Aggressive maxillary squamous odontogenic tumour in a child: histological dilemma and adaptative surgical behaviour.

A case of a maxillary osteolytic tumour is described in a 9-year-old boy. Histological analysis led to an initial diagnosis of benign squamous odontogenic tumour, although this was not straightforward due to swelling, and cellular pseudo-malignant and non-specific signs. Because of the young age of the patient, a local surgical tumourectomy was first chosen with respect to the mixed dentition. For 10 months, the evolution was satisfactory. Then, a very aggressive tumoural recurrence with lip and palate infiltration led to doubts as to the histologic nature of the tumour. Efficient collaboration between several specialized pathologist teams finally confirmed that this was a squamous odontogenic tumour but in a very aggressive form. Radical surgery was then carried out.

[Giant-cell tumors: three recurrent cases in young patients]. / Tumeurs à cellules géantes: à propos de trois cas récidivants chez des sujets jeunes.

INTRODUCTION: True giant-cell tumor is a rare jaw osteolytic benign tumor belonging to the larger family of giant-cell tumors. It is particular because of the risk of recurrence and potential metastatic spread. OBSERVATION: Since 1973, we have managed four cases of true giant-cell tumors in our unit. The three cases reported here concerned young patients who developed recurrence after tumorectomy-curettage. DISCUSSION: Based on a literature review we defined this entity among the other giant-cell tumors. We emphasize the importance of early definitive diagnosis based on rigorous clinical and radiological confrontations. Because of its benign nature, the most conservative surgical treatment (tumorectomy-curettage) is generally proposed for the young patient. We noted however that in the three cases presented here, more radical surgical treatment with an enlarged tumorectomy removing the adjacent bone was advisable because of the high risk of recurrence and metastasis.