Odontogenic myxoma: Clinico-pathological, immunohistochemical and ultrastructural findings of a multicentric series
Introduction
Myxomas of the jaw bones have been traditionally considered to have an odontogenic origin. According to the literature, odontogenic myxomas (OM) represent between 1% and 17.7% of all odontogenic tumors.1, 2, 3 Microscopically these lesions are characterized by stellate and spindle-shaped cells embedded in a richly myxoid extracellular matrix, with little collagen; those cases with higher amounts of collagen may be denominated as myxofibroma.1, 4 These neoplasms are thought to be derived from the mesenchyme of a developing tooth or from the periodontal ligament.5 Islands of inactive odontogenic epithelium may be found in a few cases, but there are no evidences that they exert inductive effects over the surrounding mesenchyme.6 It is unknown the exact nature of OM, but some studies have found that the cells and the extracellular matrix of OM are different from the ectomesenchymal tissues of developing tooth.7, 8, 9
The aim of this study was to analyze the clinico-pathological and immunohistochemical features of 62 cases of OM diagnosed in three Oral Pathology Diagnostic Services in Latin America, as well as to describe the ultrastructural features of three of these cases, in order to explore the possible histogenesis of this neoplasm.
Section snippets
Material and methods
Sixty-two cases of OM of the jaws were retrieved from the files of three Diagnostic Services from North, Central and South America (Oral Pathology Laboratory, Health Care Department, Universidad Autónoma Metropolitana Xochimilco, Mexico [33 cases]; Centro de Medicina Oral de Guatemala, Guatemala City [14 cases], and Oral Pathology Laboratory, School of Dentistry of Piracicaba, State University of Campinas – UNICAMP, Brazil [15 cases]). Clinical and radiographical informations were obtained from
Clinical findings
Fig. 1 shows the age and gender distribution of OM. Age ranged from 9 to 71 years (mean: 27.9 yr, SD: 11.01), and there were 19 male (30.7%) and 43 female (69.3%) patients (male to female ratio 1:2.2). Mandible was affected in 37 cases (59.6%) and maxilla in 25 (40.4%). 22 cases (35.5%) were located in the posterior mandible and 16 (25.8%) in the posterior maxilla, 13 (21%) in the anterior region (11 in the mandible and 2 in the maxilla), 7 (11.3%) affected more than one region (5 cases in the
Discussion
Since its original description by Thoma and Goldman in 194710 the nature of OM has been a matter of controversy. Several studies have been performed in order to define its precise nature, but at present there is not a universally accepted theory about its probable histogenesis. Based on the presence of occasional small islands of odontogenic epithelium, its occurrence almost exclusive in the jawbones and the histomorphological similarity to the mesenchymal component of the developing tooth,
Conflict of interest statement
None declared.
Acknowledgements
This study was funded by CNPq (The National Council for Scientific and Technological Development) and FAPESP, Brazil. Special thanks are due to Ana Cristina do Amaral Godoy for her immunohistochemical assistance.
References (38)
- et al.
Odontogenic tumors in Mexico. A collaborative retrospective study of 349 cases
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1997) - et al.
Relative frequency of central odontogenic tumors: a study of 1088 cases from Northern California and comparison to studies from other parts of the world
J Oral Maxillofac Surg
(2006) - et al.
Odontogenic myxoma: a clinicopathological study of 33 cases
Int J Oral Maxillofac Surg
(2004) - et al.
Odontogenic myxoma – characterization of the extracellular matrix (ECM) of the tumor stroma
Oral Oncol Eur J Cancer
(1994) - et al.
Advanced central myxoma of the jaws in Nigeria
Int J Oral Surg
(1984) - et al.
Myxoma of the mandible – a fibroblastic tumor
Oral Surg Oral Med Oral Pathol
(1978) - et al.
Myofibroblasts in stroma of odontogenic cysts and tumors can contribute to variations in the biological behavior of lesions
Oral Oncol
(2005) - et al.
Odontogenic myxoma
Oral Surg Oral Med Oral Pathol
(1975) - et al.
Giant odontogenic myxofibroma. Report of a case with histochemical and ultrastructural studies and a review of the literature
Oral Surg Oral Med Oral Pathol
(1974) - et al.
The expression of apoptotic proteins and matrix metalloproteinases in odontogenic myxomas
J Oral Maxillofac Surg
(2003)