Clinicopathologic and imaging features of odontogenic myxomas: a multi-institutional study.

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Oral and Maxillofacial Surgery-Heidelberg Pub Date : 2024-12-01 Epub Date: 2024-06-26 DOI:10.1007/s10006-024-01271-w

Paulo Ricardo Elias de Melo, Wliana Pontes de Lima, Israel Leal Cavalcante, Vitória Maria Sousa Cruz, Roberta Barroso Cavalcante, Eveline Turatti, Sebastião Silvério Sousa-Neto, Elismauro Francisco Mendonça, Sara Juliana de Abreu de Vasconcellos, Paulo Almeida Júnior, Cassiano Francisco Weege Nonaka, Ricardo Luiz Cavalcanti de Albuquerque Júnior, Pollianna Muniz Alves, Bruno Augusto Benevenuto de Andrade, John Lennon Silva Cunha

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Abstract

Purpose: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings.

Methods: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed.

Results: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%).

Conclusions: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.

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牙源性肌瘤的临床病理学和影像学特征：一项多机构研究。

目的：本研究旨在报告牙源性肌瘤（OM）的临床病理学和影像学特征，并重点关注不常见的发现：方法：收集并分析巴西五家病理诊断中心确诊的牙源性肌瘤的临床病理和影像学数据：该系列包括42名女性（68.9%）和19名男性（31.1%），男女比例为2.2:1，平均年龄为34.5±15.4岁（范围：4-80岁）。临床上，大多数口腔黏膜瘤表现为下颌骨无痛性口内肿胀（36 例；70.6%）（37 例；59.7%）。多孔病变（n=30；83.3%）比单孔病变（n=6；16.7%）更为常见。单眼和多眼OMs的平均大小差异无统计学意义（P=0.2431）。OMs的边界主要清晰（n=24；66.7%），有不同程度的骨质增生。只有 7 个肿瘤导致牙齿吸收（15.9%），24 个肿瘤（54.5%）导致牙齿移位。12例（38.7%）观察到皮质骨穿孔。从形态上看，OMs的主要特征是在肌样背景下的星状或纺锤形细胞（n=53；85.5%）。手术切除是最常见的治疗方式（15 例；65.2%），其次是保守手术（8 例；34.8%）。20例患者（32.3%）获得了治疗结果。其中七名患者局部复发（35%）。内核切除术是复发率最高的治疗方法（4/7；57.1%）：结论：乳头状瘤好发于成年女性的颌骨后部。尽管其形态外观平淡无奇，但其影像学特征却多种多样。临床医生在鉴别诊断颌骨溶骨性病变时，必须将 OM 包括在内。需要长期随访以监测可能的复发。

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来源期刊

Oral and Maxillofacial Surgery-Heidelberg DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.20

自引率

5.60%

发文量

118

期刊介绍： Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).