Odontogenic myxoma. Surgical management and an ultrastructural study.

Odontogenic myxoma is a tumor of primitive mesenchyme, probably derived from the dental apparatus. Surgical management of this benign but locally aggressive tumor is either by curettage or en bloc resection. Two cases of odontogenic myxoma of the mandible are reported. In one case, en bloc resection. Two cases of odontogenic myxoma of the mandible are reported. In one case, en block resection with immediate reconstruction was undertaken. In the second case, the neoplasm was thoroughly curetted. The first case was studied by electron microscopy. Six ultrastructural studies of seven odontogenic myxomas have been previously reported. The ultrastructural features of odontogenic epithelium that may be present in myxomas of the jaws have been examined by electron microscopy once before. Our observations are in agreement with those of other workers who suggest that the connective tissue cell is the proliferating component of the tumor and is very similar to a fibroblast but has enough ultrastructural and functional features to deserve the term myxoblast. The majority of the tumor cells are metabolically active and secretory and there is adequate evidence that the tumor matrix consists of large amounts of mucopolysaccharides. It is reasonable, therefore, to conclude that myxoblasts secrete the mucoid matrix that is so characteristic of odontogenic myxomas. Unlike normal or neoplastic fibroblasts, the myxoblasts are not engaged in abundant synthesis of banded collagen throughout the entire lesion.