Central Odontogenic Myxoma: A Radiographic Analysis

Abstract

Objective. This study aimed to determine the radiographic characteristics of odontogenic myxomas (OMs) and their associations. Materials and Methods. The study enrolled radiographs of patients taken between 2005 and 2019 with a confirmed histopathological diagnosis of central OM. OM radiographic features were evaluated, including location, border, locularity, involved area, the number of included teeth, root resorption, tooth displacement, bone expansion, bone perforation, and periosteal reaction. Fisher’s exact test was used for statistical analysis. Results. Significant associations were found between the OM border and the affected jaw ( p = 0.036 ), locularity ( p = 0.036 ), involved areas ( p = 0.009 ), and bone perforation ( p = 0.036 ). OMs with an ill-defined border were associated with maxillary lesions, multilocularity, dentate areas, and cortical bone perforation. The number of included teeth (2 or fewer or 3 or more) was significantly associated with locularity ( p = 0.010 ), involved area ( p = 0.045 ), and bone expansion ( p = 0.010 ). Larger OMs including 3 or more teeth, were associated with a multilocular appearance, dentate areas, and bone expansion. Conclusion. The border of OM and the number of included teeth are related to other radiographic appearances. Understanding these relationships could help in treatment decisions and help better understand the nature of OM.

Characteristic yet unusual presentation of an odontogenic myxoma in the anterior mandible

“…8 Additionally, despite being locally aggressive, anterior OMs seldom cross the midline, and if found to be doing so, are again usually those occurring in the maxilla. In this aspect, our case of OM crossing the midline in the mandibular anterior region is quite a rare occurrence and was similar to a case reported by Ghazali et al 5 A lesion appears to be multilocular when the septae of bone are left while the surrounding medullae are resorbed by the active disease process. OM being nonencapsulated and highly aggressive, substantial infiltration occurs in the adjacent medullary bone owing to the action of hyaluronidase that resorbs hyaluronic acid proteoglycan in the extracellular matrix.…”

“…OM has been reported to occur mostly in patients within the age range of 21 to 51 years and a mean age of 31 to 32.4 years has been described. 1,5 While some databases have reported no sexual predilection, some investigators have found that a greater number of cases of OM have occurred in females. 7 Most of the cases do not present any clinical symptoms or at most with only swelling.…”

“…The mandible is affected in two-thirds of cases of OM while only one-third of cases occur in the maxilla, especially with a propensity to occur in the posterior/molar region. 2,5 Those occurring in the anterior region are usually maxillary OMs. 8 Additionally, despite being locally aggressive, anterior OMs seldom cross the midline, and if found to be doing so, are again usually those occurring in the maxilla.…”

“…4 OM generally tends to occur in the second and third decades of life and exhibits a female predilection. 2,5 Two-thirds of OM occur in the mandible, particularly in the molar region. 2 The tumors occurring in the anterior region are mostly described in the maxilla.…”

“…The bony infiltration by the tumor imparts a characteristic 'soap bubble', 'honeycomb', or 'tennis racquet' radiographic appearance to the lesion. 5 Characteristics. Thus, most cases of OM appear radiographically as a multilocular lesion with welldefined borders and intervening trabeculae.…”