Abstract：
OBJECTIVE: This study aims to report clinicopathologic and imaging features of odontogenic myxomas (OM), highlighting uncommon findings.
METHODS: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed.
RESULTS: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%).
CONCLUSIONS: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.
METHODS: Clinicopathologic and imaging data of OMs diagnosed in the five Brazilian diagnostic pathology centers were collected and analyzed.
RESULTS: The series comprised 42 females (68.9%) and 19 males (31.1%), with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years (range: 4-80). Clinically, most OMs presented as painless intraoral swelling (n = 36; 70.6%) in the mandible (n=37; 59.7%). Multilocular lesions (n=30; 83.3%) were more common than unilocular lesions (n=6; 16.7%). There was no statistically significant difference between the average size of unilocular and multilocular OMs (p=0.2431). The borders of OMs were mainly well-defined (n=24; 66.7%) with different degrees of cortication. Only seven tumors caused tooth resorption (15.9%), while 24 (54.5%) caused tooth displacement. Cortical bone perforation was observed in 12 (38.7%) cases. Morphologically, OMs were characterized mainly by stellate or spindle-shaped cells in a myxoid background (n=53; 85.5%). Surgical resection was the most common treatment modality (n=15; 65.2%), followed by conservative surgery (n=8; 34.8%). Outcomes were available in 20 cases (32.3%). Seven of these patients had local recurrence (35%). Enucleation was the treatment with the highest recurrence rate (4/7; 57.1%).
CONCLUSIONS: OM has a predilection for the posterior region of the jaws of female adults. Despite their bland morphological appearance, they displayed diverse imaging features. Clinicians must include the OM in the differential diagnosis of osteolytic lesions of the jaws. A long follow-up is needed to monitor possible recurrences.
摘要：
目的：本研究旨在报告牙源性粘液瘤（OM）的临床病理和影像学特征，突出不寻常的发现。
方法：收集并分析在巴西五个诊断病理中心诊断的OMs的临床病理和影像学资料。
结果：该系列包括42名女性（68.9％）和19名男性（31.1％），男女比例为2.2：1，平均年龄为34.5±15.4岁（范围：4-80）。临床上,大多数OMs表现为下颌骨无痛性口内肿胀（n=36；70.6％）（n=37；59.7％）。多房性病变（n=30；83.3％）比单眼病变（n=6；16.7％）更常见。单眼和多房OMs的平均大小之间没有统计学上的显着差异（p=0.2431）。OMs的边界主要是明确的（n=24；66.7％），具有不同程度的皮质化。只有7个肿瘤引起牙齿吸收（15.9%），而24(54.5%)引起牙齿移位。皮质骨穿孔12例(38.7%)。形态学上,OMs的特征主要是粘液样背景下的星状或纺锤形细胞（n=53；85.5％）。手术切除是最常见的治疗方式（n=15；65.2％），其次是保守性手术(n=8;34.8%)。20例（32.3%）有结果。这些患者中有7例局部复发（35％）。摘除术是复发率最高的治疗方法（4/7；57.1％）。
结论：OM对成年女性颌骨的后部区域具有优势。尽管它们的形态外观平淡，他们表现出多样化的成像特征。临床医生必须在颌骨溶骨性病变的鉴别诊断中包括OM。需要长时间的随访以监测可能的复发。
方法：收集并分析在巴西五个诊断病理中心诊断的OMs的临床病理和影像学资料。
结果：该系列包括42名女性（68.9％）和19名男性（31.1％），男女比例为2.2：1，平均年龄为34.5±15.4岁（范围：4-80）。临床上,大多数OMs表现为下颌骨无痛性口内肿胀（n=36；70.6％）（n=37；59.7％）。多房性病变（n=30；83.3％）比单眼病变（n=6；16.7％）更常见。单眼和多房OMs的平均大小之间没有统计学上的显着差异（p=0.2431）。OMs的边界主要是明确的（n=24；66.7％），具有不同程度的皮质化。只有7个肿瘤引起牙齿吸收（15.9%），而24(54.5%)引起牙齿移位。皮质骨穿孔12例(38.7%)。形态学上,OMs的特征主要是粘液样背景下的星状或纺锤形细胞（n=53；85.5％）。手术切除是最常见的治疗方式（n=15；65.2％），其次是保守性手术(n=8;34.8%)。20例（32.3%）有结果。这些患者中有7例局部复发（35％）。摘除术是复发率最高的治疗方法（4/7；57.1％）。
结论：OM对成年女性颌骨的后部区域具有优势。尽管它们的形态外观平淡，他们表现出多样化的成像特征。临床医生必须在颌骨溶骨性病变的鉴别诊断中包括OM。需要长时间的随访以监测可能的复发。
