Management of odontogenic myxoma of the maxilla (original) (raw)

Myxoma is a relatively rare tumor of mesenchymal origin 1 that can be found in numerous sites throughout the body including the heart, skin, and subcutaneous tissues 'along with various sites in the head and neck. 2 Within bone, a myxoma is most often located centrally in the maxilla and mandible. Odontogenic myxoma is a rare, benign, locally invasive, and nonmetastasizing neoplasm of the jaw bones. The purpose of this article is to review the literature on odontogenic myxoma and to present three cases that were treated at Sunnybrook Health Science Centre with analysis of their management. Special emphasis is placed on the surgical treatment of odontogenic myxoma of the maxilla. CASE RPPORTS Case l. A 15-year-old boy was found by his dentist to have a right palatal lesion. He underwent radiographic investigation, which suggested a cystic lesion involving the maxilla. Biopsy and transoral curettage were performed by an outside oral surgeon. After surgery the patient reported intermittent drainage from an oroantral fistula but had no other symptoms referable to his maxilla. His medical history and review of systems were unremarkable. On examination of his oral cavity, he had an oroantral fistula on the right side. His right maxillary first premolar was mobile without evidence of persistent tumor. The rest of his head and neck examination and general examination was unremarkable. The patient was admitted to the head and neck service at our institution. CT was performed and was noncontributory. A review of the previous pathology confirmed the diagnosis of odontogenic myxoma. He underwent a right partial maxillectomy during which a transoral, sublabial approach with insertion of a maxillary obturator was used. Pathologic analysis revealed replacement fibrosis with scattered peripheral foci of residual myxomatous tumor. He has been followed up for 2 years and has remained disease free. Case 2. A 22-year-old man went to his dentist with a right maxillary mass. He had no other symptoms referable to