Dr Bhavik Miyani, Resident Doctor in Department of Oral & Maxillofacial Surgery, Narsinhbhai Patel Dental College & Hospital, SPU, Visnagar.

1. Odontogenic Fibromyxoma of
Maxilla Case Report- A Rare Entity
DR. BHAVIK MIYANI, DEPARTMENT OF OMFS, NPDCH

2. CONTENTS
 Introduction
 Case Report
 Conclusion
 References

3.  Fibromyxomas of head and neck are rare, non
capsulated, benign neoplasms which consist either
partly or wholly of myxomatous tissue, depending upon
the amount of collagen which is present.
 The term “odontogenic myxoma” is often applied
when the tumor occurs in the jaws to reflect its
odontogenic origin.
INTRODUCTION
Thoma and Goldman, 1947

4.  Myxomas can be found in heart, skin, and
subcutaneous tissue and centrally in the bone, but
myxomas of the jaws are encountered rarely. It accounts
for only 1% to 3% of all cysts and tumors of the jaws.
 We report a case of odontogenic fibromyxoma of the
maxilla in a 25-years old female patient.

5.  A 25 years old female patient
reported to the Department of Oral
and Maxillofacial Surgery with a
chief complaint of swelling in
upper right front region of jaw
since 1 year.
CASE REPORT

6.  Patient was relatively asymptomatic before one year.
 Then patient developed swelling in right front side of upper jaw
which was an symptomatic.
 The swelling was initially small and gradually increased to its
present size of approximately 3 x 2 cm.
 There was no preceding history of trauma, fever, dental trouble
or the nasal obstruction.
 H/O - Maxillary sinusitis since six months.
HISTORY OF PRESENET ILLNESS

7. EXTRA-ORAL EXAMINATION

8. INTRA-ORAL EXAMINATION

9.  Adenomatoid Odontogenic Tumor
PROVISIONAL DIAGNOSIS

10. FIBRO- OSSEOUS
DIFFERENTIAL DIAGNOSIS

11. DIFFERENTIAL DIAGNOSIS
ADENOMATOID
ODONTOGENIC
TUMOR
ANTRAL
POLYP
FIBRO-
OSSEOUS
LESION
AMELOBLASTIC
FIBROMA
ODONTOGENIC
FIBROMYXOMA
AMELOBLASTIC FIBROMA
× Etiology: Arising from the enamel organ or dental
lamina.
× Age: 1st and 2nd Decades of life.
× Gender Predilection: Male> Female.
× Site: Posterior Mandible F/B Posterior Maxilla.
 Painless, Slow Growing Swelling.
× Associated with Impacted tooth.
× Radiographic Findings: Unilocular Lesion.

12. DIFFERENTIAL DIAGNOSIS
ADENOMATOID
ODONTOGENIC
TUMOR
ANTRAL
POLYP
FIBRO-
OSSEOUS
LESION
AMELOBLASTIC
FIBROMA
ODONTOGENIC
FIBROMYXOMA
ADENOMATOID ODONTOGENIC TUMOR
× Etiology: Arising from the enamel organ or dental
lamina.
 Age: Young People.
 Gender Predilection: Female: Male = 2:1.
 Site: Anterior Maxilla: Anterior Mandible = 2:1.
× Associated with Impacted tooth (Mostly Canine).
 Painless Swelling, Slow Growing.
× Radiographic Findings: Radiolucency extends apically
beyond CEJ of unerupted tooth.

13. DIFFERENTIAL DIAGNOSIS
ADENOMATOID
ODONTOGENIC
TUMOR
ANTRAL
POLYP
FIBRO-
OSSEOUS
LESION
AMELOBLASTIC
FIBROMA
ODONTOGENIC
FIBROMYXOMA
ANTRAL POLYP
× Etiology: Recurrent Allergic Diseases.
× Age: Children and Young Adult.
× Gender Predilection: Female: Male = 1:2.
 Site: Unilaterally in Maxillary Sinus.
 Nasal Obstruction.
 CT Scan Findings: Expansion or Erosion of
bony wall.

14. DIFFERENTIAL DIAGNOSIS
ADENOMATOID
ODONTOGENIC
TUMOR
ANTRAL
POLYP
FIBRO- OSSEOUS
LESION
AMELOBLASTIC
FIBROMA
ODONTOGENIC
FIBROMYXOMA
FIBRO- OSSEOUS LESION
× Etiology: Genetic.
× Age: Children are more affected.
 Gender Predilection: Female: Male = 1:1.
× Site: Maxilla< Mandible.
× Associated with Impacted tooth.
 Painless Swelling, Slow Growing.
× Radiographic Findings: Expansion of Bony
walls and Cotton wool appearance.

15. DIFFERENTIAL DIAGNOSIS
ADENOMATOID
ODONTOGENIC
TUMOR
ANTRAL
POLYP
FIBRO-
OSSEOUS
LESION
AMELOBLASTIC
FIBROMA
ODONTOGENIC
FIBROMYXOMA
ODONTOGENIC FIBROMYXOMA
 Etiology: Arising from Odontogenic epithelium
or ectomesenchymal origin.
 Age: 2nd to 3rd decades of life.
 Gender Predilection: Female: Male = 2:1.
 Site: Posterior Mandible F/B Posterior Maxilla.
 Painless, Slow Growing.
 Radiographic Findings: Honey Comb Appearance
and Expansion of Bony walls.
ODONTOGENIC
FIBROMYXOMA

16. INVESTIGATIONS
 Routine blood investigations.
 Radiological investigations.
1. OPG
2. CT Scan
 Histopathological investigations.

17. Complete Obliteration of Right Maxillary Sinus with irregular, diffuse haziness
OPG

18. CT Coronal and Axial Scan Showing Complete Obliteration of Right Maxillary Sinus And Lesion size of 5 X 4 cm.
CT SCANCT SCAN

19. HISTOPATHOLOGY
Histopathology Photograph showing Loose Myxoid Stroma with Interspersed Dense Collagen
Bundles and Numerous Stellate to Plump Spindle Shaped Cells in the Stroma

20. Odontogenic Fibromyxoma of Maxilla
FINAL DIAGNOSIS

21.  Enucleation and Curettage of lesion including radical
resection including a margin of 1.5-2 mm healthy
bone using crevicular incision under general
anesthesia.
 Long term follow up because higher recurrence rate.
TREATMENT PLAN

22. 1. Incision Marking 2. Reflection and Exposure of Site
4. Complete Curettage of Lesion
Showing Empty Cavity
6. Closure5. Resected Specimen
3. Enucleation of Lesion
TREATMENT GIVEN

23. Healing after 1 month
POST OPERATIVE

24. Reported cases of fibromyxoma of the maxilla in literature

25.  Myxomas of head and neck are rare tumors and the maxilla
is a rare location of a fibromyxoma.
 It poses a diagnostic and therapeutic challenge hence
correlation of clinical, radiological and histopathological
features are essential when trying to diagnose lesions which
lack the characteristic appearance.
 Its management is surgical, and ranges from enucleation and
curettage to complete resection and peripheral osteotomy
according to its size. In this young married woman as the
extent of lesion was confined to the maxillary sinus, we have
operated for an intraoral surgical approach.
CONCLUSION

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