Answer for CoW 24 Sep 2017
Odontogenic myxoma
Findings
Large,expansile,multiloculated,hypodense cystic lesion with lytic component – soap bubble appearance extending from the periapical region of 13th teeth on right side;posteriorly lesion is seen to reach posterior wall of maxilla . In craniocaudal direction, lesion extends from alveolar crest to reach upto floor of orbit with obliteration of right maxillary sinus; orbital rim is intact. Marked bulging of buccal cortex with indent thinning to perforation seen along the posterior and lateral aspect of the lesion. Fine trabeculae seen along the periphery of the lesion Right 2nd and 3rd molar not visualized Resorption of right premolar noted HPE: Shows myxoid stromainterspersed with spidle or stellate shaped cells.The section also shows residual bony fragments.HPE consistent with the diagnosis of odontogenic myxoma.
Discussion
Epidemiology seen in 2nd to 3rd decades of life(earlier than ameloblastoma) They are not usually painful Arises from mesenchymal odontogenic tissue. Radiographic appearance : “soap bubble” – appearing lytic septated cystic lesion of the mandible (similar to ameloblastoma)
DD: Ameloblastoma Calcifying epithelial odontogenic tumour
Findings
Large,expansile,multiloculated,hypodense cystic lesion with lytic component – soap bubble appearance extending from the periapical region of 13th teeth on right side;posteriorly lesion is seen to reach posterior wall of maxilla . In craniocaudal direction, lesion extends from alveolar crest to reach upto floor of orbit with obliteration of right maxillary sinus; orbital rim is intact. Marked bulging of buccal cortex with indent thinning to perforation seen along the posterior and lateral aspect of the lesion. Fine trabeculae seen along the periphery of the lesion Right 2nd and 3rd molar not visualized Resorption of right premolar noted HPE: Shows myxoid stromainterspersed with spidle or stellate shaped cells.The section also shows residual bony fragments.HPE consistent with the diagnosis of odontogenic myxoma.
Discussion
Epidemiology seen in 2nd to 3rd decades of life(earlier than ameloblastoma) They are not usually painful Arises from mesenchymal odontogenic tissue. Radiographic appearance : “soap bubble” – appearing lytic septated cystic lesion of the mandible (similar to ameloblastoma)
DD: Ameloblastoma Calcifying epithelial odontogenic tumour
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!