A Case Of Recurrent Odontogenic Myxoma Of The Mandible: Clinical And Radiographic Diagnosis With Review Of Literature

Odontogenic myxomas are benign tumors of ectomesenchymal origin and comprise of 3%-8% of all odontogenic tumors. They may be derived from cells of the  dental follicle, dental papilla or periodontal ligament. Most of the tumors occur in the second to third decades of life and show a marked female predilection.  They occur in the premolar-molar region of both jaws but show a preference to the mandible over the maxilla. Radiographically they may be identified due to  their characteristic ‘tennis racquet’ appearance although other radiographic forms such as soap-bubble, honeycomb or wispy lace-like trabeculae also exist.  Histological appearance of a myxoid stroma made up of 80% hyaluronic acid and 20% chondroitin sulphate with collagen fibres and spindle shaped fibroblasts  is distinctive. Owing to the absence of a capsule and the gelatinous nature of the ground substance, a high degree of recurrence is seen especially in tumors that  are conservatively managed. Therefore adequate surgical resection with other modes of tissue destruction such as cryotherapy should be followed. Long term  follow-up with radiologic surveillance is advocated in order to recognize a possible recurrence and prevent massive tissue destruction and its associated  morbidity.