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.