Oral Burkitt's lymphoma in children: the Moroccan experience

Thirty-seven children with Burkitt's lymphoma of the oral region diagnosed between 1998 and 2005 were reviewed. There were 31 boys and 6 girls. The mean age at diagnosis was 6.64 years (range 2-15 years) with a mean delay to diagnosis of 41 days (range 10 days-2 months). There was a predominance of maxillary over mandibular involvement: 1.44:1. Complaints included exophytic mass with dental displacement (100%), abdominal pain (68%), nerve palsy (28%) and orbital swelling (21%). Toothache as initial complaint led to dental extraction in 12 cases. According to the Murphy classification, there were 4 stage II, 11 stage III and 22 stage IV tumours; 43% and 41% had bone marrow and central nervous system involvement, respectively. After chemotherapy, complete remission was seen in 59% of cases. Remission in two children was relatively brief, lasting no more than 3 months. After a median follow-up of 45 months (range 9-99 months), the disease-free survival rate was 54%. In conclusion, in this series, oral presentation of Burkitt's lymphoma was a component of more widely disseminated disease. The pattern seemed to fall between that of the endemic and the sporadic types. Even with intensive chemotherapy, patients with advanced disease maintained a poor prognosis.