Nguyen Truc Thi Hoang, Eo Mi Young, Cho Yun Ju, Myoung Hoon, Kim Soung Min
Department of Oral and Maxillofacial Surgery, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea.
J Korean Assoc Oral Maxillofac Surg. 2021 Apr 30;47(2):112-119. doi: 10.5125/jkaoms.2021.47.2.112.
Myxomatous odontogenic tumors (MOTs) are the third most common odontogenic tumors in the oral and maxillofacial region. Due to its slow-growing, but locally invasive nature, the tumor is usually detected by accident or only when it becomes a large mass, which causes facial deformity.
Current study reports three unusual cases of MOT including huge myxoma involve the mandible in middle-aged man, MOT with ossifying fibroma pattern in mandible, and MOT in maxilla of young female patient. The diagnosis and treatment strategy of MOTs was also summarized and updated.
In reported three cases of patients with large MOTs, surgical treatment was indicated with fibular free flap reconstruction in the mandible and plate reconstruction in the maxilla. The tumors were successfully treated with radical resection and did not show signs of recurrence during the follow-up period.
Surgical treatment indication depends on size, the position of the lesion, patient systemic condition and surgeon individual experience. In the case of a large tumor, radical resection and reconstruction is the standard surgical strategy. The conservative surgical treatment including enucleation with wide curettage is still under controversy. The recurrence rate for MOTs is significantly high, up to 30%, therefore long-term follow-up is essential.
黏液瘤样牙源性肿瘤(MOTs)是口腔颌面部第三常见的牙源性肿瘤。由于其生长缓慢但具有局部侵袭性,该肿瘤通常是偶然发现的,或者只有在它长成大肿块导致面部畸形时才被发现。
本研究报告了3例不寻常的MOT病例,包括累及中年男性下颌骨的巨大黏液瘤、下颌骨具有骨化性纤维瘤样表现的MOT以及年轻女性患者上颌骨的MOT。还总结并更新了MOTs的诊断和治疗策略。
在所报告的3例患有大型MOTs的患者中,手术治疗方案为下颌骨采用游离腓骨瓣重建,上颌骨采用钢板重建。肿瘤通过根治性切除成功治疗,随访期间未显示复发迹象。
手术治疗指征取决于肿瘤大小、病变位置、患者全身状况和外科医生的个人经验。对于大型肿瘤,根治性切除和重建是标准的手术策略。包括广泛刮除术的保守手术治疗仍存在争议。MOTs的复发率显著较高,高达30%,因此长期随访至关重要。