Primary Jaw Tumors in Children

Instructor, Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, MA, and Attending Surgeon, Department of Plastic and Oral Surgery, Children's Hospital Boston, Boston, MA.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons (Impact Factor: 1.43). 07/2012; 71(1). DOI: 10.1016/j.joms.2012.04.045
Source: PubMed


PURPOSE: To document tumor type, biological/clinical behavior, management, and outcomes in children with primary jaw tumors. MATERIALS AND METHODS: A retrospective analysis of children with primary benign jaw tumors evaluated at Massachusetts General Hospital and Children's Hospital Boston from 1991 to 2009 was conducted. Patients were included if they were aged 16 years or younger and had adequate records and follow-up. Patient charts, radiographs, and pathology reports were reviewed. Demographic data; clinical, radiographic, and histopathologic findings; treatment; and outcomes were recorded. Predictor variables were tumor type, clinical behavior (nonaggressive/aggressive), and treatment. Outcome variables included presence or absence of recurrence and complications. Descriptive statistics were computed. RESULTS: There were 102 patients (44 male and 58 female patients) with a mean age of 8.3 years (range, 6 months to 16 years). Tumors were grouped by tumor type: mesenchymal (n = 96), neurogenic (n = 5), vascular (n = 5), or hematopoietic (n = 3); in addition, when appropriate, they were classified as nonaggressive (n = 54) or aggressive (n = 27). Treatment was based on the tumor's clinical/biological behavior and radiographic features and whether it was solitary or multifocal. Patients with nonaggressive tumors were treated by enucleation, debulking/contouring, or observation, and the recurrence rate was 0%. Aggressive tumors underwent en bloc resection or enucleation with systemic adjuvant therapy, and the recurrence rate was 7.1%. Mean follow-up was 2.4 years. CONCLUSIONS: The results of this study indicate that primary jaw tumors in children exhibit variable biological/clinical behavior, often not predicted by descriptive histologic findings. Management of these tumors should therefore be guided by clinical/biological behavior.

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