Odontogenic myxofibroma or myxoid neurofibroma?: a case report

 Odontogenic myxoma is a benign, uncommon odontogenic tumor that includes about 3 to 6% of odontogenic tumors and has an ectomesenchymal origin. It usually occurs in the second to fourth decade of life. Its common site is lower jaw and posterior parts. Treatment of lesion is complete surgical excision of tumor.

Case Report: 

The patient, a 17-year-old girl, complained of swelling of palate two months ago. In the panoramic radiograph, a single, multilocular, radiolucent lesion with relatively well demarcated borders was observed on left side of maxilla. The lesion had spread from midline to mesial of left second molar. The lesion was removed by osteoctomy. In microscopic examination, the possibility of myxoid neurofibroma was raised due to presence of wavy cells. Neurofibroma diagnosis was rejected by immunohistochemical method and odontogenic myxofibroma was diagnosed.

 In clinical and radiographic examination of this tumor, the possibility of a non-odontogenic lesion of nerve origin was raised, and in microscopic examination of excisional sample, due to the observation of wavy cells, the possibility of a myxoid neurofibroma was raised, but the IHC findings were not in favor of it. Therefore, definitive diagnosis requires relationship between clinical and radiographic findings and examination of various microscopic sections, and in case of doubt, IHC should be performed. Since odontogenic myxoma is a locally invasive lesion and has the potential for recurrence, its correct diagnosis is of great importance.