ABSTRACT
Odontogenic myxoma is a rare tumor, often diagnosed during routine radiographs or when it is so severe that it causes pain, a noticeable increase in volume or tooth displacement and mobility. Young adults (25-30 years of life) are more often affected by the lesion but all ages are vulnerable. The mandible is more commonly involved than the maxilla and the tumors usually grow slowly and silently. However, growth can be rapid and destructive. The radiographic aspect of a myxoma is that of a uni or multilocular, radiolucent lesion reminiscent of honeycomb or soap bubbles, depending on its size. It is an expansive tumor that may cause displacement or resorption of the teeth involved. Microscopically, the tumor is composed of round and spindle cells, with a star arrangement, arranged in a loose abundant myxoid stroma, containing only a few collagen fibrils. The treatment of choice is radical surgical excision because myxomas are not encapsulated and tend to infiltrate the surrounding bone. However, small tumors can be treated by curettage. Periodic reassessment is required for at least five years due to the high rate of recurrence. Larger tumors may need to be treated using a more extensive resection with a safety margin. This study reports a clinical case of odontogenic myxoma in a child aged 7 years. The tumor was located in the posterior region of the mandible and was surgically treated with an en bloc resection with preservation of the base of the mandible. The follow-up of the case is ongoing and no recurrence has been observed to date.
Subject(s)
Humans , Male , Female , Child , Pathology , Odontogenic TumorsABSTRACT
O cementoblastoma benigno (CB) é um tumor odontogênico raro, de crescimento lento e ilimitado. Ocorre mais frequentemente em caucasianos, entre as 2ª e 3ª décadas de vida, sem predileção por gênero. Mais comum na mandíbula, área de molares e pré-molares, geralmente envolve o primeiro molar permanente. Em imagem radiográfica, apresenta massa radiopaca delimitada por delgada linha radioluscente, simulando uma hipercementose. Em cortes histológicos, assemelha-se fortemente com osteoma osteoide, osteosarcoma ou osteoblastoma benigno. O objetivo do presente trabalho foi descrever um caso incomum de cementoblastoma. I.D.S., gênero masculino, melanoderma, 32 anos que compareceu ao ambulatório do Grupo de Apoio Aprendizes do Amor Cristão - GAAAC, Brasília - DF, sem queixa de dor, portando lesão na região do 2º molar mandibular esquerdo, apresentando imagem radiográfica sugestiva de cementoblastoma. O tratamento consistiu na remoção completa da lesão acompanhada de extração do dente 37. Após dois anos, observou-se a remissão dos sinais, não havendo recorrência do tumor. O caso relatado apresentou como variante incomum ter acometido indivíduo da raça negra, relacionado ao 2º molar mandibular esquerdo - 3%. O sítio de localização atípico e as discrepâncias encontradas entre o presente relato e a literatura reforçam a importância do diagnóstico e a pesquisa por novas evidências relacionadas ao cementoblastoma.
The cementoblastoma benign (CB) is a rare odontogenic tumor, slow growth and unlimited. It occurs more frequently in caucasians, between 2nd and 3rd decades of life, with no predilection for gender. More common in the mandible area of molars and premolars, usually involving the first permanent molar. In radiographic image shows a radiopaque mass bounded by thin radiolucent line simulating a hypercementosis. Using histological resembles strongly with osteoid osteoma, osteosarcoma and benign osteoblastoma. The aim of this study was to describe an unusual case of cementoblastoma. IDS, male, melanoderma, 32 years old, came to the Grupo de Apoio Aprendizes do Amor Cristão - GAAAC, Brasília - DF, without pain, with a lesion in the 2nd left molar region, presenting radiographic image suggestive of cementoblastoma. The treatment consisted of complete removal of the lesion accompanied by the extraction of the tooth 37. After two years, there was remission of signs, with no tumor recurrence. This case presents unusual variant as the fact that it involved an individual of black, related to 2nd left mandibular molar - 3%. The rarity of the condition and the discrepancies found between this case and the literature of reinforce even more the importance of any new evidence related to cementoblastoma.