Unusual presentation of localized gingival enlargement associated with a slow-growing odontogenic myxoma

Odontogenic Myxoma: Follow-Up of 13 cases after conservative surgical treatment and review of the literature

Background

We aim to report a serie of odontogenic myxoma over a 40-year period.

Material and Methods

We conducted a retrospective and sectional review of OM cases. The clinical, radiographic and treatment data were collected from clinical records included cases whose medical records contained clinical, radiographic, histopathological, follow-up data of at least six months.

Results

There was a mild preference for the male with a mean age of 22.8 years. Seventy-seven percent of the lesions occurred in the posterior region of the mandible, presenting a multilocular radiolucent aspect (54%) with one presenting symptomatology. Conservative treatment was performed in all patients initially and recurrence was observed in two cases.

Conclusions

Odontogenic myxoma has a well-defined clinical profile and the choice of treatment should consider aspects such as patient’s age, lesion size, and location.

Key words:Myxoma, odontogenic tumors, diagnosis, treatment.

Odontogenic myxoma: ambiguous pathology of anterior maxilla

Swellings in the anterior maxilla are uncommon and if present can be deemed as paradoxical conundrums presenting diagnostic and therapeutic dilemmas. Odontogenic myxoma is a rare, locally aggressive lesion that is primarily seen affecting the mandibular posterior region in association with an impacted tooth. It is found to be associated with odontogenesis. Treatment is usually surgical, with extent varying from curettage to resection. This report describes a rare case of odontogenic myxoma of the anterior maxilla in a 14-year-old boy, with an emphasis on its epidemiology, clinical presentation, histopathology, diagnosis and treatment planning.

Long-Term Follow-Up after Conservative Surgical Treatment of Odontogenic Myxoma: A Case Report and Literature Review

Odontogenic myxoma (OM) is a relatively rare, benign odontogenic tumor with locally aggressive behavior, but it is a nonmetastasizing neoplasm of the jaw bones. Although radical resection with an appropriate surgical margin is recommended, emerging evidence has suggested that a more conservative approach will result in acceptable recurrence rates with less morbidity if careful long-term follow-up is provided. A 56-year-old Japanese man with odontogenic myxoma of the left mandible was conservatively treated by surgical enucleation and curettage because he desired functional and cosmetic preservation. During a follow-up period of 100 months, the patient has remained clinically and radiologically free of recurrence. As far as we can ascertain, 20 reports published after 1990 described 37 patients with mandibular OM that had been treated by conservative surgery. Tumors recurred during a mean follow-up of 49.2 ± 42.8 months in 7 (18.9%) patients, and only one of five patients who were followed up for over 100 months developed recurrence. The rate of recurrence decreased from 24.0% to 8.3% when follow-up exceeded 60 months. Although enucleation and curettage have proven effective, the risk of recurrence remains considerable and long-term follow-up is indispensable. More evidence of long-term outcomes after conservative surgery for OM is needed.

The Periodontium as a Potential Cause of Orofacial Pain: A Comprehensive Review

Introduction:

Orofacial pain of periodontal origin has a wide range of causes, and its high prevalence and negative effect on patients' quality of life make intervention mandatory. This review provides a periodontological overview of the field of orofacial pain, focusing on the entities which involve the periodontal tissues and may be the cause of this pain or discomfort.

Methods:

The study comprised a literature search of these pathologies conducted in the MEDLINE/PubMed Database. Acute infectious entities such as gingival and periodontal abscesses are emergencies that require a rapid response. Periodontitis associated with endodontic processes, necrotizing periodontal disorders, desquamative gingivitis, gingival recession, and mucogingival herpetic lesions, cause mild to severe pain due to tissue destruction and loss. Other lesions that lead to periodontal discomfort include gingival enlargement and periodontal ligament strains associated with occlusal trauma, parafunctional habit and the impaction of food or foreign bodies.

Conclusion:

A range of therapeutic, pharmacological and surgical alternatives are available for the management of these injuries. However, the wide variety of causes of orofacial pain or periodontal discomfort may confuse the clinician during diagnosis and may lead to the wrong choice of treatment.

Localized Gingival Overgrowths: A Report of Six Cases

Localized gingival overgrowths are commonly encountered in our day-to-day clinical practice and often present a diagnostic dilemma to the clinicians. These lesions vary depending on the location, site, extent, histology, and/or etiopathology. Although most of the localized gingival enlargements represent the reactive lesion to plaque accumulation, the differential diagnosis ranges from peripheral fibroma to pyogenic granuloma to peripheral fibroma with ossification and/or calcification, peripheral giant cell granuloma, etc., Even the peripheral ameloblastoma may present clinically as a mere localized gingival enlargement. Therefore, proper histopathological diagnosis along with biopsy is necessary to effectively manage these lesions and to reduce their propensity for recurrence.

Odontogenic myxoma: A review with report of an uncommon case with recurrence in the mandible of a teenage male

We describe a 13-year-old boy with recurrence of an odontogenic myxoma of the mandible. We review the existing published literature on the lesion, emphasizing the similarities and differences among lesions in the differential diagnosis. Odontogenic myxoma is an uncommon benign tumor that mainly affects the mandible, with a peak incidence in the second to fourth decades of life and predilection for the female sex. Clinical, radiological, and histopathological features should be considered when making a diagnosis. Several of these characteristics overlap with those of other benign and some malignant tumors. Odontogenic myxoma is known for recurrence. The treatment plan should consider the age and sex of the patient and the site and size of the lesion. Reconstructive surgery may be required, but should be delayed until after an adequate follow-up to rule out recurrence.

Odontogenic myxofibroma of gingiva in a pediatric patient with tuberous sclerosis: A rare case report

Tuberous sclerosis complex (TSC) is a rare multisystem genetic disease, with an estimated incidence of 1 in 6000-1 in 10,000. TSC is an autosomal dominant syndrome involving heart, kidneys, lungs, and skin. The classic triad of TSC is seizures, mental retardation, and angiofibromas; this triad occurs in only 29% of patients. The clinical diagnostic guidelines on TSC are prepared based on clinical features, radiographic findings. The most common oral manifestations of TSC are fibroma, gingival hyperplasia, and enamel hypoplasia. Odontogenic myxofibroma represents a rare slow-growing benign neoplasm found rarely in children below 10 years or adults over 50 years of age. The prevalence of myxoma is between 0.04% and 3.7%. Here, we are reporting a rare case of myxofibroma of gingiva in an 8-year-old female TSC patient.

An unusual odontogenic myxoma in mandible and submandibular region: a rare case report

An otherwise healthy 14-year-old male was referred to our hospital for the evaluation of a mass that was noticed 2 months previously. The mass was located in the left submandibular area. Comprehensive imaging examinations including panoramic radiography, CT and positron emission tomography-CT were performed. Appropriate surgical management and histopathological examination were taken for the patient. Histopathological examination demonstrated an odontogenic myxoma.

A Gray-purple Mass on the Floor of the Mouth: Gigantic Mucogingival Pyogenic Granuloma in a Teenage Patient

Pyogenic granuloma is defined as a benign neoplasm of vascular phenotype. This case describes the clinical and histopathological features of a gigantic mucogingival pyogenic granuloma, in a 14-year-old healthy black boy. This exophytic gray-purple mass, related to a toothpick injury, had more than twelve-month evolution on the anterior mandible involving lingual area besides to the floor of the mouth pressing the right salivary duct. Conservative excision was performed, followed by uncomplicated healing with no recurrence in two years. The histopathological examination reported a pyogenic granuloma (lobular capillary haemangioma). The authors provide a discussion of the presurgical differential diagnosis of the lesion. This case report presents an extremely uncommon location of a gigantic pyogenic granuloma, involving mucogingival complex and affecting the salivary outflow. This clinical manuscript may shed light on the controversies about possible mechanisms inducing oral pyogenic granuloma.

Surgical management of odontogenic myxoma: a case report and review of the literature

BACKGROUND

Odontogenic myxoma is a benign odontogenic tumor with locally aggressive behavior, and is relatively rare in the oral cavity. There are currently no clear surgical management guidelines for odontogenic myxoma, and a variety of approaches may be used. This study evaluated the literature concerning the surgical management of odontogenic myxoma, and reports the long-term outcome of a case managed by using a more conservative surgical approach.

CASE PRESENTATION

We managed a 40-year-old Japanese man with odontogenic myxoma in the right mandible by enucleation and curettage, a relatively conservative approach that has proved to have been justified by a lack of recurrence over 10 years. Our strategy was compared with others reported in the literature, which was identified by a PubMed search using the term "odontogenic myxoma". Articles without full text or with missing data were excluded. The age and sex of patients, the tumor location (maxilla/mandible), treatment (conservative/radical), recurrence, and follow-up period were compared in the reported cases that we evaluated. From the initial 211 studies identified, 20 studies qualified as mandibular cases of odontogenic myxoma. Recurrence was reported in three cases that had been treated with a more conservative surgical approach.

CONCLUSIONS

Enucleation and curettage has proved an effective approach in several cases in ours there has been no recurrence more than 10 years after surgery but the risk of recurrence appears to be higher. We discuss the important factors that must be considered when determining the correct management approach to odontogenic myxoma.