Long-Term Follow-Up after Conservative Surgical Treatment of Odontogenic Myxoma: A Case Report and Literature Review

Abstract

Odontogenic myxoma (OM) is a relatively rare, benign odontogenic tumor with locally aggressive behavior, but it is a nonmetastasizing neoplasm of the jaw bones. Although radical resection with an appropriate surgical margin is recommended, emerging evidence has suggested that a more conservative approach will result in acceptable recurrence rates with less morbidity if careful long-term follow-up is provided. A 56-year-old Japanese man with odontogenic myxoma of the left mandible was conservatively treated by surgical enucleation and curettage because he desired functional and cosmetic preservation. During a follow-up period of 100 months, the patient has remained clinically and radiologically free of recurrence. As far as we can ascertain, 20 reports published after 1990 described 37 patients with mandibular OM that had been treated by conservative surgery. Tumors recurred during a mean follow-up of 49.2±42.8 months in 7 (18.9%) patients, and only one of five patients who were followed up for over 100 months developed recurrence. The rate of recurrence decreased from 24.0% to 8.3% when follow-up exceeded 60 months. Although enucleation and curettage have proven effective, the risk of recurrence remains considerable and long-term follow-up is indispensable. More evidence of long-term outcomes after conservative surgery for OM is needed.

Odontogenic Myxoma: Follow-Up of 13 cases after conservative surgical treatment and review of the literature

“…The follow-up of patients with OMs should be prolonged, depending on the likelihood of recurrence, especially in the first two years. Recurrence rates decreased from 24% to 8.3% among patients who were conservatively treated with follow-up longer than 60 months ( 8 ), which was observed in the present study.…”

“…Selecting the modality of treatment for OM is a controversial topic in the literature due to its benign nature but high recurrence rates, often attributed to incomplete lesion removal due to the gelatinous and friable appearance of the tumor ( 2 , 8 ).…”

“…Currently, new evidence suggests that more conservative approaches result in accepTable recurrence rates with lower patient morbidity in a long-term follow-up ( 8 ). However, there is a lack of information about the actual follow-up of patients with OM after conservative surgery.…”

“…However, there is a lack of information about the actual follow-up of patients with OM after conservative surgery. The understanding of how modality of treatment influences the outcome is still under scrutiny ( 8 , 9 ). Interestingly, this study reports successful cases in conservative approach in the follow-up of up to 10 years with only two recurrences, showing that enucleation combined with modified Carnoy’s solution can be adopted as a first-line treatment modality to OM.…”

“…OM is associated with a possible aggressive behavior and high recurrence rates with a mean of 25%, and understanding of how modality of treatment influences the outcome is still under scrutiny because there is no properly standardized studies ( 8 - 10 ). There are only few reports in the literature about this lesion without bring follow up period.…”