Oral tumors and tumor-like lesions in infants and children

Abstract

The aim of this retrospective study was to survey the spectrum of oral tumors and tumor-like lesions treated in a pediatric surgical unit. The clinical features and treatment outcome are presented, and guidelines for management discussed. Long-term follow-up was carried out both by re-examination and by means of a questionnaire. A total of 95 patients were encountered over a 30-year period. The age at presentation ranged from 1 day to 16 years, and the male to female ratio was 0.7:1. The lesions were located predominantly on the lips (22%), tongue (21%), and cheek (19%). Patients were divided into five groups based on histological diagnosis. Benign lesions accounted for 83 (87%) of the cases. Of these, 41 (43%) were benign tumors, the most common of which were the hemangiomas (17 cases). Hamartomas accounted for a further 22 benign lesions (23%), among which 12 were lymphangiomas. Furthermore, we saw 14 cases (15%) of mucoceles, ranula and dysontogenetic cysts, and a further 6 cases (6%) were classed as miscellaneous lesions. Simple surgical resection was successful in treating most benign lesions, with occasional re-excision being necessary in lymphangiomas. The long-term effects of treatment include reduction of the red volume of the lips, scarring following resection of parotid hemangiomas, a forked tongue after wedged resection, and partial facial nerve palsy. The group of 12 (13%) malignant tumors consisted of 5 rhabdomyosarcomas, 2 fibrosarcomas, 2 carcinomas of the parotid, 1 osteosarcoma, and 2 metastases. A multimodal approach was used in patients with rhabdomyosarcomas, while fibrosarcomas and parotid carcinomas were normally treated by surgical excision. Six of 12 patients with malignant tumors were alive after a median follow-up of 20.5 years. Re-examination of the malignant tumor group revealed scarring, impaired growth and function of the maxilla associated with local irradiation, and an external salivary fistula. In conclusion, while most oral and maxillofacial tumors of children are benign, malignant tumors of soft tissue, salivary glands and bones must be taken into account. There are specific aspects related to certain developmental and biological characteristics that make a mainly conservative approach preferable in these children.

Paediatric Salivary Gland Epithelial Neoplasms

“…The lesions should be biopsied and a diagnosis aggressively pursued [44] . Pleomorphic adenoma should be considered in the differential diagnosis of young patients with swellings in the oral cavity, particularly in the palate, lips, tongue and buccal mucosa.…”

Hamartomas of the oro- and nasopharyngeal cavity in infancy: two cases and a short review

“…Malignant tumours are reported in a minority of cases and consist of carcinomas originating from the parotid gland, malignant lymphomas, soft tissue sarcomas and metastasis [3].…”

Palatal Lesion in a 3‐Year‐Old Boy

“…1 Palatal lesions in children present as a diagnostic dilemma and are usually investigated by paediatricians, surgeons and dentists. [1][2][3] They are challenging to discover in the younger patient due to their location and, often, asymptomatic nature. Impatience of health professionals to uncooperative patients can ally this issue and contribute to a less detailed evaluation.…”

“…The majority of oral lesions in children are benign, ranging from 84 to 99% of cases. 3 However, malignant disease is underestimated. 3 Cases should be assessed with urgency, preferably in Fig.…”

“…3 However, malignant disease is underestimated. 3 Cases should be assessed with urgency, preferably in Fig. 1 Photograph demonstrating the palatal lesion.…”