International Journal of Surgery Case Reports 112 (2023) 108945

Contents lists available at ScienceDirect

International Journal of Surgery Case Reports

journal homepage: www.elsevier.com/locate/ijscr

Case series

Surgical management of odontogenic myxomas: A case series

Hannah Trode a, *, Celso Pouget b, Marouane Talbi c, Etienne Simon d, e, Muriel Brix e, f
a
Faculty of Medicine, Lorraine University, 9 avenue de la Forêt de Haye, 54505 Vandoeuvre-lès-Nancy, France
b
Department of Anatomical Pathology, Nancy University Hospital Center, Hôpitaux de Brabois, Rue du Morvan, Vandœuvre-lès-Nancy, France
c
Department Maxillo-facial and Plastic Surgery, Regional Metz Hospital, 1 allée du Château, 57 085 Ars-Laquenexy, France
d
Department Maxillo-facial and Plastic Surgery, Nancy University Hospital Center, Hôpital Central, 29 avenue de Lattre de Tassigny, Nancy, France
e
Lorraine University, Faculty of Medicine, Vandoeuvre-lès-Nancy, France
f
Department Maxillo-facial and Plastic Surgery, Nancy University Hospital Center, Hôpital Central, 29 avenue de Lattre de Tassigny, Nancy, France

A R T I C L E I N F O A B S T R A C T

Keywords: Introduction: Odontogenic myxoma is a relatively rare bone tumor involving exclusively the jaws. Despite its
Cases series of odontogenic myxomas benign nature, odontogenic myxoma can exhibit aggressive, locally invasiveness and has a high potential of
Surgical management of odontogenic myxoma recurrence. Surgical treatment can be conservative of radical. The choice of surgical procedure is controversial,
Odontogenic tumors
and there are no established guidelines.
Management algorithm of odontogenic
myxoma
Case series presentation: We present a case series of three cases of odontogenic myxomas. This case series illus­
trates the variability of the radioclinical presentation of odontogenic myxoma and the resulting surgical man­
agement, ranging from simple enucleation to mandibular interruptive resection surgery with free flap
reconstruction.
Discussion and conclusion: Through this case series, we highlighted and described decision criteria contributing to
treatment choice and summarized this in an algorithm. Radiological tumor characteristics and also patient
specific factors such as age need to be considered to make a personalized decision to each patient.

1. Introduction
According to the latest 2017 WHO classification, odontogenic myx­
oma is categorized as a benign odontogenic mesenchymal tumor.
Odontogenic tumors comprise a heterogeneous group of benign or ma­
lignant lesions arising from epithelial and/or mesenchymal components
involved in odontogenesis [1]. These tumors are exclusively found
within the maxillo-mandibular region. Odontogenic myxoma ranks as
the third most prevalent odontogenic tumor after odontoma and ame­
loblastoma, but it remains relatively rare [2].
Despite its benign nature, odontogenic myxoma can display aggres­
sive behavior, local invasiveness, and a substantial potential for
recurrence.
The treatment of odontogenic myxoma necessitates surgical inter­
vention, which can range from conservative to more radical approaches.
Due to its low prevalence, no established guidelines currently exist for its
management.
We present then an analysis of the clinical, radiological, and pri­
marily therapeutic aspects of three cases of odontogenic myxomas re­
ported at Nancy University Hospital and Metz Regional Hospital. Our
objective is to highlight the decision criteria that influence the choice of
surgical procedures.
2. Methods
This case series include three cases of odontogenic myxoma reported
at the Maxillofacial Surgery Department at Nancy University Hospital
and at the Metz Regional Hospital.
This case series has been reported in line with PROCESS criteria [3].
3. Results
3.1. Case 1 presentation
A 26-year-old female patient was referred to the Maxillofacial Sur­
gery Department at Nancy University Hospital by her dentist due to
radiological findings revealing a recurrence of an asymptomatic
mandibular osteolytic lesion. She had no other specific medical history.
Five years prior, the 21-year-old patient had undergone the tooth 36
extraction along with with curettage of the mandibular lesion by her

* Corresponding author.
E-mail address: hannah.trode@hotmail.fr (H. Trode).

https://doi.org/10.1016/j.ijscr.2023.108945
Received 23 September 2023; Received in revised form 6 October 2023; Accepted 7 October 2023
Available online 17 October 2023
2210-2612/© 2023 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY-NC-ND license
(http://creativecommons.org/licenses/by-nc-nd/4.0/).
H. Trode et al. International Journal of Surgery Case Reports 112 (2023) 108945

dentist.
A cone beam computed tomography (CBCT) showed a poorly
delineated 17-mm long multilocular hypodensity surrounding the roots
of tooth 36, with a resorbed distal root. There was no cortical effraction.
Some intra-lesional septa were observed (Fig. 1A). Pathological analysis
identified an odontogenic myxoma.
Only one radiography was performed one month postoperatively.
Thereafter, no further follow-up was not conducted. CBCT was per­
formed only 5 years later, primarily to assess the alveolar bone level for
the purpose of rehabilitating tooth 36 (Fig. 1B).
Patient was asymptomatic and clinical examination was normal.
Facial CT scan showed a voluminous multilocular osteolytic lesion
extending approximately 55 mm between teeth 34 and 38, with multiple
septas. Both vestibular and lingual cortical bone were thinned, with a 20
mm rupture observed in the lingual cortical bone adjacent to tooth 38
(Figs. 1B and 2).
Conservative treatment was performed under general anesthesia by
an experienced maxilla-facial surgeon, consisting of enucleation of the
lesion with meticulous curettage of the resection cavity and extractions
of teeth 37 and 38. Post-operative prescriptions included analgesics,
Amoxicillin-clavulanic acid antibiotic therapy, and antiseptic
mouthwash.
Pathological analysis revealed proliferation of low cell density,
composed of cells arranged in an abundant, loose, fibrous myxoid
background. No identifiable epithelial structures were present. Immu­
nohistochemical staining yielded negative results for AE1/AE3, MUC4,
P-S100, CD34, and EMA markers. Ki67 proliferation index was low
(Fig. 3).
The patient was currently undergoing follow-up. Reossification of
Fig. 2. Facial CT scan revealing 5-year recurrence of a larger odontogenic
the surgical site defect was in progress after 15 months. myxoma, with lingual cortical effraction.

3.2. Case 2 presentation
A 34-year-old patient with no previous medical history presented to
the Maxillofacial Surgery Department of the Regional Hospital of Metz
for a painless right submandibular swelling evolving for one year.
On clinical examination, a firm right submandibular swelling was
observed, along with intraoral swelling on the lingual surface of the
mandible in the retromolar region. Moreover, the oral mucosa appeared
healthy. There was no hypoesthesia in the inferior alveolar nerve
territory.
Contrast-enhanced cervicofacial CT-scan revealed a large multi­
locular mandibular osteolytic lesion measuring up to 65 mm in its long
axis. This lesion extended from the right parasymphysis to 1 cm below
the right condylar head. The lesion featured angular bony septa within
it, and there were multiple cortical effractions, particularly along the
lingual border.
At the mandibular angle, there was an expansion of the lingual cortex
and the basilar margin, resulting in a pseudo-nodule with a diameter of
approximately 50 mm (Fig. 4).
The lesion showed slight enhancement after contrast injection.
A biopsy was performed, which revealed the diagnosis of odonto­
genic myxoma.
Subsequently, the patient underwent a segmental mandibular
resection from tooth 32 to the mandibular condyle, obtaining margins of
1 to 1.5 cm by an experienced maxilla-facial surgeon. Mandibular
reconstruction was performed simultaneously using a micro-
anastomosed free fibula flap, osteosynthesized with custom-made tita­
nium plates. Some cervical lymph nodes were fortuitously indentified
during surgery and were removed for analyse. The patient remained
hospitalized for 15 days following the procedure. Post-operative pre­
scriptions included analgesics, Amoxicillin-clavulanic acid antibiotic
therapy, antiseptic mouthwash, scar care and the recommendation of an
appropriate diet.
Macroscopically, upon cross-section, the lesion appeared grayish,

Fig. 1. Constructed pantomographies.

A: Localized odontogenic myxoma around tooth 36 with root resorption.
B: 5-year recurrence of a larger odontogenic myxoma, displacing tooth 35.

2
H. Trode et al. International Journal of Surgery Case Reports 112 (2023) 108945

Fig. 3. Rounded to spindle-shaped cells dispersed in a partly fibrous myxoid matrix Hematoxylin eosin staining ×20.

Fig. 4. Preoperative CT scan showing extensive osteolysis of the cortical bone, mainly lingual, basilar edge (Fig. 3A) and involvement of the right condylar
head (Fig. 3B).

translucent, and mucinous.
Pathological analysis revealed an odontogenic fibromyxoma char­
acterized by stellate, spindle-shaped or round cells with cytoplasmic
expansions, without mitotic activity, dispersed within a myxoid sub­
stance containing collagen fibers (Fig. 5). No tumor capsule was
observed, but peripheral fibrous densification was present. The medul­
lary space was infiltrated by proliferation and no odontogenic epithe­
lium was identified. Margins of resection were free of tumoral lesion.
Lymph node analysis showed a non-specific reactive lymphadenitis.
To achieve implant-supported rehabilitation, the patient received a
gingival graft from palatal mucosal on the fibula flap, by an oral
surgeon. Four months later, four implants were placed. Dental rehabil­
itation was achieved with an implant-supported bridge one year after
resection surgery (Fig. 6).
After forty months post-surgery, there was no radiological evidence
of recurrence.
3.3. Case 3 presentation
A 15-year-old patient with no medical history was referred by his
dentist to the Oral Surgery Department of the Metz Regional Hospital
due to the incidental radiological discovery of a radiolucent lesion in the

3
H. Trode et al. International Journal of Surgery Case Reports 112 (2023) 108945

Fig. 5. Histological sections.

A: Proliferation of spindle cells within a fibromyxoid matrix, infiltrating the adjacent bone trabeculae (arrow), without tumor capsule - Hematoxylin and eosin stain
×2,5.
B and C: Cellularity within the matrix from low (Fig. 7B) to high (Fig. 7C) collagen density – Hematoxylin and eosin stain ×10.

Fig. 6. Dental panoramic radiograph 40 months post-operatively.

mandibular symphysis. There was no evidence of recurrence detected 40 months

The lesion was entirely asymptomatic. Upon clinical examination, no
abnormalities were noted. There was no vestibular swelling, no pain and
the teeth adjacent to the lesion were vital.
CBCT showed a well-defined multilocular radiolucency adjacent to
the apex of the teeth 31 to 34, measuring 19 × 15 mm. Cortical bone
appeared locally thinned, but no signs of resorption or tooth displace­
ment were observed (Fig. 7).
A surgical procedure under general anesthesia was performed, con­
sisting of enucleation of the lesion and curettage of the excision cavity.
This surgical intervention was conducted by an experienced oral sur­
geon. Post-operative care included the prescription of analgesics,
Amoxicillin antibiotic therapy, antiseptic mouthwash and the recom­
mendation of an appropriate diet.
Pathological findings showed a poorly defined, non-encapsulated
lesion characterized by proliferation of small spindle-shaped or stel­
late cells with condensed nuclei devoid of atypical character and
without significant mitotic activity. These cells were arranged in an
abundant myxoid background. Immunohistochemical study using anti-
CK AE1/AE3 antibodies confirmed the absence of epithelial structure
(Fig. 8).
postoperatively.
4. Discussion
Odontogenic myxoma is a relatively rare benign tumor first
described in 1947 by Thoma and Goldman [4]. According to the latest
2017 WHO classification of head and neck tumors, it is classified as a
benign odontogenic mesenchymal tumor [1].
Although its odontogenic origin is a subject of debate, several factors
suggest its association with tooth development. These factors include its
frequent occurrence in the maxillo-mandibular site, particularly in the
dentate region, its resemblance to different tissues of a developing tooth,
the inconsistent presence of an odontogenic epithelium and the possible
association with an impacted or delayed eruption tooth [5–7].
The intraosseous (or central) location of odontogenic myxoma is the
most common. All the presented cases in the series are central forms.
Similar to other odontogenic tumors, it can also be localized in the
peri-maxillary soft tissues such as the gingiva and alveolar mucosa
(peripheral form) [8].
The frequency of odontogenic myxoma among odontogenic tumors

4
H. Trode et al.
Fig. 7. Constructed pantomography showing a multilocular osteolytic lesion.
Fig. 8. Histological sections - Hematoxylin and eosin stain ×10.
A: Spindle cells proliferation within a myxoid matrix.
B: Residual intralesional bone trabeculae (*) within the myxoid proliferation.
varies widely across studies, ranging from 0.5 to 20 % [9,10]. Most
authors have described a slight female predominance [11,12]. This
condition can occur at any age, but it tends to have a predilection for
individuals in their third decade of life [10,13].
Most of the odontogenic myxomas are incidentally discovered
through radiography and are asymptomatic, as was observed in two of
our patients. Otherwise, odontogenic myxoma appears as a painless,
slow-growing swelling that may lead to facial deformity [14].
Radiologically, the majority of cases show unilocular or multilocular
radiolucency capable of eroding and expanding cortical bone. The
multilocular form, as observed in our cases, is the most common pre­
sentation. A “soap bubble”, “honeycomb”, or “tennis racket” appearance
is characteristic, but not specific to odontogenic myxoma. Dental
displacement is more frequent than dental resorption [11].
The radiological presentation can vary significantly from one lesion
5
International Journal of Surgery Case Reports 112 (2023) 108945
to another, highlighting the importance of considering a wide range of
benign and potentially malignant differential diagnoses, particularly
when periosteal reaction is present [15].
The predominant location is the mandibular region, more commonly
in the posterior than the anterior part [11,13,16]. In our series, all cases
were located in the mandible, as are two thirds of odontogenic myxomas
[17].
Odontogenic myxoma is a non-encapsulated, locally invasive tumor
that infiltrates adjacent bone. Microscopically, it is characterized by a
proliferation of spindle or star-shaped cells, dispersed in a myxoid to
fibromyxoid matrix. The presence of a significant amount of collagen
may catgorize the tumor as an odontogenic fibromyxoma. Only one of
our cases is an odontogenic fibromyxoma, with strong collagenous
component.
Some bone trabeculae may be visible within the lesion, contributing
H. Trode et al.
to the “soap bubble” radiological appearance or suggesting a mixed
lesion. The presence of an odontogenic epithelium (lamina remnant) is
possible in 13 % of cases but is not essential for the diagnosis [8,13,18].
Although odontogenic myxoma is classified as a benign tumor, it
possesses the potential for locally invasiveness into surrounding tissues,
sometimes leading to extensive tumors [19].
In cases of extensive, aggressive-appearance osteolytic lesions, a bi­
opsy is often performed initially to establish a diagnosis, as was the case
in case 2. A prior diagnosis is crucial for planning an appropriate surgical
strategy [20].
Treatment of odontogenic myxoma is surgical. Due to its low inci­
dence, there is no standardized recommendation for its management.
The choice of treatment is a topic of debate in the literature. Treatment
options can vary from conservative approaches, such as simple enucle­
ation, to more radical procedures involving resection with margins of up
to 1.5 cm [21].
Recurrence rate is estimated to range from 10 and 43 % [22]. Ac­
cording to Chrcanovic et al., this rate is significantly influenced by the
type of treatment performed (conservative or radical).
Absence of capsule, local tumor infiltration, gelatinous and friable
aspect of the tumor make a complete removal difficult. These factors are
sources of recurrence after treatment [23–25].
Radical treatment allows an improved control of the risk of recur­
rence by conducting an extended excision in healthy areas, but at the
expense of aesthetic and functional sequelae.
In case 1, the patient presented a recurrence of an odontogenic
myxoma measuring 55 mm long, with invasion of the lingual cortex. In
this case, the height of residual bone after enucleation and extensive
curettage, as well as the absence of basilar edge involvement are
decision-making criteria in favor of conservative treatment [26,27].
After reviewing the literature, Kansy et al. suggest that radical sur­
gery does not always seem to be the most appropriate to reduce the
recurrence rate [28]. Conservative surgery, whenever feasible, results in
fewer morphological and functional sequelae than radical surgery [29].
Case 1 illustrates the importance of regular post-treatment follow-up,
especially when conservative treatment is employed. Five years after the
initial surgery, the patient experienced a recurrence that reached a size
of 55 mm.
According to Chrcanovic et al., recurrence occurs within 2 years
post-surgery in 73 % of cases [13]. A rigorous follow-up during the
initial post-operative years is essential and should be maintained over
the long term. This vigilance facilitates the early detection of potential
recurrences, regardless of the type of treatment performed.
Long term recurrence can still occurs, even following radical surgery.
MRI, due to its ability to explore soft tissues, could be valuable in the
follow-up of odontogenic myxoma, particularly in cases where doubts
exists regarding recurrence.
In case 2, the patient presented an extensive lesion. CT scan indicated
multiple cortical effractions, and extensive cortical expansion notably
affecting the basilar margin and mandibular angle. The bone thickness
was very low or absent in several areas, which reduces the consolidation
potential. Conservative treatment was therefore difficult to achieve
[29].
Extension of the tumor to the condyle in this patient was also an
argument in favor of radical treatment. Indeed, in situations involving
complex surgical access location, a wide resection is recommended in
order to minimize the risk of recurrence that could potentially extend
further, possibly up to the skull base, as exemplified in this case [28,30].
In case 3, conservative treatment is performed immediately for both
diagnostic and therapeutic purposes, due to the well-defined appearance
and small size of the lesion.
Different decision-making criteria have been delineated in the
literature and illustrated through these cases. They mainly concern
tumor characteristics.
The size of odontogenic myxoma is often employed by several au­
thors as a criterion for determine whether conservative or radical
6
International Journal of Surgery Case Reports 112 (2023) 108945
treatment should be pursued [10,13,31]. Kauke et al. state that the
maximum diameter alone is insufficient for assessing the aggressiveness
of the lesion and determining the appropriate treatment approach [32].
Various scanographic characteristics also necessitate careful
consideration: type of locularity, appearance of the cortices (integrity,
effraction), appearance of the tumor margins, tumor location (complex
surgical access), involvement of the basilar margin, height of residual
bone [10,22,24,26,27,30,31,33].
Conservative treatment is more delicate in cases of cortical discon­
tinuity and multilocular tumors. A history of recurrence is also a sig­
nificant factor in the decision-making process.
In addition to tumor characteristics, patient-specific factors need to
be considered, in particular age, co-morbidities and compliance with
follow-up [17,21,28].
As a summary, we propose a decision-making algorithm based on
both radiological criteria and patient-specific characteristics, to help
determine the most suitable treatment approach (Fig. 9).
5. Conclusion
Odontogenic myxoma is a benign but its potential for aggressiveness
and tissue destruction cannot be underestimated.
The potential for recurrence and its difficulty of removal must be
taken into account when planning the management. The balance be­
tween benefits and risks must be carefully assessed and customized to
each patient. Regular follow-up remains crucial, regardless of the chosen
treatment approach.
Consent
Written informed consent was obtained from the patients for publi­
cation of these case reports and accompanying images. Written informed
consent was obtained from the patient's parents/legal guardian for
publication and any accompanying images.
A copy of the written consent is available for review by the Editor-in-
Chief of this journal on request.
Ethical approval
Exception from ethical approval because the study was a case series
of 3 case reports. This was research not involving the human person.
Patients provided written consent to undergo the procedures described
and for their data and anonymous images to be published.
Funding
No funding was received.
Author contribution
Conceptualization, Data Curation: Trode Hannah, Celso Pouget,
Marouane Talbi, Etienne Simon, Muriel Brix.
Supervision: Muriel Brix.
Writing -original draft: Trode Hannah.
Writing -review and editing: Trode Hannah, Muriel Brix.
Validation: Trode Hannah, Celso Pouget, Marouane Talbi, Etienne
Simon, Muriel Brix.
Guarantor
Ms Trode Hannah.
Research registration number
Not applicable.
H. Trode et al.
Fig. 9. Decision support algorithm for the management of odontogenic myxoma [6,9,12,25,26,29–31,33–35].
Conflict of interest statement
All authors declare that there are no financial and personal re­
lationships with other people or organizations that could inappropri­
ately influence their work.
References
[1] A. El-Naggar, J. Chan, J. Grandis, T. Takata, P. Slootweg, WHO Classification of
Head and Neck Tumours, IARC, Lyon, 2017.
[2] D.R. Gnepp, J.A. Bishop, Gnepp’s Diagnostic Surgical Pathology of the Head and
Neck, 2021.
[3] R.A. Agha, C. Sohrabi, G. Mathew, T. Franchi, A. Kerwan, N. O’Neill, et al., The
PROCESS 2020 guideline: updating consensus Preferred Reporting Of CasESeries in
Surgery (PROCESS) guidelines, Int. J. Surg. Lond. Engl. 84 (2020) 231–235.
[4] K.H. Thoma, H.M. Goldman, Central myxoma of the jaw, Am. J. Orthod. Oral Surg.
33 (7) (1947) B532–B540.
[5] G. Iezzi, A. Piattelli, C. Rubini, L. Artese, M. Fioroni, F. Carinci, MIB-1, Bcl-2 and
p53 in odontogenic myxomas of the jaws, Acta Otorhinolaryngol Ital Organo Uff
Della Soc Ital Otorinolaringol E Chir Cerv-facc. 27 (5) (2007) 237–242.
[6] A. Shah, P. Lone, S. Latoo, I. Ahmed, A. Malik, S. Hassan, et al., Odontogenic
myxoma of the maxilla: a report of a rare case and review on histogenetic and
diagnostic concepts, Natl. J. Maxillofac. Surg. 2 (2) (2011) 189–195.
[7] Z. Chaudhary, P. Sharma, S. Gupta, S. Mohanty, M. Naithani, A. Jain, Odontogenic
myxoma: report of three cases and retrospective review of literature in Indian
population, Contemp. Clin. Dent. 6 (4) (2015) 522–528.
[8] P. Reichart, H. Philipsen, Odontogenic Tumors and Allied Lesions, Quintessence
Publishing Co Ltd, Illinois, 2004.
[9] F. Titinchi, B.A. Hassan, J.A. Morkel, C. Nortje, Odontogenic myxoma: a
clinicopathological study in a South African population, J. Oral. Pathol. Med. Off.
Publ. Int. Assoc. Oral. Pathol. Am. Acad. Oral Pathol. 45 (8) (2016) 599–604.
[10] J.H. Dotta, L.N. Miotto, R. Spin-Neto, T.M. Ferrisse, Odontogenic myxoma:
systematic review and bias analysis, Eur. J. Clin. Invest. 50 (4) (2020), e13214.
[11] I. Kaffe, H. Naor, A. Buchner, Clinical and radiological features of odontogenic
myxoma of the jaws, Dento Maxillo Facial Radiol. 26 (5) (Sept. 1997) 299–303.
7
International Journal of Surgery Case Reports 112 (2023) 108945
[12] A.C.U. Vasconcelos, F.M. Silveira, A.P.N. Gomes, S.B.C. Tarquinio, A.P.V. Sobral, J.
A.A. de Arruda, et al., Odontogenic myxoma: a 63-year retrospective multicenter
study of 85 cases in a Brazil population and a review of 999 cases from literature,
J. Oral Pathol. Med. Off. Publ. Int. Assoc. Oral Pathol. Am. Acad. Oral Pathol. 47
(1) (2018) 71–77.
[13] B.R. Chrcanovic, R.S. Gomez, Odontogenic myxoma: an updated analysis of 1,692
cases reported in the literature, Oral Dis. 25 (3) (2019) 676–683.
[14] Y. Kawase-Koga, H. Saijo, K. Hoshi, T. Takato, Y. Mori, Surgical management of
odontogenic myxoma: a case report and review of the literature, BMC. Res. Notes 7
(2014) 214.
[15] J. Zhang, H. Wang, X. He, Y. Niu, X. Li, Radiographic examination of 41 cases of
odontogenic myxomas on the basis of conventional radiographs, Dento Maxillo
Facial Radiol. 36 (3) (2007) 160–167.
[16] G. Martínez-Mata, A. Mosqueda-Taylor, R. Carlos-Bregni, O.P. de Almeida,
E. Contreras-Vidaurre, P.A. Vargas, et al., Odontogenic myxoma: clinico-
pathological, immunohistochemical and ultrastructural findings of a multicentric
series, Oral Oncol. 44 (6) (2008) 601–607.
[17] T.J. King, J. Lewis, L. Orvidas, D. Kademani, Pediatric maxillary odontogenic
myxoma: a report of 2 cases and review of management, J. Oral Maxillofac. Surg.
66 (5) (2008) 1057–1062.
[18] A. Best-Rocha, K. Patel, J. Hicks, J.L. Edmonds, M.J. Paldino, H. Wu, Novel
association of odontogenic myxoma with constitutional chromosomal 1q21
microduplication: case report and review of the literature, Pediatr. Dev. Pathol.
Off. J Soc. Pediatr. Pathol. Paediatr. Pathol. Soc. 19 (2) (2016) 139–145.
[19] R. Bologna-Molina, A. Mosqueda-Taylor, H. Domínguez-Malagón, S. Salazar-
Rodríguez, G. Tapia, R. Gónzalez-Gónzalez, et al., Immunolocalization of VEGF-A
and orosomucoid-1 in odontogenic myxoma, Romanian J. Morphol. Embryol. Rev.
Roum. Morphol. Embryol. 56 (2) (2015) 465–473.
[20] J. Kourda-Boujemâa, F. Farah-Klibi, S. Rammeh, A. Adouani, R. Zermani, Jilani-
Baltagi S. Ben, Le myxome odontogénique: étude de quatre cas et revue de la
littérature, Ann. Pathol. 30 (3) (2010) 168–175.
[21] E. Robert, D. Stern, Oral and Maxillofacial Pathology: A Rationale for Diagnosis
and Treatment, 2nd edition, Quintessence Publishing Co Ltd, 2012.
[22] M. Saalim, K. Sansare, F.R. Karjodkar, A.G. Farman, S.N. Goyal, S.R. Sharma,
Recurrence rate of odontogenic myxoma after different treatments: a systematic
review, Br. J. Oral Maxillofac. Surg. 57 (10) (2019) 985–991.
[23] Y.L. Lin, J.R. Basile, A case of odontogenic myxoma with unusual histological
features mimicking a fibro-osseous process, Head Neck Pathol. 4 (3) (2010)
253–256.
H. Trode et al.
[24] H.D.D. Martins, E.L. Vieira, A.L.M.F. Gondim, H.A. Osório-Júnior, J.S.P. da Silva,
É.J.D. da Silveira, Odontogenic myxoma: follow-up of 13 cases after conservative
surgical treatment and review of the literature, J. Clin. Exp. Dent. 13 (7) (2021)
e637–e641.
[25] T.J. Li, L.S. Sun, H.Y. Luo, Odontogenic myxoma: a clinicopathologic study of 25
cases, Arch. Pathol. Lab. Med. 130 (12) (2006) 1799–1806.
[26] H. Sato, Y. Kurihara, S. Shiogama, K. Saka, Y. Kurasawa, M. Itose, et al., Long-term
follow-up after conservative surgical treatment of odontogenic myxoma: a case
report and literature review, Case Rep. Dent. 2019 (2019) 1634842.
[27] A.C. Rocha, C. Gaujac, M.M. Ceccheti, G. Amato-Filho, G.G. Machado, Treatment
of recurrent mandibular myxoma by curettage and cryotherapy after thirty years,
Clin. Sao Paulo Braz. 64 (2) (2009) 149–152.
[28] K. Kansy, P. Juergens, Z. Krol, M. Paulussen, D. Baumhoer, E. Bruder, et al.,
Odontogenic myxoma: diagnostic and therapeutic challenges in paediatric and
adult patients – a case series and review of the literature, J. Craniomaxillofac. Surg.
40 (3) (2012) 271–276.
[29] B. Ruhin, F. Guilbert, J.C. Bertrand, Traitement des kystes, tumeurs et
pseudotumeurs bénignes des maxillaires, EMC - Stomatol. 1 (1) (2005) 42–59.
International Journal of Surgery Case Reports 112 (2023) 108945
[30] Jala Hamama, Lahcen Khalfi, Kamal Fiqhi, Jarim El Khatib, Odontogenic myxoma
of maxilla: conservative or radical surgery? Int. Arch. Oral Maxillofac. Surg. 2 (1)
(2018).
[31] P. Boffano, C. Gallesio, A. Barreca, F.A. Bianchi, P. Garzino-Demo, F. Roccia,
Surgical treatment of odontogenic myxoma, J. Craniofac. Surg. 22 (3) (2011)
982–987.
[32] M. Kauke, A.F. Safi, M. Kreppel, A. Grandoch, H.J. Nickenig, J.E. Zöller, et al., Size
distribution and clinicoradiological signs of aggressiveness in odontogenic
myxoma-three-dimensional analysis and systematic review, Dento Maxillo Facial
Radiol. 47 (2) (2018) 20170262.
[33] A.M. Banasser, M.M. Bawazir, M.N. Islam, I. Bhattacharyya, D.M. Cohen, S.
G. Fitzpatrick, Odontogenic myxoma: a 23-year retrospective series of 38 cases,
Head Neck Pathol. 14 (4) (2020) 1021–1027.
[34] A.L.N. Francisco, T.C. Chulam, F.O. Silva, D.G. Ribeiro, C.A.L. Pinto, R.O. Gondak,
et al., Clinicopathologic analysis of 14 cases of odontogenic myxoma and review of
the literature, J. Clin. Exp. Dent. 9 (4) (2017), e560‑3, 1 avr.
[35] Y. Takahashi, K. Tanaka, H. Hirai, E. Marukawa, T. Izumo, H. Harada, Appropriate
surgical margin for odontogenic myxoma: a review of 12 cases, Oral Surg. Oral
Med. Oral Pathol. Oral Radiol. 126 (5) (2018) 404–408.