PMC5824510_01
Intra oral extension of lesion with floating premolar within the lesion
JOMFP-22-2-g001.jpg
PMC5824510_01_JOMFP-22-2-g001.jpg
F1
On intraoral examination, the lesion extended from the mesial end of 37-33 region, mobility was observed with 35 appears to be floating within the lesion [Figure 1].
Ortho pantamo graph showing soap bubble appearance, and arrow mark showing eroded bone
JOMFP-22-2-g002.jpg
PMC5824510_01_JOMFP-22-2-g002.jpg
F2
The further patient was advised for radiographic investigations and routine hematological examination before incisional biopsy. ortho pantamo graph (OPG), computed tomography (CT) scan was taken, OPG revealed multilocular radiolucency with soap bubble appearance extending from the distal root of 37-41 regions. The teeth involved in the lesional area showed displacement and mild root resorption, along with bony erosion in left mandible body region [Figure 2].
Computed tomography image showing perforation of cortical plates of mandible
JOMFP-22-2-g003.jpg
PMC5824510_01_JOMFP-22-2-g003.jpg
F3
CT revealed radiolucency extending from the distal root of 37-41 regions with perforation of cortical plates [Figure 3].
Gross image showing glistening gelatinous creamy white tissue bits
JOMFP-22-2-g004.jpg
PMC5824510_01_JOMFP-22-2-g004.jpg
F4
On gross examination, the tissue bits were approximately measuring 2 cm x 2.5 cm, creamy white, round to oval in shape, soft gelatinous in consistency [Figure 4].
Spindle- or stellate-shaped mesenchymal cells within loose myxoid stroma. Arrow representing odontogenic epithelial islands (H&E, x40)
JOMFP-22-2-g005.jpg
PMC5824510_01_JOMFP-22-2-g005.jpg
F5
On histopathological examination, hematoxylin and eosin-stained sections showed spindle or stellate-shaped mesenchymal cells seen in loose myxoid stroma with few collagen fibrils, interspersed with odontogenic islands [Figure 5].
Arrow mark showing alcian blue positive mucoid material
JOMFP-22-2-g006.jpg
PMC5824510_01_JOMFP-22-2-g006.jpg
F6
Histochemical staining of mucoid stroma with alcian blue stain at pH2.5 showed positivity of the stromal component indicating the presence of acidic glycosamino glycans within the mucoid stroma confirming the diagnosis of odontogenic myxoma [Figure 6].
Photomicrograph showing negative reactivity for BCl2 marker
JOMFP-22-2-g007.jpg
PMC5824510_01_JOMFP-22-2-g007.jpg
F7
Further immunohistochemical analysis using BCl2 marker showed negativity of tumor cells [Figure 7].