Mandibular Odontogenic Fibromyxoma: A Case Report of Clinical and Radiographic Presentations

Odontogenic fibromyxoma (OFM) is an uncommon benign neoplasm originating from the odontogenic ectomesenchyme. It exhibits a slow-growing yet locally aggressive behavior, most frequently presenting in young adults, although it can occur at any age and shows no significant gender predilection. Despite its clinical relevance, current research provides limited information regarding the risk factors, causative agents, and molecular pathways that contribute to its development and aggressive behavior. We present a case of OFM located in the mandible of a 38-year-old African male who reported a painless swelling in the right mandible extending from the first premolar to the second premolar. The clinical examination revealed a limited, firm, painless vestibular swelling in the region of teeth 44 and 45. The affected teeth exhibited normal vitality and physiological mobility. Radiographic imaging demonstrated a multilocular radiolucency with a "soap bubble" appearance, without evidence of root resorption. Histopathological analysis confirmed the diagnosis of odontogenic fibromyxoma, showing a proliferation of fibroblasts and myofibroblasts within a loose, myxomatous stroma rich in acid mucopolysaccharides, with scattered stellate cells displaying minimal pleomorphism. This case underscores the importance of a comprehensive diagnostic approach that integrates clinical, radiological, and histopathological findings to accurately identify OFM and distinguish it from other similar jaw lesions. Although conservative treatments such as enucleation with curettage offer notable benefits, the ideal surgical approach and follow-up protocol remain subjects of ongoing investigation. A more profound understanding of OFM's underlying pathogenesis could lead to improved treatment outcomes and guide future research on targeted therapeutic strategies.