Juvenile fibromatosis. A case report showing invasion of the bone.

This paper reports a growth occurring at the angle of the mandible of a 6-year-old boy. The growth consisted of mature-looking fibroblasts with a generous collagenous matrix. The course of this patient up to the present is described as it portrays some of the problems encountered in children with fibrous growths. Despite recent articles on the nature of such growths there remain many instances where it cannot be decided on histological grounds alone whether they are true tumours or fibrous dysplasia. If they are tumours they cannot be separated with certainty into benign and malignant groups by their microscopic appearance. It cannot even be proven whether they are growths of mature fibroblasts, i.e. well-differentiated mesenchymomata, or growths of peripheral nerve cells, i.e. benign schwannomata (neurofibromata). The clinical course of such growths is not totally predictable. Hence the clinician is confronted with the problem of determining how best to manage them; steering a middle course between the Scylla of inadequate and belated removal and the Charybdis of unnecessary mutilation.