Malignant tumors of the maxillofacial and oral region in children: A clinicopathologic study

Abstract

This is a retrospective study of malignant tumours of the maxillofacial and oral region in children that presented over a 20 year period (1973 to 1993) at the Red Cross War Memorial Children's Hospital and Groote Schuur Hospital, Cape Town. Of the 352 children that were treated for a malignant tumour arising from various anatomic sites in the head and neck region, 30 were found to have had maxillofacial and oral involvement. This represented an incidence of 8,5%. Histologically, the majority of the tumours were non-odontogenic and mesenchymal in origin. The rhabdomyosarcoma was found to be the most common neoplasm, followed by the Burkitt's lymphoma. The age range was 6 months to 13.8 years (mean age 5.7 years). Males were more commonly affected than females, with a ratio of 1.3:1. There were 26 (86,7%) black patients and 4 (13,3%) white patients, representing a ratio of 6.5:1. Fifty percent of the cases were from the Eastern Cape. The mandible and the maxilla were the most common sites to be involved, followed by the soft tissues of the face. The most common presenting symptom was a painless swelling (73,3%) of the face. Twenty percent of the patients had "floating" or loose teeth. Radiographic features in the jaws were poorly circumscribed destructive lytic lesions with displacement of teeth. Histologic type was found to be the most significant variable affecting the outcome, with the Burkitt's lymphomas having the best prognosis and the rhabdomysarcomas the worst. The most common cause of death was metastases to the lungs. It is concluded that although malignant tumours of the maxillofacial and oral region in children are rare, their prognosis is poor. Therefore, any child presenting with a facial swelling should be viewed with suspicion.