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Cysts and Tumours of the Bony Facial Skeleton
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Julia A. Woolgar, Gillian L. Hall
This rarely affects the jaws with only 60–70 reported cases, mainly in teens/young adults with a slight female predilection.21 Most arise in the mandibular posterior molar/angle and present as a firm, expansile swelling with facial deformity and often, pain. Radiographs reveal a uni- or multilocular, balloon or soap-bubble-like radiolucency (similar to ameloblastoma and odontogenic myxoma, Figure 25.9). Surgical exploration leads to the characteristic welling-up of blood. The curetted tissue consists of numerous blood-filled spaces without obvious endothelial lining. Multinucleated giant cells and haemosiderin are frequent within the fibrous septae. The pathogenesis is uncertain. In some, a translocation involving chromosome 17 and the oncogene USP6 can be demonstrated suggesting they are neoplastic.22 Other cases may be associated with an intramedullary haemodynamic disturbance and 20–30% appear to complicate central giant cell granulomas or other fibro-osseous lesions.23 Curettage is generally curative.
Cysts of the jaws, face and neck
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
One diagnostic and treatment dilemma for oral and maxillofacial surgeons involves the clinical and radiographic distinction between a dentigerous cyst and an enlarged dental follicle. This distinction becomes clinically significant when the surgeon considers whether to submit tissue removed with an impacted third molar for histopathologic examination as opposed to clinical designation as a follicle that may be discarded without microscopic analysis. The radiographic distinction becomes somewhat arbitrary; however, any pericoronal radiolucency that is larger than 4–5 mm is considered a cyst and should be submitted for microscopic examination. It is noteworthy that pathologists also struggle with the distinction between dental follicles associated with developing teeth and odontogenic lesions.3, 4 It seems that odontogenic cysts, odontogenic fibroma and odontogenic myxoma are the lesions most often incorrectly offered as diagnoses for follicles by surgical pathologists owing to a general unfamiliarity with the normal process of odontogenesis.3 Of perhaps even greater concern in terms of proper diagnosis and treatment is the large unilocular radiolucency. Although most commonly classified radiographically as dentigerous cysts, it is incumbent upon the surgeon to section these excised specimens in the operating room and to consider frozen-section analysis. This exercise is important so as to rule out the existence of a unicystic ameloblastoma that would at least require an aggressive curettage with curative intent.
Odontogenic Tumors
Published in Dongyou Liu, Tumors and Cancers, 2017
Benign odontogenic tumors consist of epithelial odontogenic tumors (e.g., ameloblastoma, unicystic-type ameloblastoma, squamous odontogenic tumor, calcifying epithelial odontogenic tumor, and adenomatoid odontogenic tumor), mixed odontogenic tumors (e.g., ameloblastic fibroma, odontoma, and developing odontoma), mesenchymal odontogenic tumors (e.g., odontogenic fibroma, granular cell odontogenic tumor, odontogenic myxoma/myxofibroma, cementoblastoma, and cemento-ossifying fibroma), and peripheral odontogenic tumors. All together, these tumors account for >95% of odontogenic tumors diagnosed [4].
Odontogenic myxoma involving the right nasal cavity, orbital floor, and skull base in a 20-year-old woman: Removal and review of the literature
Published in Acta Oto-Laryngologica Case Reports, 2023
Danlin Huang, Fei Liu, Junyi Liang, Xiao Xing, Xingsha Wu, Shuai Yang, Xinfeng Wei, Shuo Li
Because the mucinous tumor in this patient had occupied the entire maxillary sinus cavity and was bulging toward the nasal septal surface, a trans maxillary sinus conventional opening approach was unable to expose the mass. In combination with CT and MRI, the right Odontogenic myxoma tumor occupied the entire maxillary sinus cavity; in order to better expose the mass and gain room for manipulation, we performed the procedure using a transnasal endoscopic anterior lacrimal fossa approach. A greyish-white mass that could not be reached by instruments was still present after using the 70-degree nasal endoscope to explore the anterior medial aspect of the maxillary sinus and the floor wall. so the mass was completely removed endoscopically in combination with the lacrimal gingival sulcus approach. The postoperative pathology was reported as an Odontogenic myxoma tumor.
Isolated intraosseous extra-gnathic orbital myxoma: a clinicopathologic case report
Published in Orbit, 2019
Fairooz P. Manjandavida, Shaifali Chahar, Brijal Dave
Bony (intraosseous) myxomas are known to arise most commonly from dental elements of the jaw (odontogenic myxoma).15 Often they arise in the mandible, and less commonly in the maxilla, known as gnathic myxomas.16,17 Myxomas arising from other bony elements (osteogenic) are termed extra-gnathic.