Abstract
Objectives: Odontogenic myxomas (OMs) are considered slow-growing tumours with the potential for extensive bone destruction, cortical expansion, and a relatively high recurrence rate. We analysed the cases histologically diagnosed as OM in our centre and compared these to the data found in the literature.
Method: A record-based study of OMs histologically diagnosed at the Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife, Southwest Nigeria between 1990 and 2009 was conducted. The tumours were classified as myxomas, fibromyxomas or myxofibromas depending on the histologic picture. Gingival masses with similar histologic features but not showing bone involvement were included in the series as soft tissue myxomas.
Results: A total of 16 histologically diagnosed cases were recorded, 11(68.8%) in females and 5 (31.2%) in males giving a male:female ratio of 1:2.2. The most common tumour site was the maxilla (7 cases, 43.8%) and the mean age of the patients at the time of diagnosis was 31.1+18.0 years. Myxomas, exhibiting complete myxomatous tissue (8 cases, 50%) with no appreciable fibrous component were the most common histological type.
Conclusion: The peak incidence was in the 2nd decade of life and there was a predilection for females (M:F = 1:2.2) and the maxilla. The recommended treatment of choice is radical surgery or conservative excision depending on tumour size.
Keywords: Myxoma; odontogenic myxoma; fibromyxoma; myxofibroma; odontogenic tumour.
Résumé
Objectifs: Les myxomes odontogènes (MO) sont considérées comme des tumeurs à croissance lente avec un potentiel de destruction de l’os, une expansion corticale, et un taux de récidive relativement élevé. Nous avons analysé les cas histologiquement diagnostiqués comme celui des MO dans notre centre et les ont comparés aux données trouvées dans les documents.
Methode: Une étude basée sur les dossiers des MO histologiquement diagnostiqués au CHU de l’Université Obafemi Awolowo (OAUTHC), Ile-Ife, au Sud-Ouest du Nigeria entre 1990 et 2009 a été réalisée. Les tumeurs ont été classées comme myxomes, fibromyxomas ou myxofibromas selon le tableau histologique. Les masses gingivales ayant les mêmes caractéristiques histologiques mais ne présentant pas d’atteinte osseuse ont été inclues dans la série comme myxomes de tissus mous.
Résultats: Un total de 16 cas diagnostiqués par examen histologique a été enregistré, 11 (68,8%) chez les femmes et 5 (31,2%) chez les hommes donnant un ratio masculin: féminin de 1:2,2. Le site de la tumeur la plus fréquente était le maxillaire (7 cas, 43,8%) et l’âge moyen des patients au moment du diagnostic était de 31,1 ± 18,0 ans. Les myxomes, présentant un tissu myxome complet (8 cas, 50%) sans composant fibreux appréciable était le type histologique le plus fréquent.
Conclusion: L’incidence de pointe se trouvait à la 2ème décennie de la vie etil y avait une prédilection pour les femmes (M: F = 1:2.2) et le maxillaire. Le traitement de choix recommandé est une chirurgie radicale ou une excision conservatrice en fonction de la taille des tumeurs.
Correspondence: Dr. Kehinde E. Adebiyi, Department of Oral/Maxillofacial Surgery, and Oral Pathology, Obafemi Awolowo University, Ile-Ife, Nigeria. E-mail: kenad@justice.com
Referenser
Kourda-Boujemâa J, Farah-Klibi F, Rammeh S, et al. Odontogenic myxoma: About four cases and review of literature. Ann Pathol. 2010;30:168-175.
Ajayi OF, Ladeinde AL, Adeyemo WL and Ogunlewe MO. Odontogenic tumours in Nigerian children and adolescents- a retrospective study of 92 cases. World J Surg Oncol. 2004 Nov 27;2:39.
Lombardi T, Lock C, Samson J and Odell EW. S100, alpha-smooth muscle actin and cytokeratin 19 immunohistochemistry in odontogenic and soft tissue myxomas. J Clin Pathol 1995;48:759-762
Rocha AC, Gaujac C, Ceccheti MM, Amato-Filho G and Machado GG. Treatment of recurrent mandibular myxoma by curettage and cryotherapy after thirty years. Clinics. 2009; 64: 149–152.
Buchner A and Odell EW. Odontogenic myxoma/myxofibroma. In: Barnes L, Eveson JW, Reichart P, Sidransky D, editors. Head and neck tumours. Pathology and genetics. WHO Classification of tumours. Lyon: IARC Press; 2005. p. 316.
Halfpenny W, Verey A, and Bardsley V. Myxoma of mandibular condyle: A case report and review of literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:348-353.
Iezzi G, Piattelli A, Rubini C, et al. MIB-1, Bcl-2 and p53 in odontogenic myxomas of the jaws. Acta Otorhinolaryngol Ital. 2007; 27: 237–242.
Sivakumar G, Kavitha B, Saraswathi TR and Sivapathasundharam B. Odontogenic myxoma of maxilla. Indian J Dent Res. 2008;19:62-65.
Barnes L, Eveson JW and Reichart P, Sidransky D. (Eds.). World Health Organization Classification of Tumours. Pathology and Genetics of Head and Neck Tumours. Lyon: IARC Press; 2005. p. 283-328.
Thoma, K. H. and Goldman H.M. Central myxoma of the jaw. Am J Oral Surg Orthod 1947. 33:532–540.
Li TJ, Sun LS, and Luo HY. Odontogenic myxoma: a clinicopathologic study of 25 cases. Arch Pathol Lab Med. 2006;130:1799-1806.
Allphin AL, Manigilia AJ, Gregor RT and Sawyer R. Myxomas of the mandible and maxilla. Ear Nose Throat J 1993;72:280-284.
Lu Y, Xuan M, Takata T. et al. Odontogenic tumours: a demographic study of 759 cases in a Chinese population. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998. 86:707–714.
Slootweg, P J, and Wittkampf ARM. Myxoma of the jaws: an analysis of 15 cases. J Maxillofac Surg 1986. 14:46–52.
Aytac-Yazicioglu D, Eren H and Görgün S. Peripheral odontogenic myxoma located on the maxillary gingiva: report of a case and review of the literature. J Oral Maxillofac Surg. 2008;12:167-171.
Perrotti V, Rubini C, Fioroni M and Piattelli A. Soft tissue myxoma: report of an unusual case located on the gingiva. J Clin Periodontol. 2006;33:76-78.
Ramaraj PN and Shah SP. Peripheral myxoma of maxilla. A case report. Indian J Dent Res. 2003;14:67-69.
Adekeye, E. O. , Avery B.S, Edwards M.B and Williams H.K. Advanced central myxoma of the jaws in Nigeria: clinical features, treatment and pathogenesis. Int J Oral Surg 1984. 13:177–186.
Odukoya, O. Odontogenic tumours: an analysis of 289 cases. J Oral Pathol Med 1995. 24:454–457.
Oygür T, Dolanmaz D, Tokman B and Bayraktar S. Odontogenic myxoma containing osteocement-like spheroid bodies: Report of a case with an unusual histopathological feature. J Oral Pathol Med 2001;30:504-506.
Simon EN, Merkx MA, Vuhahula E, Ngassapa D and Stoelinga PJ. Odontogenic myxoma: a clinicopathological study of 33 cases. Int J Oral Maxillofac Surg. 2004;33:333-337.