Extra-abdominal fibromatosis invading the mandible: case report

[Aggressive fibromatosis in the jaw and facial region with bone involvement. A review]

BACKGROUND

Aggressive fibromatosis (AF) involving bones of the head is rare and surgery is often complicated by a high recurrence rate. Interdisciplinary treatment is of the utmost importance to avoid extensive, mutilating resection. Two cases emphasize the difficulties in the management.

CASE REPORTS

A 67-year-old woman was referred to our unit with a blepharochalasis of the left upper palpebra and a palsy of the face on the left side. Her medical history included 12 operations over the previous 4 years for an extensive AF.

MATERIAL AND METHODS

Our review includes all case reports of AF involving bones of the head published between 1960 and 2004. Additionally, our two cases are presented. Signs, symptoms and outcome were analyzed in relation to different treatment options.

CONCLUSION

According to the literature, surgery is the most common treatment for AF in the head and neck region. Alternative modes of therapy must be considered because of the high recurrence rate and to avoid mutilating operations.

Agressive fibromatosis involving the mandible—Case report and review of the literature

BACKGROUND

Aggressive fibromatosis (AF) involving the mandible is rare, and surgery is often complicated by a high recurrence rate.

CASE REPORT

A 4-year-old boy was referred because of a fast growing painless mass which involved the entire left angle of the mandible. Excisional biopsy revealed AF, and local excision of the tumor was performed. Six months after surgery a recurrence was detected. The tumor was determined to be unresectable and the boy was treated with low-dose chemotherapy including methotrexate and vinblastine for 1 year. With combined chemotherapy and surgical debulking, mutilating surgical resection will be delayed as long as possible or until completion of facial growth.

CONCLUSION

According to the literature, surgery is the most common treatment of AF in the head and neck region. However, particularly in children, alternative modes of therapy must be considered because of the high recurrence rate and to avoid mutilating operations.