The Rare Radiographic Sunburst Appearance of Odontogenic Myxomas: A Case Report and Review of the Literature
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CASE REPORTS
The Rare Radiographic Sunburst Appearance of Odontogenic Myxomas: A Case Report and Review of the Literature Jamie A. White1 · Naomi Ramer1 · Todd R. Wentland1 · Molly Cohen1 Received: 4 November 2019 / Accepted: 19 December 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Odontogenic myxomas often have a distinctive radiographic presentation described as a “soap bubble”, “tennis racket”, or “honeycomb” pattern. Less frequently, examples of odontogenic myxomas with a “sunray” or “sunburst” pattern have been reported. Because malignant entities such as osteosarcomas more classically present with a sunray/sunburst appearance, odontogenic myxomas are rarely considered in the radiographic differential diagnosis of a sunburst lesion. The objective of this paper is to report a case of an odontogenic myxoma presenting with a sunburst appearance and to review similar reported cases in the literature. To the best of the authors’ knowledge, this additional case of an odontogenic myxoma presenting with a sunburst appearance brings the total number of sunray/sunburst cases reported in the English language literature to 21. Keywords Odontogenic tumor · Myxoma · Radiography · Diagnostic imaging · Sunray · Sunburst
Introduction The odontogenic myxoma (OM) is a benign, intraosseous neoplasm that arises from odontogenic ectomesenchyme [1]. Histologically, the OM resembles the dental papilla and consists of stellate, spindle-shaped, and round cells with long, pale cytoplasmic processes [1–3]. These cells are evenly distributed in an abundant and loose myxoid stroma containing varying amounts of collagen [1, 2]. OMs most commonly occur in the posterior mandible, and the average age of patients is 25 to 30 years old [2]. Some literature states there is no sex predilection [2], while others have found the OM to be up to twice as common in females [3]. Radiographically, the OM can appear as unilocular or multilocular radiolucencies, and has well-known patterns including “soap bubble”, “tennis racket”, and “honeycomb” [3]. The * Jamie A. White [email protected] Naomi Ramer [email protected] Todd R. Wentland [email protected] Molly Cohen [email protected] 1
Mount Sinai Hospital, 1 Gustave L. Levy Place, New York, NY 10029, USA
“sunray” or “sunburst” radiographic appearance of OMs has been infrequently reported in the English language literature with only 20 cases reported to date [4–18]. Although it is rare for the OM, a benign tumor, to display a sunray or sunburst pattern it is a classic presentation for some malignancies such as osteosarcomas [1, 19]. The objective of this paper is to report a case of an OM displaying a radiographic sunburst appearance, provide a review of the literature on this uncommon presentation, and discuss the prognosis and recurrence of this radiographic variant.
Case Report A 34-year-old male presented to the oral surgery department at Mount Sinai Hospital with mild expansion of the left posterior mandible. He stated
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