Tumors of the Pediatric Maxillo-facial Skeleton: A 20-Year Clinical Study

Abstract

Objectives:

Review the clinical presentation, radiologic features, management, and outcomes of jaw tumors diagnosed in children treated in a tertiary care academic center.

Methods:

Retrospective review of children age 16 and under who presented to the University of Maryland Medical Center between 1992 and 2012 and were diagnosed with a jaw tumor. Charts were reviewed for symptoms, physical exam, radiological findings, pathology, intervention, and outcomes.

Results:

The charts of 76 patients evaluated for a jaw mass were reviewed, and 22 were diagnosed with a jaw tumor. The two most common pathologies were ameloblastoma (27%) and ossifying fibroma (18%). Two tumors were malignant, both rhabdomyosarcomas. One-third of patients presented asymptomatically with lesions found on surveillance panorex, while the remaining two-thirds presented with evidence of a mass or swelling. All but one infant with a suspected lymphangioma underwent biopsy and surgical excision. Twenty-seven percent of patients underwent more than one procedure, including secondary reconstruction, prior to a satisfactory outcome.

Conclusions:

Pediatric jaw tumors are rare lesions most commonly presenting with a swelling or mass in the location. One-third of patients are asymptomatic with a lesion identified on imaging. A majority of jaw tumors are benign but require surgical intervention for excision of disease. Multiple procedures, including reconstruction, may be required for certain lesions prior to cure.