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

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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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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES). The authors Wliana Pontes de Lima and Sebastião Silvério Sousa-Neto received a PhD scholarship by the Coordination for the Improvement of Higher Education Personnel (CAPES, Finance Code 001). Bruno Augusto Benevenuto de Andrade is a research fellow of Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro (FAPERJ) E-26/201.289/2022. We also thank Brazilian National Council and Technological Development (CNPq, Grant number 311390/2022-6) for financial support. Elismauro Francisco Mendonça is research fellow of CNPq.

Author information

Authors and Affiliations

  1. Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, PB, Brazil

    Paulo Ricardo Elias de Melo, Wliana Pontes de Lima, Cassiano Francisco Weege Nonaka, Pollianna Muniz Alves & John Lennon Silva Cunha

  2. Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, SP, Brazil

    Vitória Maria Sousa Cruz & Sebastião Silvério Sousa-Neto

  3. School of Dentistry, University of Fortaleza (UNIFOR), Fortaleza, CE, Brazil

    Israel Leal Cavalcante, Roberta Barroso Cavalcante & Eveline Turatti

  4. Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil

    Israel Leal Cavalcante & Bruno Augusto Benevenuto de Andrade

  5. Department of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil

    Sebastião Silvério Sousa-Neto & Elismauro Francisco Mendonça

  6. Department of Dentistry, Tiradentes University (UNIT), Aracaju, SE, Brazil

    Sara Juliana de Abreu de Vasconcellos & Paulo Almeida Júnior

  7. Department of Pathology, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil

    Ricardo Luiz Cavalcanti de Albuquerque Júnior

  8. Center of Biological and Health Sciences, Federal University of Western Bahia (UFOB), Barreiras, BA, Brazil

    John Lennon Silva Cunha

Authors
  1. Paulo Ricardo Elias de Melo
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  2. Wliana Pontes de Lima
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  3. Israel Leal Cavalcante
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  4. Vitória Maria Sousa Cruz
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  5. Roberta Barroso Cavalcante
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  6. Eveline Turatti
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  7. Sebastião Silvério Sousa-Neto
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  8. Elismauro Francisco Mendonça
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  9. Sara Juliana de Abreu de Vasconcellos
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  10. Paulo Almeida Júnior
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  11. Cassiano Francisco Weege Nonaka
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  12. Ricardo Luiz Cavalcanti de Albuquerque Júnior
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  13. Pollianna Muniz Alves
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  14. Bruno Augusto Benevenuto de Andrade
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  15. John Lennon Silva Cunha
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by 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, Ricardo Luiz Cavalcanti de Albuquerque Júnior, Cassiano Francisco Wegee Nonaka, Polliana Muniz Alves and Bruno Augusto Benevenuto de Andrade. The first draft of the manuscript was written by Paulo Ricardo Elias de Melo and John Lennon Silva Cunha, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to John Lennon Silva Cunha.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the State University of Paraíba (Date April 25th 2022/No 5.366.436).

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Informed consent to participate in the study was obtained from participants, and the manuscript is in accordance with the Institutional Ethics committee.

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The authors affirm that human research participants provided informed consent for publication of the images in Figures 1, 2 and 3.

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de Melo, P.R.E., de Lima, W.P., Cavalcante, I.L. et al. Clinicopathologic and imaging features of odontogenic myxomas: a multi-institutional study. Oral Maxillofac Surg (2024). https://doi.org/10.1007/s10006-024-01271-w

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