Resection of Mandibular Tumor of Odontogenic Myxoma Type, A View on Modern Surgery: Case Report

Abstract

Introduction: Odontogenic myxoma (OM) is a benign, locally invasive neoplasm that affects the maxillomandibular complex and has a high recurrence rate. It accounts for an average of 8.3% of odontogenic tumors. Its clinical course is usually asymptomatic in the early stages; however, it may present with pain, paresthesia, tooth mobility, and limitations in mastication and swallowing in more advanced stages. Diagnosis includes imaging studies such as computed tomography (CT) and magnetic resonance imaging (MRI), which typically reveal multilocular radiolucent lesions described as having a "soap bubble" or "honeycomb" appearance. Due to the asymptomatic nature of the lesion, diagnosis is often delayed. Case report: We report the case of a 15-year-old male patient with no relevant medical history, presenting with a space-occupying lesion in the right mandibular body and ramus. Imaging studies raised the diagnostic suspicion of a possible odontogenic myxoma. Histopathological examination revealed a low-grade spindle cell tumor with extensive myxoid transformation, focal atypia, and no necrosis. Given the extension of the tumor, age of the patient, and degree of invasion, a wide surgical resection with safety margins was performed, followed by mandibular reconstruction using a custom-designed prosthesis based on three-dimensional imaging and a vascularized free fibula flap. Discussion: Extensive mandibular myxomas require a multidisciplinary approach and meticulous, individualized preoperative planning aimed at achieving optimal functional, aesthetic, and oncologic outcomes. Conclusion: This case highlights the importance of applying three-dimensional imaging technologies in the reconstructive surgery of complex maxillofacial lesions.