DIAGNOSIS OF ODONTOGENIC MYXOMA

Abstract

Odontogenic myxoma (OM) is a rare benign neoplasm of ectomesenchymal origin (or mesenchymal origin associated with the dental apparatus), locally aggressive and invasive. It preferentially affects the bones of the maxilla and mandible in young adults, with a slight predominance in females. OM initially presents as a slow-growing and asymptomatic lesion, but it may exhibit an infiltrative behavior that results in bone destruction, cortical expansion, and facial deformity. Despite its benign histological nature, the lesion has significant destructive potential and a high recurrence rate when treated conservatively. The definitive diagnosis is challenging due to the absence of pathognomonic signs and the similarity of its clinical and radiographic features to other osteolytic or odontogenic benign and malignant lesions, requiring careful integration of histopathological data. Recent studies indicate that factors such as radiographic pattern, tumor extent, histological characteristics, and biological behavior are directly related to prognosis and recurrence risk; therefore, early identification and integrated analysis of clinical, imaging, and histopathological data are essential for appropriate therapeutic planning. This article, therefore, presents an updated narrative review on the diagnosis of odontogenic myxoma, with emphasis on clinical presentations, radiographic findings, main differential diagnoses, the role of immunohistochemistry, and diagnostic implications in defining surgical extent and recurrence risk, aiming to review the main diagnostic criteria, indicators of tumor aggressiveness, advanced imaging methods, and relevant histological aspects for treatment definition and clinical follow-up.