Odontogenic myxoma (OM) is a rare locally invasive benign neoplasm, almost exclusively occurring in the jawbones, comprising 3-6% of all the odontogenic tumors. The mandible is more commonly involved than the maxilla. Intraoral soft tissue myxoma is an extremely rare lesion and only few reports are available in the literature. We present probably the first of its kind in literature a soft tissue OM occurring in an unusual location: the infratemporal fossa.

Background Intracranial dermoid cysts are rare tumors of congenital origin. We report a case of a large dermoid tumor arising in the infratemporal fossa (ITF) with erosion into the middle cranial fossa. After reviewing the literature, we believe this represents the first reported dermoid tumor of the ITF with extension into the middle cranial fossa. Results A 21-year-old women presented with a large cystic mass involving the left infratemporal fossa and middle cranial fossa that was discovered following a motor vehicle collision. Neurologic examination was normal. The mass was resected through a frontotemporal extradural approach with endoscopic assistance. Imaging studies, gross findings, and histopathology were consistent with a dermoid tumor. Conclusion This is the first report of a dermoid cyst arising in the ITF with extension into the middle cranial fossa. We suggest including dermoid tumor in the differential diagnosis of cystic abnormalities in this region. Complete resection of the cyst remains the preferred treatment with surgical approach guided by preoperative imaging.

Tumors occurring in the infratemporal region present a surgical challenge and access osteotomies of the facial skeleton is the answer to access these deeply situated, inaccessible tumors of the head and neck. Various approaches have been devised for their better exposure and it is our expertise as maxillofacial surgeons to provide surgical access by transmaxillary, transzygomatic and transmandibular approaches. We followed this concept in our institute and report here two case reports. The first is a 45-year-old female who presented with right facial pain and temporal swelling due to schwannoma in the right infratemporal region extending into middle cranial fossa. This was jointly treated by a team of neurosurgeons, maxillofacial surgeons and ENT surgeons by right temporal craniotomy, right transmandibular and transzygomatic approach. The second is a rare tumor occurring in a 26-year-old male with the chief complaint of right frontal headache and diplopia. The tumor was excised via access through the zygomatic arch and lateral orbital wall; diagnosed later as Rosai Dorfmans disease. No recurrence was seen at follow-up period of 2 years. These approaches help to reduce the surgical morbidity. Thus, oral and maxillofacial surgeons form a vital role in the multidisciplinary approach to provide access to difficult anatomic locations.