J Korean Assoc Oral Maxillofac Surg.  2021 Apr;47(2):112-119. 10.5125/jkaoms.2021.47.2.112.

Large myxomatous odontogenic tumor in the jaw: a case series

• Nguyen TTH
• Eo MY
• Cho YJ
• Myoung H
• Kim SM

• KMID: 2515309
• DOI: http://doi.org/10.5125/jkaoms.2021.47.2.112

Abstract

Objectives
Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity.
Materials and Methods
Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated.
Results
In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the followup period.
Conclusion
Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.

Keyword

Odontogenic tumors; Myxoma; Resection margin; Mandibular reconstruction

Figure

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  Fig. 1 Radiograms and clinical view of Case No. 1 with the giant myxomatous odontogenic tumor (arrows) in mandible. A. Preoperative panoramic view. B, C. Preoperative computed tomography image including axial and coronal views, respectively. D. Preoperative facial photo. E. Postoperative panoramic view, patient underwent mass resection and reconstruction surgery with fibular free flap. F. Extraoral view in 5-year follow-up visit, there was no sign of recurrence and patient achieve good mouth-opening. G. Intraoral view, 5-year follow-up.

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  Fig. 2 Radiograms and clinical view of Case No. 2 with the large myxomatous odontogenic tumor (arrows) in mandible. A. Preoperative panoramic view. B, C. Preoperative computed tomography image including coronal and axial views. D. Postoperative panoramic view, the patient underwent resection and reconstructive surgery. E. Five years after odontogenic myxoma treatment surgery, bone augmentation and implant installation were performed.

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  Fig. 3 Radiograms and clinical view of Case No. 3 with the large myxomatous odontogenic tumor (arrows) in mandible. A. Preoperative panoramic view. B. Preoperative Waters’ view. C, D. Preoperative computed tomography image including coronal and axial views. E. Postoperative panoramic view, the patient underwent resection and reconstructive surgery with two plates. F. Postoperative Waters’ view. G. Intraoral view at 1-year follow-up visit.

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  Fig. 4 A flowchart shows the diagnosis strategy of myxomatous odontogenic tumors.

Reference

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