Pathological Case of the Month | Pediatrics | JAMA Pediatrics | JAMA Network
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Special Feature
June 2001

Pathological Case of the Month

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Arch Pediatr Adolesc Med. 2001;155(6):735-736. doi:10.1001/archpedi.155.6.735

A 10-MONTH-OLD girl was evaluated for facial swelling lasting for 3 days over the left premaxilla-nasal area. There was no history of trauma, nasal discharge, or fever. On physical examination a 3-cm mass in the left nasomaxillary area was evident. On palpation the mass was firm, fixed, nontender, and extended toward the malar eminence. Intraorally, the mass obliterated the left maxillary vestibule from the midline to the molar region; palatal displacement by the mass was noted. A facial computed tomographic scan showed a large 19 × 21-mm round/ovoid lucency in the anterior maxilla. The margins of the lesion included the left alveolar ridge to just under the orbital floor. The sinuses were intact. Focal bony destruction of the maxilla over the anterior portion of the mass and perforation of the nasal floor was noted. Multiple developing teeth were engulfed by the lesion (Figure 1). Several days later, she underwent surgical exploration, frozen section biopsy, and possible enucleation of the left maxillary mass. An intraoral approach through the left maxillary alveolar crest revealed a large multilocular mesenchymatous tissue mass (Figure 2); aggressive excision and curettage was performed. All unerupted teeth engulfed in the mass were removed. Her postoperative course was uneventful, and she was discharged 2 days later. The excised specimen consisted of 3 pieces of soft, pale, yellow-gray tissue, the largest of which was 1.5 × 1.2 × 1.1 cm (Figure 3 and Figure 4).