Management of Oncology Cases in Pediatric Patients

Benign and malignant tumors in children and adolescents present certain differences to those of adulthood, with regards to their origin or to their therapeutic approach. When located in the jaws, they can interfere with growth and permanent dentition.

Odontogenic tumors are a group of different tumors of developmental origin, benign in their majority, which may appear in the jaws of children showing a variety of clinical, biologic or radiologic appearance; they can be odontomas which are benign requiring resection only, or large in size osteolytic lesions, such as ameloblastoma, ameloblastic fibroma etc associated with dentition derangement locally. Some of them may show locally aggressive behavior and increased recurrence rates. Following biopsy, local excision and follow-up with regards to development, is the usual treatment, without excluding the need for reconstruction in extended cases.

Fibro-osseous lesions and giant cell granulomas are other groups of tumors that may affect the jaws and cause bone loss. Their treatment includes surgical excision, possible loss of permanent teeth, as well as need for long lasting follow-up and further reconstruction.

Sarcomas and not carcinomas are the malignancies most often affecting the jaws of children such as rabdomyosarcoma and Ewing Sarcoma. They appear as painful fast growing swellings, destroying the bone and involving adjacent soft tissues. Following biopsy and diagnosis, children are treated according to the appropriate therapeutic protocols which include circles of chemotherapy, surgical resection, with or without radiotherapy.

The highlights of nosological entities, benign and malignant, most often encountered in the jaws of children, as well as representative cases will be presented during the lecture.