Odontogenic myxoma
A 26-year-old female patient reported with the chief complaint of a painless gradually progressive swelling in the lower left side of face, which was initially noticed as a small swelling in the lower left vestibule and grew to the present size within a span of one and a half years. There was no history of trauma. Past medical and dental histories were non-contributory.\nExtra-oral examination revealed a diffuse, non-tender, bony hard swelling of the left body region of mandible, approx. 3-4 cm in size []. No local rise in temperature or change in color of the overlying skin was seen. No lymphadenopathy was observed.\nOn intra-oral examination, a single well-defined localized swelling at left buccal as well as lingual vestibular region, extending from 34 to 37 region, with displacement of 35, 36 and mobility of 34, 35, 36 and 37, was observed. There was no erythema, ulceration or pus discharge in the overlying mucosa [].\nRadiographically, the Orthopantomograph (OPG) showed a multilocular radiolucency, extending antero-posteriorly from the midline to left ramus region, and supero-inferiorly from the alveolar process to the lower border of the mandible. Poorly defined radiolucent lesion causing slight cortical expansion, with fine trabeculae, some intersecting at right angles, were evident. Displacement of 34, 35, 36, root resorption of 34, 35, 36, 37, 38 as well as scalloping between the roots of the involved teeth, was also apparent [].\nThe lesion was biopsied and submitted to the Department of Oral Pathology with the provisional diagnosis of ameloblastoma or odontogenic keratocyst (OKC).\nOn macroscopic examination, the biopsy specimen was in multiple pieces, 1–2 cm in size, whitish in color, transparent and slippery in nature and soft in consistency. On microscopic examination, H and E stained section revealed loosely arranged stellate-shaped cells with intermingled fibrillar processes in a homogenous mucoid ground substance with few collagen fibrils and capillaries [Figures and ]. Very few scattered odontogenic epithelial rests, areas of hemorrhage, and foci of bony trabeculae were visible. Odontogenic myxoma was the definitive diagnosis.