ODONTOGENIC FIBROMYXOMA: CASE REPORT AND A REVIEW OF THE LITERATURE

Abstract

<h3>BACKGROUND</h3> Fibromyxoma is a rare benign ectomesenchymal intraosseous tumor and is essentially a form of myxoma. The abundant collagen content in the lesion characterizes it as fibromyxoma. Myxomas can be found in many parts of the skeleton such as the extremities; however, this tumor is classified as odontogenic because of the existence of odontogenic epithelium. Histopathologically, fibromyxoma contains collagen with stellate and spindled-shaped cells floating in a mucoid intercellular matrix. This myxomatous matrix gives the lesion the ability to infiltrate marrow spaces. <h3>CASE REPORT</h3> A 63-year-old African American male patient presented for routine dental treatment. A panoramic radiograph revealed a unilateral, partially well-defined, multilocular radiolucent lesion with straight thin septa and scalloped and corticated borders, extending antero-posteriorly from the distal root of tooth 19 to the left ramus, causing expansion and thinning of cortical boundaries. The mandibular canal was displaced inferiorly. Cone beam computed tomography revealed faint septa most consistent with an odontogenic myxoma. Histopathologic examination was consistent with an odontogenic fibromyxoma. The management was a left mandibular resection and placement of a reconstruction plate with condylar prosthesis. <h3>DISCUSSION/CONCLUSIONS</h3> Odontogenic fibromyxomas are benign but locally aggressive, with a 25% recurrence rate due to its ability to infiltrate adjacent marrow spaces. As a consequence, management of this tumor is more aggressive. The radiographic features are similar to benign multilocular lesions such as ameloblastoma and odontogenic keratocyst (OKC). Contrast magnetic resonance imaging maybe useful in differentiating among these lesions because fibromyxomas show homogenous high signal intensity owing to the collagenous content. The presentation of this lesion in our current case has clinical and statistical relevance for its rare nature.