1. Introduction
The odontogenic myxoma is a painless, locally invasive but benign odontogenic neoplasm of the jaws which most frequently occurs in the second to fifth decade of life and the average age of occurrence ranges from 23 to 30 years [1,2]. It is the third most common odontogenic tumor after odontoma and ameloblastoma respectively and accounts for 3-6% of all odontogenic neoplasms [3]. There is a slight predilection for occurrence in the mandible and furthermore women are more commonly affected than men [1,5].
Diagnosis of odontogenic myxoma is primarily based on clinical and radiological and/or histopathological findings. From a clinical point of view, odontogenic myxoma is characterized by presenting insidious and asymptomatic slow growth and expansion of the jaw bones, but with locally aggressive behavior leading to occasional cortical bone destruction, soft tissue infiltration and dental disorders including root resorption and displacement [6-11]. Radiographically, this lesion always presents radiolucent with multiple variations. It may present as a well-circumscribed or diffuse and unilocular or multilocular lesion. Multilocular patterns include “soap-bubble”, “honeycomb” and “tennis racket” appearances [2]. A “sun-ray” or “sun-burst” appearance has also been reported that may suggest a destructive, expanding behavior of this lesion [1]. Histologically, the odontogenic myxoma is composed of haphazardly arranged stellate, spindle-shaped, and round cells in an abundant, loose, fibrillary myxoid/mucoid stroma which contains only a few wisps of collagen fibril [12].
Despite its benign nature, high recurrence rates have been reported, specifically after removal by curettage alone [13]. Surgical treatment through bone resection is proposed to be the treatment of choice for this lesion [14].
Here we discuss a rare case of an odontogenic myxoma in an uncommon location which yielded a diagnostic challenge. Furthermore, we review the available literature, discuss differential diagnosis and available modalities for treatment of this lesion.