Pathological and Molecular Features of Odontogenic Myxoma: A Systematic Review

Odontogenic myxoma (OM) is an intraosseous benign mesenchymal odontogenic neoplasm. It is slow-growing and it may determine an extensive and painless expansion of the bone. The aim of the present article is to review the literature regarding the pathological features of OM as well as the genetic, pathogenetic, and molecular aspects of this neoplasm. An electronic search of the search terms "oral myxoma" and "odontogenic myxoma" was performed in the PubMed and Scopus databases for articles published between January 1990 and July 2024. Based on the abstracts of the articles, the articles were included or excluded in the review. Finally, data were extracted from the selected articles. Demographic data, number of patients, localization of OMs, and pathological features were extracted from the studies. The systematic review showed that OM affects patients at an average age of 8.1-40.1 years, with a female and mandibular predilection. Most study populations have a mean age within the 20-29 years and the 30-39 years decades. Most of the case series presented conventional microscopic findings, including stellate to spindle-shaped cells in a loose mucoid and/or myxoid extracellular stroma with sparse collagen fibrils. Most of the included articles confirmed the positivity to vimentin and SMA, the negativity to GFAP, keratin, NSE, and S-100. The invasive behavior of OMs has not been clarified yet. Further studies about biomarkers related to OM development and invasiveness are needed, in order to develop new therapeutical conservative approaches for this locally aggressive neoplasm.