Maxillo Facial Surgery Department, University Hospital Center Mohammed VI, Marrakech, Morocco.
Pan Afr Med J. 2022 Jun 8;42:103. doi: 10.11604/pamj.2022.42.103.34690. eCollection 2022.
Maxillary myxomas are rare benign odontogenic tumors with a high potential for infiltration and destruction. Clinical and radiological manifestations are variable and non-specific and often lead to confusion with other benign and malignant lesions. We present here two cases of odontogenic myxoma of different localization (maxilla and mandible). In both cases, the patient presented with a progressively enlarging facial swelling without any neurologic disturbance or lymph nodes. On computed tomography, the lesions appeared as a large unilocular, homogeneous image causing a cortical thinning and rupture along with repression of surrounding tissues. The clinical and radiological features were poorly suggestive of precise nature, and only histological examination of biopsy specimen was able to reveal the diagnosis of myxoma. Given the large size of the tumors and the locally aggressive pattern, we have opted for large maxillecetomy and marginal mandibulectomy. In conclusion, myxoma is a slow growing but locally aggressive tumor that the clinician should keep in mind. As there is a lack of consensus regarding their treatment, we can suggest a conservative treatment for small non-extensive lesions, which consists of enucleation and curettage of the tumor; and a radical excision in case of large tumors given the high risk of recurrence.
上颌部黏液瘤是一种罕见的良性牙源性肿瘤，具有高度浸润和破坏的潜力。临床表现和影像学表现多样且非特异性，常导致与其他良性和恶性病变混淆。我们在此介绍两例不同部位（上颌和下颌）的牙源性黏液瘤病例。在这两例患者中，患者均表现为逐渐增大的面部肿胀，无任何神经功能障碍或淋巴结肿大。在计算机断层扫描（CT）上，病变表现为一个大的单房性、均匀的图像，导致皮质变薄和破裂，同时压迫周围组织。临床和影像学特征提示性质不明确，只有活检标本的组织学检查才能明确诊断为黏液瘤。鉴于肿瘤的体积较大且具有局部侵袭性，我们选择了上颌骨切除术和下颌骨边缘切除术。总之，黏液瘤是一种生长缓慢但具有局部侵袭性的肿瘤，临床医生应牢记这一点。由于缺乏对其治疗的共识，我们可以建议对小的非广泛性病变进行保守治疗，即肿瘤的剜除和刮除；对于大的肿瘤，由于复发风险较高，建议进行根治性切除。
