[A Rare Case Report of Central Mandibular Fibrosarcoma in a Child Treated with Long-Term Prognostic Follow-Up and...

Fibrosarcoma in the mandible in children is a very rare condition. We present a rare case of central mandibular fibrosarcoma in a child, treated with radical tumor resection, reconstructive surgery, long-term prognostic evaluation, and morphofunctional reconstruction. The patient was an 8-year-old boy. In 2008, he was referred to us with a chief complaint of tenderness in the gingiva of the right mandibular molar region. Suspecting an odontogenic benign tumor or cyst, we performed an excisional biopsy. Histopathological examination diagnosed fibrosarcoma. Systemic evaluation showed no metastasis involvement. We performed right mandibular segmental resection, submandibular dissection, and temporary bridging with a mandibular reconstruction plate. Postoperative chemotherapy consisted of 1 course of vincristine, actinomycin D, cyclophosphamide(VAC). The postoperative course was uneventful, with no recurrence or metastasis. In 2010, right mandibular reconstruction with a vascularized fibula flap was performed. In 2017, at the age of 17, alveolar ridge augmentation with iliac corticocancellous bone grafts was performed on the reconstructed mandible, followed by the placement of four dental implants in a staged approach. Three years have passed since the activation of the bridge-type dental implant prosthesis, with no recurrence or metastasis of the fibrosarcoma and satisfactory recovery of oral and maxillofacial function.