Locally Aggressive Benign Processes of the Oral and Maxillofacial Region
Pathologic processes of the oral and maxillofacial region are generally classified as benign or malignant based on specific histologic criteria, including the presence or absence of necrosis, mitotic figures as well as a basic understanding of the entity. The term aggressive has most commonly been reserved to describe malignant tumors because of their ability to grow quickly and invade surrounding structures, resulting in significant local growth, metastatic disease and possibly death of the patient. However, the oral and maxillofacial region is the site of many benign yet locally aggressive processes that can result in significant anatomic destruction, deformation and resultant loss of function (Fig. 1). Locally, aggressive benign processes can be distinguished from their malignant counterparts by a lack of skin invasion, a lack of epineural infiltration and the paradox of aggressive but slow growth. In some cases, many benign tumors of the oral and maxillofacial region can be more aggressive, destructive, and deforming than some malignant tumors, even though they grow less quickly.