Odontogenic myxoma is a relatively rare benign odontogenic lesion characterized by slow yet infiltrative growth. The lesion is generally non-encapsulated, allowing it to infiltrate surrounding tissues, which makes lesion boundaries difficult to define on imaging. Although benign, myxoma can cause extensive jawbone destruction and facial deformity if not properly managed.
An article from Jurnal MKGI FKG UGM written by Y. Mulyaka and drg. Muhammad Masykur Rahmat, Sp. BM., entitled “Mixoma Odontogenik: Tinjauan Klinis dan Penatalaksanaanya”, reports the clinical and radiological features of a case of jaw myxoma as well as reconstructive surgical options to address the damage. From this case, several important clinical lessons can be drawn to improve diagnosis and management of jaw myxoma.
Clinical and Radiological Features
Based on the case report:
- A 24-year-old male patient presented with a painless swelling on the right cheek for approximately three years. The lesion showed slow growth. Jurnal Universitas Gadjah Mada
- The lesion measured approximately 9 × 9 × 7 cm, had a rubbery consistency, and exhibited tissue coloration similar to the surrounding area.
- Radiological examination revealed a radiolucent lesion, often multilocular or with a “honeycomb” appearance, with poorly defined margins.
Surgical Management
Based on the case, the following management steps were taken:
- Hemimandibulectomy, involving resection of the affected side of the mandible.
- Placement of a mandibular reconstruction plate to maintain jaw continuity and facial structural function.
Challenges and Risks
Several important considerations in odontogenic myxoma cases include:
- Due to its non-encapsulated and infiltrative nature, residual lesion tissue may remain, leading to a relatively high risk of recurrence.
- Extensive surgery such as hemimandibulectomy has significant consequences for facial aesthetics, oral function (mastication and speech), and reconstructive needs.
Clinical Implications
From this case analysis, the following clinical strategies are recommended:
- Accurate diagnosis
- Comprehensive radiological evaluation (e.g., CT or CBCT) to assess lesion boundaries, morphology, and degree of infiltration.
- Histopathological examination to confirm myxoma and characterize lesion type and aggressiveness.
- Appropriate surgical approach
- Large or extensively infiltrative lesions may require radical resection such as hemimandibulectomy.
- More limited lesions may be managed with conservative surgery if clean margins can be ensured
- Reconstruction
- Immediate reconstruction following resection is essential to maintain jaw continuity, preserve oral function, and prevent permanent facial deformity.
- Postoperative monitoring
- Long-term follow-up to detect recurrence, given the slow-growing nature of myxoma.
- Functional and aesthetic evaluation postoperatively (mastication, speech, facial symmetry).
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Although odontogenic myxoma is benign, it requires meticulous clinical management due to its infiltrative characteristics and potential for extensive jaw destruction. The reported case demonstrates that hemimandibulectomy followed by reconstruction with a plate can be an effective option for large lesions, provided accurate diagnosis and adequate surgical margins are achieved.
References
MKGI, Y. Mulyaka, drg. Muhammad Masykur Rahmat, Sp. BM., Mixoma Odontogenik: Tinjauan Klinis dan Penatalaksanaanya, https://jurnal.ugm.ac.id/mkgi/article/view/16067
Author: Rizky B. Hendrawan | Photo: Freepik
