Treatment of Recurrent Mandibular Myxoma by Curettage and Cryotherapy after Thirty Years

Odontogenic myxoma is a slow-growing, painless, and site-aggressive tumor. Large-sized lesions may cause tooth dislodgement and cortical bone expansion. Since pain and hypoesthesia are not common, the lesion may reach a considerable size before the patient perceives its existence and seeks treatment. This lesion is not encapsulated, thus promoting significant infiltration into the adjacent medullar bone. In addition, this condition carries a high recurrence rate. The treatment of choice for this condition is surgical excision by either enucleation, curettage, or block resection. The average recurrence rate is 25%, especially when more conservative treatments are used. Cryotherapy has been used in the maxillofacial region for the removal of neoplasias or abnormal cell elements with no need for extensive segmental resection. Liquid nitrogen is the most efficient type of freezing spray available for bone cryosurgery. The most commonly observed complications associated with cryotherapy are pathologic fractures and bone sequestra. This paper reports the case of a recurrent mandibular myxoma diagnosed 30 years after the initial lesion treatment, and discusses the possibility of conservative management of extensive odontogenic lesions with high recurrence rates. CASE REPORT