Clinical History.—A 3½-year-old boy was brought to the Hospital Infantil IMAN with a history of a progressively growing tumor of six months' duration in the left submaxillary region. Moderate fever and chills had been present for the past three months. One month before hospitalization the lower part of the tumor began to drain purulent material.
Physical Examination.—The examination revealed a pale child with a tumor covering an area from the left malar region to the left submaxillary region. The tumor was hard, painful, and fixed. In the lower part of the tumor was an opening through which drained purulent material. Inside the mouth was another small opening at the base of the left first molar, also draining purulent material. The results of the rest of the examination were normal. There was no liver or spleen enlargement. Vital signs were as follows: temperature, 37 C (98.6 F); pulse rate,