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Case Report: A Calcifying Epithelial Odontogenic Tumor in Early Childhood
Brian W. Starr, MD, Elizabeth A. Lax, MD, David Parizh, DO, Haithem M. Elhadi Babiker, MD, DMD
University of Cincinnati
2019-02-13
Presenter: Brian W. Starr, MD
Affidavit:
All authors have made substantial contributions defined by the conception and design of the study, acquisition of data, analysis and interpretation of data, and/or drafting/revising the article critically for important intellectual content.
Director Name: Ann Schwentker, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: There are approximately 350 cases of calcifying epithelial odontogenic tumor (CEOT) reported in literature since its first description by Dr. Jorgen Pindborg in 1958. None of these cases have been reported in a patient younger than eight years of age. Given the paucity of data that exists on CEOT in the pediatric population, a consensus on diagnostic approach and timing of treatment and skeletal reconstruction does not exist.
Methods: We present an interesting case of a five-year-old girl who presented with a mandibular mass that, on further workup, was diagnosed as a CEOT. We discuss our approach and treatment algorithm to these types of lesions in the pediatric population.
Results: A five year-old girl presented to our institution with a slow-growing mandibular mass and a CT demonstrating a 2 x 2 x 3 cm expansile lesion. Giving strong consideration to the patient's young age and morbidity associated with wide resection and additional reconstruction, the decision was made to proceed with excision and peripheral ostectomy. We opted to defer immediate reconstruction with the aim that we would avoid obscuring surveillance picture, minimize infectious risk, and allow time for spontaneous regeneration.
Conclusions: Pindborg tumors are rare and slow-growing, usually presenting around 40 years of age. There is no established consensus regarding management of these lesions in the pediatric population. Relying heavily on our experience with other pediatric mandibular tumors and drawing from the existing data for adults, we make the case for conservative, single-stage approach to these lesions.
