Presentation
Swollen right maxilla.
Patient Data
Bubbly lytic lesion in the right-side of the maxilla, maximal transaxial dimensions are approximately 26 x 20 mm.
Further separate unilocular cystic lesion in the left side of maxilla just lateral to the midline. This measures approximately 12 mm in maximal dimension. Immediately adjacent to it, there is a cavity related to a recent extraction of the left maxillary tooth. The cystic lesion also surround the root of the second left maxillary incisor. It is presumably related to periapical disease. However, given the close proximity of the biopsy-proven malignant lesion, this is not definitive.
There is no adjacent soft tissue abnormality on soft tissue windows. The deep structures of the neck appear unremarkable. The mucosal spaces appear unremarkable.
Bubbly lytic lesion in the right-sided of the maxilla.
Case Discussion
Odontogenic myxomas are rare tumors that involve the mandible or maxilla and account for 3-6% of odontogenic tumors.
Typically seen in the 2nd to 3rd decades of life (slightly earlier than ameloblastomas). They are usually not painful.
The radiographic appearance is very similar to that of an ameloblastoma: a "soap bubble" lytic septated cystic lesion of the mandible.
Wide marginal excision is the treatment of choice. Local recurrence can occur.
Differential diagnoses:
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