Pitfalls in Differential Diagnosis of Pediatric Periapical Lesions: A Case of Maxillary Odontogenic Myxoma

Abstract

Radiolucent lesions in pediatric patients are frequently presumed to be inflammatory in origin. However, certain odontogenic tumors may present with similar clinical and radiographic features, leading to diagnostic challenges and potential mismanagement. A 12-year-old male presented with a gradually enlarging, painless swelling of the left maxilla initially suspected to be periapical pathology. Radiographic evaluation using orthopantomogram and Cone Beam Computed Tomography revealed a large radiolucent lesion with cortical expansion and displacement of developing teeth. Fine needle aspiration was non-contributory. Incisional biopsy established the diagnosis of odontogenic myxoma. Surgical excision was performed under general anaesthesia with satisfactory postoperative healing. This case underscores the importance of comprehensive radiographic assessment and histopathological confirmation in pediatric jaw lesions and highlights the need for clinicians to consider non-inflammatory pathologies when evaluating periapical radiolucencies.