Abramowicz Shelly, Simon Lisa E, Kozakewich Harry P, Perez-Atayde Antonio R, Kaban Leonard B, Padwa Bonnie L
Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, and Attending Surgeon, Children's Hospital Boston, Boston, MA 02445, USA.
J Oral Maxillofac Surg. 2012 Aug;70(8):1880-4. doi: 10.1016/j.joms.2011.09.029. Epub 2011 Dec 30.
Controversy exists as to the most appropriate treatment strategy for myofibromas of the jaws: en bloc resection versus enucleation. The purpose of the present study was to evaluate the treatment outcomes in children with these uncommon benign tumors.
We performed a retrospective chart review of pediatric patients with jaw myofibromas. The predictor variables included patient demographics, clinical presentation, imaging characteristics, pathologic features, treatment, and follow-up. The outcome variable was cure or recurrence. The descriptive statistics were computed.
A total of 12 patients (mean age 6.7 years) met the inclusion criteria. There were 2 presentations: exophytic soft tissue mass in dentoalveolar segment (n = 5); and intraosseous mass (n = 7). No distinct histopathologic differences were found between the 2 groups. Exophytic myofibromas displayed rapid growth, tooth displacement and/or mobility, bony expansion, and/or cortical thinning/perforation. Most were treated by resection. The intraosseous lesions were asymptomatic and/or incidentally discovered. They were treated by enucleation and curettage. The mean follow-up for the 2 groups was 6.5 and 3.9 years, respectively. There were no recurrences.
The results of the present study indicate that there are 2 clinical presentations of myofibromas of the jaws in children: an aggressive exophytic type and a nonaggressive intraosseous type. They are histopathologically indistinguishable.
