Odontogenic myxoma (OM) are benign, locally aggressive tumours that are rarely found in the paediatric maxillofacial region. OMs derive from mesenchymal odontogenic tissue. We describe the management of a 3-year-old girl who presented with a large right-sided mandibular lesion. Her treatment included conservative excision, curettage and peripheral ostectomy. A literature review was performed which calls into question the dogmatic practice of resection with 1 to 1.5 cm margins. Treatment approaches to the OM could potentially be altered in the paediatric patient.

Cervicofacial actinomycosis remains a rare pathogenic finding in the paediatric population. Diagnosis is challenging, as findings are often non-specific and Actinomyces species are generally difficult to culture. Treatment is a prolonged course of antibiotics, either intravenous and oral, often combined with a surgical procedure to remove the lesion. This patient had non-specific intermittent left mandibular pain for 8 months that was eventually attributed to an Actinomyces odontolyticus infection in the mandible. Diagnosis required incisional biopsy, and treatment involved 12 months of oral antibiotics.

Oral focal mucinosis (OFM) is the rare oral manifestation of cutaneous focal mucinosis. It is a diagnosis made histopathologically, as OFM remains clinically similar to other more common oral lesions, and radiographs do not provide any diagnostic information. This case is a report of a teenage female with left mandibular involvement of an elevated, rounded, asymptomatic, mucosa-coloured lesion in the facial and lingual gingiva between her left first and second mandibular molars. The cause was unclear, although the patient stated that she may have sustained a laceration in that area several months prior. An incisional biopsy revealed histopathological findings consistent with OFM, and complete surgical excision of the lesion was performed under a general anaesthetic, with no signs of recurrence for 2 months. The histological, clinical and accepted treatment methods on OFM will be discussed. Clinicians, including those serving paediatric populations, should consider OFM in their differential diagnoses when evaluating gingival lesions.