Odontogenic Myxoma Histology — ORE Part 1 MCQ
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Correct answer: D — Odontogenic myxoma
The diagnosis is odontogenic myxoma. The histopathological finding of myxoid stroma containing stellate and spindle-shaped cells is pathognomonic for this rare benign odontogenic tumor. This distinctive mesenchymal histology differentiates odontogenic myxoma from ameloblastoma (which shows epithelial strands in fibrous stroma), central giant cell granuloma (which shows giant cells and haemosiderin), odontogenic keratocyst (which shows epithelial lining with parakeratinised squamous epithelium), and dentigerous cyst (which shows simple epithelial lining). Although the radiographic appearance of a multilocular 'soap bubble' or 'honeycomb' lesion with scalloped borders can overlap with ameloblastoma and odontogenic keratocyst, the definitive histological features of abundant myxoid matrix with stellate and spindle cells uniquely identify odontogenic myxoma. The mandibular molar location is typical, and radiographic-histological correlation is diagnostic.
Reference: Li TJ, Sun LS, Luo HY. Odontogenic myxoma: a clinicopathologic study of 25 cases. Archives of Pathology & Laboratory Medicine. 2006;130(12):1799–806. PMID: 17149957. https://pubmed.ncbi.nlm.nih.gov/22011900/