Pathophysiology
In odontogenic myxomas, an average of 6.5% of cells were positive for Bcl-2 and 10.4% for Bcl-XL, significantly higher than the control tissue which showed only 1.1% and 1.2% positivity, respectively [PMID:14663812].
Epidemiology
The study reported a cohort of 61 patients with a 2.2:1 female-to-male ratio and a mean age of 34.5±15.4 years [PMID:38922493].
Clinical Presentation
Most cases (70.6%) presented as painless swelling, with 59.7% located in the mandible [PMID:38922493].
This case [PMID:22976683] highlights an extensive odontogenic myxoma affecting the left mandibular angle, ascending ramus, and symphysis, underscoring the tumor's locally aggressive nature.
Diagnosis
The overexpression of Bcl-2 and Bcl-XL proteins, as demonstrated by immunohistochemical analysis, may serve as a diagnostic marker to differentiate odontogenic myxomas from other benign jaw tumors [PMID:14663812].
Management
Surgical resection was the most common treatment (65.2%), while enucleation had the highest recurrence rate at 57.1% among those with outcomes available [PMID:38922493].
In a case study [PMID:22976683], a 20-year-old patient with a large odontogenic myxoma involving the left mandibular angle, ascending ramus, and symphysis was treated with radical resection and titanium reconstruction using a condylar prosthesis, resulting in functional recovery and no recurrence.
While the study primarily focused on apoptotic proteins, it also evaluated matrix metalloproteinases (MMPs) in odontogenic myxomas, suggesting potential avenues for therapeutic interventions aimed at inhibiting tumor invasion [PMID:14663812].
Prognosis & Follow-up
The patient described in [PMID:22976683] did not experience tumor recurrence post-surgery, indicating a favorable prognosis with appropriate surgical intervention and reconstruction.
References
1 de Melo PRE, de Lima WP, Cavalcante IL, Cruz VMS, Cavalcante RB, Turatti E et al.. Clinicopathologic and imaging features of odontogenic myxomas: a multi-institutional study. Oral and maxillofacial surgery 2024. link 2 De Melo WM, Pereira-Santos D, Brêda MA, Sonoda CK, Hochuli-Vieira E, Serra e Silva FM. Using the condylar prosthesis after resection of a large odontogenic myxoma tumor in the mandible. The Journal of craniofacial surgery 2012. link 3 Bast BT, Pogrel MA, Regezi JA. The expression of apoptotic proteins and matrix metalloproteinases in odontogenic myxomas. Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons 2003. link