Management of Odontogenic Fibromyxoma in Pediatric Nigerian Patients: A Review of 8 Cases

Abstract

Odontogenic fibromyxoma (OFM) is a benign, locally invasive and aggressive nonmetastasizing neoplasm of jaw bones. They are considered relatively rare and known to be derived from embryonic mesenchymal elements of dental origin. Treatment of OFM depends on the size of the lesion and on its nature and behavior. Varying treatment modalities ranging from curettage to radical excision have been documented. Aim; This paper is a review of management of 8 pediatric patients with histologically diagnosed OFM at a Nigerian tertiary health care facility. This was a retrospective study of all patients aged 15 years and below who presented to the Oral and Maxillofacial Surgery Clinic of Aminu Kano Teaching Hospital, Kano, over a 5-year period (January 2008 to December 2012), with a histologic diagnosis of OFM. The information obtained included patients' demographics, as well as their clinical characteristics such as the anatomical site and side of lesions. Other information collated included presenting features, the onset of symptoms, type of treatment carried out, as well as treatment outcome. The data were analyzed and the results presented as frequencies and percentages. Among the 8 patients with OFM, more males (n = 5/8; 62.5%) were affected than females (n = 3/8; 37.5%). The mandible (n = 5/8; 62.5%) was the most frequent site of occurrence, and the anterior mandible was the most favored location (n = 4/8; 50%). Seven patients had excision of the lesion with peripheral ostectomy of the underlying bone while only one patient had a bone resection. These patients have been followed up for at least 1 year, and no recurrence was observed throughout the follow-up period. OFM causes gross facial disfigurement and may result in the destruction of the entire jaw bone; the impact of which may be grave for a growing child. Prompt surgical intervention and follow-up have proven to be adequate management protocol.

Keywords: Odontogenic fibromyxoma; Odontogenic tumor; Pediatric.

Figure 1

(a) Preoperative photograph of an 8-year-old boy with odontogenic fibromyxoma involving the maxilla. Note the gross disfiguring nature of the tumor. (b) Postoperative photograph of the same patient 2 years postsurgery

Figure 2

(a) Preoperative photograph of a 7-year-old boy with odontogenic fibromyxoma involving the mandible. Note the tumor has filled the whole mouth thus impeding adequate feeding. (b) Postoperative view of the same patient 2 years postsurgery

Figure 3

A three-dimensional computerized tomographic view of a 10-year-old girl with odontogenic fibromyxoma involving the mandible. Note the gross destruction of the involved segment

Figure 4

Oblique lateral radiographic view of the 7-year-old boy [Figure 2] a showing gross destruction of the mandible