Myxofibroma of the jaws

Odontogenic myxoma: A causality dilemma - Report of a nonpareil case and review of literature

Odontogenic myxoma is a benign locally aggressive neoplasm with a sparse prevalence and incertitude histogenesis. They constitute 3%-6% of odontogenic tumors in gnathic bones. It is ubiquitously seen between vicenarian to early quadragenarian group with female proclivity and fondness to the mandibular jaws. They are silent lesions clinically and show myxoid stroma amidst fibrous background. This report highlights central odontogenic myxoma in a 43-year-old male patient and focuses on concepts, differential diagnosis, molecular concepts and treatment aspect.

Fibromyxoma of the Jaw: Case Report and Review of the Literature

We report a case of fibromyxoma of the mandible, a rare benign odontogenic tumor. Our patient presented in the first trimester of pregnancy with a large mass in the right body of the mandible exhibiting displacement of teeth and destruction of an extensive area of the mandibular bone. The mass was biopsied and diagnosed as a fibromyxoma. The large size of the tumor dictated a wide mandibular resection. We will review the clinical, radiographic, and histologic features of fibromyxoma and discuss its differential diagnoses. In addition, we will provide an overview of patient management. Fibromxyoma is a benign gnathic tumor that can be locally aggressive. To ensure appropriate treatment, it is important to distinguish this neoplasm from other mimickers in which myxoid, spindle mesenchymal cell proliferation is prominent.

Rare appearance of an odontogenic myxoma in cone-beam computed tomography: a case report

Odontogenic myxoma (OM) is an infiltrative benign bone tumor that occurs almost exclusively in the facial skeleton. The radiographic characteristics of odontogenic myxoma may produce several patterns, making diagnosis difficult. Cone-beam computed tomography (CBCT) may prove extremely useful in clarifying the intraosseous extent of the tumor and its effects on surrounding structures. Here, we report a case of odontogenic myxoma of the mandible in a 27-year-old female. The patient exhibited a slight swelling in the left mandible. Surgical resection was performed. No recurrence was noted. In the CBCT sections, we observed perforation of the cortical plate and radiopaque line that extended from the periosteum, resembling "sunray" appearance-a rare feature of OM-which could not be assessed by panoramic radiography.

A rare case report of myxoid fibroma of maxilla

This case report describes about a swelling in maxillary right posterior teeth region. On examination the swelling was solid, pinkish, red, non-ulcerated & non-tender overgrowth at the right maxillary posterior teeth region with no buccal or palatal expansion. Panoramic radiograph revealed a faint radiolucent area with few radiopaque foci and histopathological examination showed myxoid fibroma. Further, correlation of clinical, radiological & histopathological feature; essential to diagnose lesion which lack the characteristic features are also discussed.

Odontogenic myxoma: Report of three cases and retrospective review of literature in Indian population

Purpose:

To review the clinical pattern and treatment modalities meted out to patients of odontogenic myxoma (OM) in Indian population in last 30 years and also to report 3 cases of OM.

Method:

A retrospective review of radiograph and histopathology of three cases of odontogenic myxoma treated between 2005 and 2011 was done. Immunohistochemical analysis was performed to examine the pattern of vimentin and NSE. Also a computerized literature search using Medline and Google scholar was conducted for published articles on OM in Indian population in last 30 years.

Result:

A total of 32 OM cases reviewed from 25 articles retrieved. Out of them 24 myxomas were present in maxilla, only 8 were in mandible and a single case was present in supraglottic region (larynx). Surgical procedure carried out was excision and curettage in 16 patients and resection with safe margin followed by reconstruction 13 patients. All the three reported cases were successfully treated by tumor enucleation and peripheral ostectomy with no recurrence after 3 to 7 years.

Conclusion:

Odontogenic myxoma is a rare odontogenic tumor with inconclusive clinical and radiographic features, hence histopathological examination is mandatory to confirm its diagnosis. Although the immunohistochemical analysis may help in diagnosis but plays no role in guiding treatment planning or predicting the rate of recurrence. Currently we lack data on number of reported OM cases in Indian population as author feels more patients must have been treated then reported.

Peripheral myxoma of the infratemporal region: An unusual case report

Odontogenic myxoma (OM) is a rare locally invasive benign neoplasm, almost exclusively occurring in the jawbones, comprising 3-6% of all the odontogenic tumors. The mandible is more commonly involved than the maxilla. Intraoral soft tissue myxoma is an extremely rare lesion and only few reports are available in the literature. We present probably the first of its kind in literature a soft tissue OM occurring in an unusual location: the infratemporal fossa.

Odontogenic myxoma of maxilla: A review discussion with two case reports

Odontogenic myxoma (OM) is a rare entity of slowly growing benign neoplasm of ectomesenchymal origin, comprising of 3-6% of all odontogenic tumors that histologically presenting spindle-shaped, stellate and round cells within loosely arranged myxomatous tissue stroma. OM originates from the dental papilla, follicle or periodontal ligament with an exclusive location in the tooth-bearing areas of the jaws, association with missing or unerupted teeth. Clinically and radiographically the reported incidence and demographic information of this tumor has wide variability. Most common clinical variant is associated with the impacted tooth and shows local invasion with destruction of adjacent structures and displacement of teeth. Radiographically, common manifestations are multilocular radiolucent areas with well-defined borders and typical soap bubble or tennis racket appearances. This paper presents two rare case reports of OM of maxilla along with review discussion.

Facial dysmorphology and odontogenic tumor development associated with inborn errors of metabolism: a case report

PURPOSE

Inborn errors of metabolism (IEMs) are genetic disorders that alter normal physiologic functioning. Deficiency of 3-methylcrotonyl-coenzyme A carboxylase is one such IEM that can lead to major episodes of metabolic dysfunction. Certain IEMs are associated with characteristic congenital dysmorphic facial features. This can be problematic, because these dysmorphisms can mask underlying tumor growth. Literature is lacking on a causal relation between IEM and odontogenic tumor development.

MATERIALS AND METHODS

This case was explained in detail and a review of the literature was undertaken. PubMed was used to search for articles involving surgical management of odontogenic myxoma (OM) and associations between odontogenic tumors and IEM.

RESULTS

It was determined that the development of odontogenic tumors, specifically OM, is associated with IEMs. These tumors can easily be overlooked as a common dysmorphic feature of an IEM.

CONCLUSION

IEMs lead to major metabolic disturbances and, thus, can alter the cellular microenvironment. Hypothetically, these alterations can lead to the development of odontogenic tumors. With the diagnosis of IEM becoming more common owing to improved newborn screening, careful attention should be given to these patients because of the possibility that dysmorphologic facial features could be masking underlying tumor growth.

A large odontogenic myxoma of the bilateral maxillae: A case report

Odontogenic myxomas (OMs) are benign mesenchymal locally aggressive neoplasms of the jaw bone. Although OMs predominantly involve the mandible, maxillary tumors are usually more aggressive than mandibular tumors. The present study describes the case of a 37-year-old male with a large odontogenic myxoma of the bilateral maxillae, which caused a defect in the right skull base bone. The tumor was successfully removed through radical resection of the hard tissue and local resection around the envelope of the soft tissue. The tumor exhibited no recurrence. However, the current methods for bilateral maxillary reconstruction to restore the maxillary buttress and achieve an optimal aesthetic appearance are complicated due to the lack of suitable conditions for oral rehabilitation with good dentition.

Report of a rare case of an odontogenic myxoma of the maxilla and review of literature

Odontogenic myxoma (OM) is a mesenchymal tissue benign neoplasia, being relatively rare which is almost exclusively seen in tooth-bearing areas. OM commonly occurs in the 2(nd) and 3(rd) decade and the mandible is involved more commonly than the maxilla. The lesion often grows without symptoms and presents as a painless swelling. Radiographically, the myxoma appears as a unilocular or multilocular radiolucency. This article presents a rare case of OM occurring in the maxilla of a 28-year-old female patient with a brief review of the literature.

Odontogenic myxoma

Odontogenic myxoma is a rare intraosseous neoplasm, which is benign but locally aggressive. It rarely appears in any bone other than the jaws. It is considered to be derived from the mesenchymal portion of the tooth germ. Clinically, it is a slow-growing, expansile, painless, non-metastasizing, central tumor of jaws, chiefly the mandible. Here we report the case of a typical odontogenic myxoma in a 26-year-old female patient, which had acquired large dimensions and involved the entire left half of the mandible including the ramus, resulting in a gross facial deformity, within a span of one and a half years.

Odontogenic myxoma of the maxilla: A report of a rare case and review on histogenetic and diagnostic concepts

Odontogenic myxoma (OM) is a rare and locally invasive benign neoplasm (comprising of 3-6% of all odontogenic tumors) found exclusively in the jaws. OM commonly occurs in the second and third decades, and the mandible is involved more commonly than the maxilla. The lesion often grows without symptoms and presents as a painless swelling. The radiographic features are variable, and the diagnosis is therefore not easy. This article presents a rare case of OM occurring in the maxilla of a 37-year-old female patient with a brief review of the pathogenesis, clinical, radiological, histopathological, ultrastructural and immunohistochemical characteristics of OM.

Odontogenic myxoma of the maxilla

Myxomas are mostly seen in the 2(th) and 3(rd) decades. They rarely occur in childhood and maxillofacial region is rarely involved. The recurrence incidence is high. We report this unusual case occurring in a 9-year-old girl in the maxillofacial region and recurrence four months after initial treatment.

Odontogenic myxoma of the maxilla: A report of a rare case and review of the literature

Odontogenic myxoma represents an uncommon benign neoplasm comprising of 3–6% of all odontogenic tumors. This article presents a rare case of odontogenic myxoma occurring in the maxilla of a 7-year-old male patient with a brief review of the pathogenesis, clinical, radiological, histopathological, ultrastructural and immunohistochemical characteristics of odontogenic myxoma.

Odontogenic myxoma: review of the literature and report of 30 cases from South Africa

OBJECTIVE

The purpose of the study was to analyze the clinical and radiographic features of central odontogenic myxomas (OM) of the jaws diagnosed over 23 years in a black South African patient sample.

STUDY DESIGN

Records of 30 cases of OMs with radiographs of diagnostic quality were retrieved from 52 cases of histopathologically verified OMs from the archives of the Oral Health Center at the University of Limpopo, South Africa. The age, sex, size, location, and radiographic features were compared with the literature.

RESULTS

The study consisted of 21 females and 9 males. The correlation between age and size of the tumor was found to be statistically significant (P = .004). Septa were shown to be either reorientated cortical bone or sheets of dense fibrous connective tissue. Indistinct borders mimicked malignancy. The most common radiographic feature was the tennis-racket appearance.

CONCLUSIONS

Variations in radiographic presentation make a radiological differential interpretation of OM challenging because the radiographic features overlap with those of other benign and malignant neoplasms.

Odontogenic Myxoma: A Clinicopathologic Study of 25 Cases

Context.—Odontogenic myxoma is an uncommon tumor that has the potential for extensive destruction of the jaws.

Objective.—To document the clinical, pathologic, and behavioral features of odontogenic myxomas.

Design.—Histologic and immunocytochemical examinations were performed on odontogenic myxomas from 25 Chinese patients. Clinical and available follow-up data were analyzed.

Results.—In the present series, 13 were male and 12 female. The age at diagnosis ranged from 6 to 66 years, with a mean age of 28.8 years. Twelve tumors involved the mandible and 13 occurred in the maxilla, with a predilection for posterior areas. The posterior maxillary tumors frequently (9/10) involved the maxillary sinus. Of the 23 cases with radiographic records, 22 lesions presented with a multilocular appearance. Although 80% of the mandibular lesions showed a well-defined border, only 33.3% of the maxillary tumors were well-defined. Histologically, odontogenic myxomas were mainly composed of spindled or stellate-shaped cells in a mucoid-rich intercellular matrix. Tumors containing noticeable fibrous components were evident in 13 cases. Apart from 5 cases treated conservatively by enucleation, the remaining 20 cases were treated by relatively radical procedures, including block/segmental resection and partial or total maxillectomy or mandibulectomy. Follow-up data were available on 22 patients and only 1 patient initially treated by enucleation had a recurrence.

Conclusions.—Odontogenic myxomas have a very bland histologic appearance that lacks atypia and may easily lead to misdiagnosis. The tumors are infiltrative with no capsulation and may recur after inadequate surgery.

Myxomatous lesions of the maxilla in children: a case series and review of management

OBJECTIVE

A paucity of data exists in the literature regarding the pediatric bony myxoma. Controversy exists regarding both its histopathologic origins and surgical management. The purpose of this study was to report on our experience in managing these patients, including diagnostic work-up, histopathologic findings and an evaluation of surgical treatment outcomes.

METHODS

A retrospective review was undertaken of all consecutive cases of pediatric bony myxoma treated between 1988 and 2001. Tumors were analyzed in terms of clinical data, imaging studies, histopathology and surgical treatment. A selective review of the literature regarding management of the bony myxoma is also presented.

RESULTS

Five lesions were identified, all of which occurred in the maxillary bone. Histopathologically our cases did not show a strong association with odontogenic epithelium. All cases were treated by surgical resection with conservative margins. No recurrences were documented over a mean follow-up period of 8.5 years.

CONCLUSION

The bony myxoma is a rare lesion in the pediatric population, and initial clinical or radiological misdiagnoses are not uncommon. The presupposed odontogenic origin of these tumors may need reassessment. Conservative resection with narrow margins is a safe and effective therapy for myxomas of the pediatric maxilla.

Odontogenic myxoma: a clinicopathological study of 33 cases

Odontogenic myxoma, a rare tumour that occurs in the jaws, has been reported to be the second commonest odontogenic tumour in many countries. Few studies, however, provide detailed clinicopathological findings of a large series of cases and no study so far has attempted to calculate the incidence of this condition. Retrospective and prospective studies were carried out in Tanzania from 1982 to 1998 (16 years) and 1999 to 2002 (4 years), respectively. A total of 33 cases of myxomas were found with a male:female ratio of 1:1.83. Most of the tumours were located in the mandible compared to the maxilla and were predominantly multilocular. Pain, diasthesia, ulceration, invasion of the soft tissues and tooth mobility were among the symptoms that patients presented with although the majority had no clinical signs or symptoms. Based on the prospective study only, an annual incidence of 0.07 per million can be ascertained. Late reporting was a common feature in this group of patients. Radical surgery with resection of the tumour with a safe margin is advocated.

Computed tomography of odontogenic myxoma

OBJECTIVES

The purpose of this study was to clarify the CT features of odontogenic myxoma.

METHODS

CT appearances were analysed in 17 patients with histologically verified odontogenic myxoma collected from five dental hospitals in Japan.

RESULTS

On the CT images, tumour borders were generally well defined with a smooth margin both for bony and soft tissue structures in all patients. Cortical status was clearly evaluated using CT and the continuity was interrupted in nine patients. Intralesional trabeculations were observed in 13 patients. Of these 13, 6 patients showed the characteristic appearance of angular or straight trabeculations within the tumour. The trabeculations were frequently observed at the peripheral portion of the tumour. In three maxillary tumours, soft tissue margins were observed beyond the cortical margin and/or intralesional trabeculations. In 10 of the 13 lesions evaluated, the majority of the whole tumour area showed relatively lower density compared with surrounding muscles.

CONCLUSION

CT clearly demonstrated characteristic features of odontogenic myxoma. CT analysis may contribute to establishing a consensus regarding the interpretation of conventional radiographic appearances in odontogenic myxoma.

Factors in the pathogenesis of tumors of the sphenoid and maxillary sinuses: a comparative study

OBJECTIVES/HYPOTHESIS

To explain the processes that lead to the development of tumors in the maxillary and sphenoid sinuses.

STUDY DESIGN

A 32-year review of the world's literature on neoplasms of these two sinuses and a randomized case-controlled study comparing the normal mucosal architecture of the maxillary to the sphenoid sinus.

METHODS

Analysis of a 32-year world literature review reporting series of cases of maxillary and sphenoid sinus tumors. Tumors were classified by histological type and separated into subgroups if an individual incidence rate was reported. Histomorphometry of normal maxillary and sphenoid sinus mucosa was performed in 14 randomly selected patients (10 sphenoid and 4 maxillary specimens). Specimens were fixed in 10% formalin, embedded in paraffin, and stained with periodic acid-Schiff (PAS) and hematoxylin. Histomorphometric analysis was performed with a Zeiss Axioscope light microscope (Carl Zeiss Inc., Thornwood, NY) mounted with a Hamamatsu (Hamamatsu Photonics, Tokyo, Japan) color-chilled 3 charge coupled device digital camera. The images were captured on a 17-inch Sony (Sony Corp., Tokyo, Japan) multiscan monitor and analyzed with a Samba 4000 Image Analysis Program (Samba Corp., Los Angeles, CA). Five random areas were selected from strips of epithelium removed from each sinus, and goblet and basal cell measurements were made at magnifications x 100 and x 400.

RESULTS

The literature review revealed that the number and variety of tumors in the maxillary sinus are much greater than those in the sphenoid. The incidence of metastatic lesions to each sinus is approximately equal. No recognized pattern of spread from any particular organ system could be determined. On histomorphometric study there were no statistically significant differences between the sinuses in the concentration of goblet cells, basal cells, or seromucinous glands.

CONCLUSIONS

Factors involved in the pathogenesis of tumors of the maxillary and sphenoid sinuses include differences in nasal physiology, embryology, morphology, and topography. There are no significant histological differences in the epithelium and submucous glands between the two sinuses to explain the dissimilar formation of neoplasms.

Myxoma of the mandibular condyle. A case report and review of the literature

Myxoma of the mandibular condyle is extremely rare and may cause signs and symptoms like those seen in patients with temporomandibular joint dysfunction (TMD). The histogenesis, histologic profile, and management of myxoma of the jaws remain controversial. We report a case of myxoma involving the mandibular condyle appearing as TMD, and we review the literature to highlight current controversies surrounding this lesion.

Clinical and radiological features of odontogenic myxoma of the jaws

OBJECTIVES

To analyse critically the clinical and radiological features of odontogenic myxoma.

METHODS

The clinical features of 164 cases of odontogenic myxoma (two new and 162 from the literature) and the radiological features of 96 cases (two new and 94 from the literature) were analysed.

RESULTS

Most of the tumors (75%) were diagnosed in the 2nd to 4th decades. The male to female ratio was 1:1.5. Tumors were located in the mandible in two-thirds and in the maxilla one-third of cases. A multilocular appearance was observed in 55% and unilocular in 36%; 9% were not loculated. There was a statistically significant correlation (P < 0.000) between the size of the lesion and its locularity with the larger lesions more likely to be multilocular. Only 5% of the tumors were associated with an unerupted tooth.

CONCLUSIONS

Odontogenic myxoma has a variable clinical and radiological appearance and it should be considered in the differential diagnosis of radiolucent and mixed radiolucent-radiopaque lesions of both jaws in all age groups.

Myxoma of the maxilla: a case with extremely aggressive biologic behavior

BACKGROUND

Osseous "bone-derived" myxoma is a benign, slow-growing, locally invasive tumor that is found exclusively in the facial skeleton. Although recurrence is frequent, uncontrolled growth is not classic.

METHODS AND RESULTS

We report the case of a patient with myxoma of the maxilla in which the growth of the myxoma was so invasive that it resulted in destruction and deformation of the facial skeleton even after repeated resections. Eventually, destruction and infiltration of the skull base with a fatal outcome was the result.

CONCLUSIONS

This case of locally aggressive myxoma of the maxilla illustrates the need for a correct primary treatment of this benign tumor. Although complete resection may result in a significant functional and aesthetic mutilation, incomplete primary removal results in high recurrence rates. Therefore, a radical primary resection of the tumor with maximal preservation of surrounding anatomic structures is necessary. Follow-up should be meticulous and based upon regular clinical and radiographic examinations.

Don't confuse dental soft tissues with odontogenic tumors

Surgical pathologists are cautioned against the misinterpretation of immature dental tissues (dental papillae and follicles) and dental pulp as odontogenic tumors, especially odontogenic myxomas and fibromas. The close histologic similarity of the immature tissues to tumors may require a clinical-radiologic correlation with the histopathologic specimen in order to distinguish the locally aggressive tumors from innocuous dental tissues.

S100, alpha-smooth muscle actin and cytokeratin 19 immunohistochemistry in odontogenic and soft tissue myxomas

AIMS

To compare the expression of S100 protein, alpha-smooth muscle actin (alpha-SMA) and keratin 19 in odontogenic myxomas and non-odontogenic myxoid lesions.

METHODS

Formalin fixed, paraffin wax embedded tissue from seven odontogenic myxomas, three soft tissue myxomas, six hyperplastic myxoid dental follicles, two intramuscular myxomas, 12 cardiac myxomas, and seven normal dental follicles were examined immunocytochemically for S100 protein, alpha-SMA and cytokeratin 19 using the Streptavidin-biotin method.

RESULTS

A minority of odontogenic myxomas (three of seven) were positive for S100 and the staining was of moderate intensity and in all myxofibroblasts. Soft tissue myxomas, normal dental follicles, intramuscular myxomas, and most enlarged myxoid follicles were negative. In the cardiac myxomas the cells forming cords and islands were positive in approximately half (seven of 12), but the dispersed stellate myxoblasts were positive in only two cases. A population of cells in all the odontogenic myxomas and hyperplastic dental follicles contained alpha-SMA, but such cells were sparse in cardiac myxomas and present in only four cases. Cytokeratin 19 was present in odontogenic epithelium of odontogenic myxoma and follicles.

CONCLUSIONS

A minority of odontogenic myxomas, but not other oral myxoid lesions, may express S100 protein and this could cause difficulty distinguishing myxoma from myxoid nerve sheath tumours. Sparse myofibroblastic cells occurred in all types of myxoma tested. The epithelium sometimes found within jaw myxomas expresses cytokeratin 19 and this is consistent with an odontogenic origin.

Myxoma in childhood: an analysis of 10 cases

PURPOSE

The object of this study was to present a series of myxoma in children and to evaluate possible differences between young and adults patients.

MATERIALS AND METHODS

All tumors of patients under 16 years of age (10 cases), were separated from the 80 myxomas found in the Oral Pathology Laboratory, Faculty of Odontology, Buenos Aires University, and were analyzed in terms of clinical data, radiographic image, histopathology, treatment, and evolution.

RESULTS

Myxoma in childhood represented 12.5% of the 80 cases in our series. The mean age was 11.6 years. Six patients were boys and four were girls. Both jaws were affected equally, predominantly in the premolar-molar region. Eighty percent of the tumors were larger than 2 cm. Only one case was clinically diagnosed as myxoma. Radiologically the most frequent image was unilocular with cortical expansion and tooth displacement. Histologically seven cases were diagnosed as myxoma and three as fibromyxoma. Treatment involved surgical resection in most cases. Two patients showed recurrence within the first year after surgery.

CONCLUSIONS

The frequency of myxoma in childhood may be higher than that of other aggressive odontogenic tumors, although some literature refers to this tumor as very uncommon in children. Clinically this tumor may not always be taken into account in the differential diagnosis of intraosseous radiolucencies in young patients. The histologic appearance is similar in young and adult patients, but myxoma in children may be larger. It was not possible to correlate the histologic type of myxoma and the age of the patients.

Myxoma of the maxillary antrum in children

Myxomas of the maxillary antrum are rare tumours, particularly in childhood. Although circumscribed, they are often more extensive than apparent and so tend to recur despite their benign nature. Myxomas are gelatinous and are composed of stellate and spindle cells embedded in an abundant alcian blue-positive, mucoid stroma in which blood vessels are often scattered throughout the tumour. Three patients with maxillary myxomas, all presenting in infancy or early childhood, are described.

Fibromyxomas of the jawbones--a study of ten cases

Ten cases of fibromyxoma of the jawbones are presented. The literature is reviewed and the age and sex incidences, clinical presentation, difficulty of diagnosis and management of this tumour are discussed.

Maxillary myxoma in a child of 11 months. A case report

A myxoma of the maxilla in an infant is presented. It was initially treated as an inflammatory lesion. Failure to respond led to biopsy, which showed that the lesion was neoplastic; initially an incorrect diagnosis was made and totally inappropriate treatment was given. Reassessment of the biopsy material established the correct diagnosis and appropriate management was initiated.

Myxoma of the jaws. An analysis of 15 cases

A retrospective study on 15 patients with myxomas of the jaws was carried out. The series consisted of 3 males and 12 females. The mean age was 26 years. The maxilla was involved in 4 cases whereas the tumour was situated in the mandible in 11 cases. Of the 9 patients who underwent conservative treatment, one exhibited recurrent tumour. Six patients were treated by resection including uninvolved adjacent tissue; none of them has so far exhibited recurrence. These results indicate that carefully performed conservative treatment for myxomas is justified in some instances. Histologically, myxomas of the jaw exhibit mitotic activity in the majority of cases which indicates a distinct proliferative activity. Myxomatous degeneration in neurofibromas may mimic myxoma. Therefore the present cases were compared with 2 cases of intramandibular neurofibroma. It is concluded that differences in nuclear morphology are sufficient to distinguish between both neoplasms.

Myxofibroma of the maxilla: a case report with computed tomogram findings

A rare case of a large myxofibroma of the maxilla is presented. Computerized tomographic features, in conjunction with clinical appearance, were highly suggestive of a definitive diagnosis. Computerized tomography may play an important role in the planning of surgical management of this tumor known for its local aggressiveness and high recurrence rate.

Unusual myxomatous odontogenic tumour with calcification

A jaw tumour in a child presented diagnostic difficulties because of the presence of myxomatous elements and actively forming cementum-like calcified material. The 5-year follow-up suggests that this was an unusual benign odontogenic tumour.

Advanced central myxoma of the jaws in Nigeria. Clinical features, treatment and pathogenesis

18 advanced cases of myxoma of the jaws are described. These had a typical age, sex and site distribution and characteristic clinical and radiographic features. Surgical treatment was radical as benefits large, poorly defined tumours, but there was no evidence that these were aggressive lesions. It is argued that the designation of myxoma as an odontogenic tumour is uncertain though not excluded. Attention is drawn to evidence that many myxomas of the jaws may be examples of myxomatous degeneration in other neoplasms.

Chondromyxoid fibroma of the jaws

A new case of chondromyxoid fibroma of the jaws is reported, and the current world literature on chondromyxoid fibroma is reviewed. Chondromyxoid fibroma is a rare tumor arising from cartilage-forming mesenchymal tissue. In the long bones, it has frequently been confused with chondrosarcoma or benign chondroblastoma. When it occurs in the jaws, apparent confusion with myxomas of myxofibromas may result. In the jaws the neoplasm typically occurs in the mandible. Initial symptoms are pain or a slowly growing expansile mass. After evaluation of the natural history of these lesions, a conservative approach to surgical therapy is advocated.

Fibromyxoma of the mandible: case report and radiographic considerations

A case of a 27-year-old black woman with typical findings of a large, asymptomatic myxoma involving the entire left half of the mandible is presented. The lesion was treated by a partial mandibulectomy and secondary bone graft with a titanium tray and condyle prosthesis. A comparison of the patient's bitewing, periapical, and panoramic radiographs was made. The lesion was not visible on the bitewings and was overlooked on the periapical films, but was clearly visible on the panoramic radiograph. The screening value of this radiograph was stressed.