Odontogenic Myxoma of the Mandible

Background: Odontogenic myxoma is a rare slow growing, benign, locally aggressive tumor of ectomesenchymal origin with or without odontogenic epithelium, comprising 3% to 6% of all odontogenic tumors. It appears to originate from dental papilla, follicle, or periodontal ligament in mandible and less commonly the maxilla. These usually present in second or third decades with marked female predilection and have recurrence rates of approximately 25%. Case report: A 22 year old female presented with swelling over the left lower jaw region for 1 year, showing facial deformity and slow progression in size. On examination, a bony hard, nontender, fixed mass of size 7 x 5 cm was seen on the body of left mandible. Intraoral examination, a mass extending to the floor of mouth on left side, obstructing the left gingivo-labial sulcus noted. Orthopantomogram (OPG) of left mandible showed multicystic, radiolucent tumor involving outer and inner table of body of the mandible. A clinical diagnosis of Ameloblastoma was made. Left hemimandibulectomy with reconstruction was done. On gross examination, hemi-mandibulectomy specimen with teeth attached measured about 6 x 6 x 4.5 cm in size and cut surface was grey white, hard in consistency with mucoid secretions. Microscopically, a diagnosis of Odontogenic myxoma was made. Conclusion: Due to its variable clinico-radiographic characteristics and propensity for recurrence, correct histopathological diagnosis is required for adequate management.