Benign lesions of the mandibular and maxillary region in children: characterization by CT and MRI.

The CT criteria for classifying lesions of the mandibular and maxillary regions in adults as benign or malignant are well recognized: irregular soft tissue margins and bone destruction. We reviewed the charts of 12 pediatric patients from 3 institutions to evaluate these criteria in children. These masses were evaluated by CT and/or MRI based solely on well-recognized and published criteria. The patients' ages ranged from 4 mo to 18 yr. The histological diagnoses were ameloblastoma (4), hemangioma (2), lymphangioma, desmoplastic fibroma, hemangiopericytoma, neurofibroma, fibrous dysplasia, and juvenile angiofibroma. All but one case was surgically proven. Among the 12 cases, 5 had bone destruction and 5 showed irregular soft tissue margins. Three cases satisfied both criteria. With well-recognized CT criteria (in adult patients), characterization of these processes led to an incorrect diagnosis of a malignant lesion in 8 of the 12 cases preoperatively. Therefore, CT and MR imaging should only be a guide to the planning and extent of surgical resection. Without clearly defined distal spread of the mass, the classification of these masses in children should be made with caution.