Incidence and structure of the bening soft tissuetumors of maxillofacial region in children

Abstract

According to the statistical data, children with tumors of the maxillofacial region (MFR) account for 12-22% of all patients with tumors, and 90% fall to the share of benign processes, where mesenchyme-related tumors or, less frequently, epithelial neoplasms, prevail. At the same time, soft tissues tumors of face and neck account for 55-62% among the MFR cancers in children. Tumors in children have specific characteristics, in contrast to adults, and the age changes in metabolism and physiological functions of child body specify possible clinical differences in tumor processes among children of different age groups. Morphologists also highlight a number of features of child tumor processes, regardless of their localization, reminding of the possibility of transformation of some malignant tumors into benign ones. The paper is aimed at representation of our data on the incidence and structure of some nosological forms of benign tumors of head and neck in children. It has been found that in the 10-year period of our observations, the number of children with benign tumors of maxillofacial region accounted for 7,5% of the total number of patients treated in the Surgical Unit of the Poltava Children’s Municipal Clinical Hospital. Among the nosological forms, dermoid cysts (32,7%) and hemangiomas (26,0%) occurred most commonly and the peak of morbidity (25,0%) was observed in infants. In most cases (55,4%) soft tissue benign tumors and tumor masses of maxillofacial region occurred in girls, with more frequent (62,9%) occurrence of hemangiomas, whereas dermoid cysts were more frequently found in boys (61,7%). In 22,4% of the cases, the pathological focus was detected on the neck, in 14,0% on the forehead, in 10,8% in the soft oral tissue, in 7,7% on the lower lip, in 7,7% on the cheek, in 6,2% on the upper lip, and in 3,1% of patients on the chin. In 25,9% of cases, hemangiomas covered several anatomical areas at ones. Recurrences of tumors after surgery have been recorded in 6,7% of patients: in 43,0 % of children it was happened after surgical excision of the middle neck cyst and per 28,5 % of the cases of angiomas and ranulas. The comparative analysis of the clinical diagnosis and postoperative morphological study of the removed tumors has established that in 15,3% of cases the clinical diagnosis was different from the pathohistological one. In most cases it was associated with dermoids (75,0%), fibromas (15,6%) and lymphangiomas (9,4%). Considering the fact that the prognosis for children with abovementioned pathology is determined by the option of histological structure and primary localization of the tumor, the timeliness and adequacy of the treatment activities, implementation of the advanced methods of diagnostics with the high level of awareness is crucial in the improvement of the effectiveness of health care provided for patients of this category, contributing to the correct diagnosis, selection of the treatment procedure and determine the extent of surgical intervention at the preparing period.