September 2019 HSC Section 1 Congenital and Pediatric Problems

Yuhan et al

Other Malignant Lesions There are several other oral cavity malignancies presenting in the pediatric population, although these are even rarer than the uncommon entities described previously. Pedi- atric head and neck squamous cell carcinoma is particularly rare, although the oral cav- ity is the most frequently reported location. Oral cavity squamous cell carcinoma has a generally poor survival with median overall survival reported to be 48 months in 1 sys- tematic review of the literature. 80 Syndromes involving defects in DNA repair mecha- nisms, including Fanconi anemia, are associated with significantly decreased survival. Aggressive multimodality therapy is the treatment of choice. Chemotherapy and radiation are usually the primary modalities with surgery reserved for small lesions or postchemoradiation therapy in cases of persistent or recurrent disease. Other pediatric malignancies presenting in the oral cavity include histiocytosis as well as salivary gland malignancies arising from the minor salivary glands, including mucoepidermoid carcinoma and adenoid cystic carcinoma. Early identification of oral lesions accompanied by tissue diagnosis is key in facilitating appropriate management. The broad range of potential etiologies underlying oral lesions in children mandates an understanding of the differential diagnosis as well as optimal diagnostic and therapeu- tic strategies. Identifying which lesions require further work-up is necessary for mini- mizing unnecessary testing and avoiding missed diagnoses of serious entities. A thorough patient history and a detailed and efficient physical examination direct the decision to pursue further work-up and intervention. Understanding normal oral cavity anatomy is crucial for performing an appropriate evaluation. SUMMARY 1. Shulman JD. Prevalence of oral mucosal lesions in children and youths in the USA. Int J Paediatr Dent 2005;15(2):89–97 . 2. Maaita JK. Oral tumors in children: a review. J Clin Pediatr Dent 2000;24(2): 133–5 . 3. Childhood Oral Cavity Cancer Treatment. National Cancer Institute. Available at: https://www.cancer.gov/types/head-and-neck/hp/child/oral-cavity-treatment-pdq . Accessed March 26, 2018. 4. Bleyer A. Cancer of the oral cavity and pharynx in young females: increasing inci- dence, role of human papilloma virus, and lack of survival improvement. Semin Oncol 2009;36(5):451–9 . 5. Stern JS, Ginat DT, Nicholas JL, et al. Imaging of pediatric head and neck masses. Otolaryngol Clin North Am 2015;48(1):225–46 . 6. Lloyd C, McHugh K. The role of radiology in head and neck tumours in children. Cancer Imaging 2010;10:49–61 . 7. Mulliken JB, Glowacki J. Hemangiomas and vascular malformations in infants and children: a classification based on endothelial characteristics. Plast Reconstr Surg 1982;69(3):412–22 . 8. Kulbersh BD, Wiatrak BJ. Pediatric lingual and other intraoral lesions. Otolaryngol Clin North Am 2015;48(1):175–90 . 9. Buckmiller LM, Richter GT, Suen JY. Diagnosis and management of hemangi- omas and vascular malformations of the head and neck. Oral Dis 2010;16(5): 405–18 . REFERENCES

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