but locally aggressive odontogenic tumor. This report describes a case of odontogenic myxoma producing diffusely dispersed calcified products in a pattern reminiscent of a fibro-osseous lesion of the jaw. Differential diagnoses for myxoid lesions of the jaws also are discussed. This paper highlights how an odontogenic myxoma can produce a large amount of calcified products to mimic a fibro-osseous process.

Odontogenic Myxoma with Diffuse Calcifications: A Case Report and Review of the Literature

“…The case by Lin and Basile [7] and by Oygur et al [8] both contained the calcifications composed of regularly-sized spherules similar to what is seen in cemento-ossifying fibromas although the stroma was myxoid/mucinous and more cellular than noted in our case. Osteo-cementum-like material surrounded by a rim of acellular osteoid that was birefringent under polarized light was present in one case [7], while the other was associated with an unerupted tooth and contained oval to round calcified bodies with peripheral collagenous radiations similar to that seen in this case [8]. Such osteo-cementum material recapitulating Sharpey fibers is not unexpected in ''bone''-forming gnathic mesenchymal tumors if one believes that the tumors arise in pluripotent cells that during odontogenesis would have played a role in deposition of bone, cementum and collagen to produce the periodontal ligament.…”

“…Radiographically, odontogenic myxoma presents as a multilocular or unilocular radiolucency often with a honeycomb or ''tennis racket'' appearance as was well-illustrated in this case [1,4,7]. Calcifications may be present in 13-20 % studies [6], and this was also noted in this case.…”

“…Islands of odontogenic epithelium may or may not be present. However, two cases exist in the literature where calcifications were produced by the tumor [7,8]. This is a case report of a third case of odontogenic myxoma with unusual calcifications.…”

Odontogenic Myxoma of the Mandible

“…Hence the term ''odontogenic myxoma'' (OM) is often applied when the tumor occurs in the jaws to reflect its odontogenic origin. 2 Odontogenic myxomas are rare slowly growing benign tumors derived from embryonic mesenchymal elements of dental anlage that represents about 3% of all odontogenic tumors with high recurrence rate. 2,5 According to the World Health Organization (WHO), OM is classified as benign tumor of ectomesenchymal origin with or without odontogenic epithelium.…”

“…7 Most of the OMs reported were young adults affected mostly in their second and third decade of life with marked female predilection. 2,4,6,7 Clinically, OMs are slow growing, painless, and locally aggressive tumors. Since pain and hypoesthesia are not common, the lesions may reach a considerable size before patient perceives its existence and seeks treatment.…”