Oral squamous cell carcinoma in patients less than 40 years in a Nigerian population

Objectives: Oral cancer ranks amongst the sixth to eight most common cancers worldwide and exhibits a great variation in incidence among countries. Oral squamous cell carcinoma (OSCC) is rare in individuals less than 40 years of age, with occurrences averaging 4 to 6% in people less than 40 years. The aim of this study was to review the clinical and pathological characteristics of OSCC cases in patients less than 40 years of age in five tertiary health facilities in Nigeria.Methods:All OSCC in the period from 1970 to 2015 from case file records and biopsy reports were retrieved from the records of the five teaching hospitals, to obtain age, gender, location and histologic grades.Results: Ninety-seven (17.4%) cases of OSCC were diagnosed in patients less than 40 years of age. These included 58 males and 38 females giving a male: female ratio of 1.5:1. The mandibular mucosa with 27 (28.7%) cases was the most common site followed by the maxillary mucosa with 24 (25.5%) and palate with 14 (14.4%) cases. Only 5 (5.3 %) cases of OSCC occurred in the tongue. The well differentiated OSCC was the most common histological grade accounting for 48 (50.0 %) cases while the moderately differentiated and poorly differentiated OSCC accounted for 31 (32.3 %) and 17 (17.7 %) cases respectively.Conclusion: OSCC was relatively more common in patients less than 40 years of age in this study than those of previous studies from other regions and OSCC in patients less than 40 years of age was relatively rare in the tongue when compared with similar cohorts from other continents. Key words: oral squamous cell carcinoma; age less than 40; tongue; mandibular mucosa, Nigeri

A retrospective review of 61 cases of adenomatoid odontogenic tumour seen in five tertiary health facilities in Nigeria

Introduction: Adenomatoid odontogenic tumor (AOT) is a benign lesion originating from the dental lamina or its remnants. It is a relatively uncommon neoplasm representing about 3% of all odontogenic tumors. The aim of this study was to examine the clinical and radiological characteristics of AOTs in five major tertiary centres in Nigeria. Methods: Archival hospital-based data stores of five tertiary health facilities in Nigeria were accessed. Case files and biopsy records were retrieved to obtain relevant information. Data was collected according to a proforma for standardization and entered into and analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Results: 61 (4.5%) cases of AOT were documented. The age range was 8-46 years with a mean age of 20.4±9.9 years. Male: Female ratio was 1:1.3. The anterior maxilla had 34 (55.8%) cases and the anterior mandible had 20 (32.8%) cases. 40 (65.6%) follicular cases, 20 (32.8%) extra-follicular cases and 1(1.6%) extraosseous case were found. 31 cases (61.1%) were associated with impacted teeth and the upper canine was involved in 19 (57.6%) cases. Conclusion: This study showed AOT to be more common in the maxilla, more in females, most often associated with impacted canines, however, the suggestion of AOT being a “Two third tumour” was not observed in this study

Cysts of the Oro-Facial region: A clinico-pathologic review of 403 Nigerian cases

Objectives: To review the types, frequency, distribution, treatment, and treatment outcome oforo-facial cysts seen at four tertiary health centres in southwestern  Nigeria and to categorise the cases using Lucas (1966), Killey and Kay (1968) and World Health Organization (WHO) (2005) classification protocols.Design: A decriptive retrospective studySetting: Tertiary hospitals across the south west zone of Nigeria.Main outcome measures: Treatment outcome of oro-facial cysts seen at four tertiary health centres in southwestern Nigeria and categorisation of the cases using Lucas (1966), Killey and Kay (1968) and World Health Organization (WHO) (2005) classification protocols.Results: The treatment modalities included marsupialisation, enucleation,  enucleation with peripheral osteotomy and surgical excision of non-epithelial cyst of the jaws. The follow-up period ranged from a minimum of six month to five years. Such follow-up consisted of examination and periapical or panoramic radiographs. All patients were without evidence of disease during the follow-up period and many of them were lost to follow up due to absence of diseased condition. Lucas  classification and WHO classification showed that inflammatory cysts were the most common accounting for 36%, developmental cysts represented 27%, 4% were non-epithelial while, 32.8%  were unclassifiable.Conclusion: The inflammatory jaw cyst is the most common type in southwest  Nigeria, occurs more in males compared to females and is more common in the mandible compared to the maxilla

Emerging Trends in the Epidemiological Pattern of Head and Neck Cancers in Lagos, Nigeria

Background: Unfortunately, despite an increase in medical knowledge, survival rates of head and neck cancers (HNCs) have not been observed to improve greatly. This is true, especially in tumors located in obscure primary sites or late presentation. Aim: The purpose of this study is to assess the epidemiologic pattern of HNCs and to evaluate its emerging trends and patterns in Lagos state. Subjects and Methods: A retrospective study was conducted from 2003 to 2013 that analyzed histologically diagnosed cases of HNC at the Pathology Departments of  he two tertiary teaching hospitals in Lagos. Data analysis was performed using the Statistical Package for the Social Sciences (version 20) statistical software. Results: One thousand and eighty‑three cases of head and neck malignancies were recorded. A female: male ratio of 1.01:1 was reported with mean age of 39.6 (standard deviation 21.1) years. The oral cavity was the most affected anatomic site (21.2%, 230/1083) in the period under review. Malignant epithelial tumors accounted for 72% (779/1083) of cases seen. Carcinomas were the most common histological variant seen (67%, 726/1083) and squamous cell carcinoma accounted for 58% (421/726) of carcinomas recorded. Oral cavity malignancies (21.8%, 118/540) were the most common in males while thyroid malignancies (28.5%, 155/543) were the most seen in females. In children (≤15 years), the most common histologic findings were carcinomas (42.3%; 77/182) and retinoblastomas (23.6%; 43/182). Conclusion: Epithelial malignancies were the most common malignancy in the study, and the oral cavity appears to be the increasingly predominant site for HNCs. A changing pattern in gender predominance, age distribution, and frequency with  histological variants and anatomical sites was also observed in this study.Keywords: Epidemiology, Head and neck cancer, Prevalenc

Oral lesions among male tobacco users in a sub-urban Nigerian community

Background: Tobacco use in different forms is one of the greatest threats to global health. It is a major preventable cause of premature death and disease and has now become a global epidemic. Limited data exists on the prevalence of oral lesions among tobacco users in Nigeria.Objective: To determine the prevalence of oral mucosal lesions among tobacco users in Mushin Local Government Area (LGA) of Lagos Stateandassess the knowledge of health risks associated with tobacco use among the users and their attitudes towards tobacco use.Materials and Methods: This was a community-based descriptive cross-sectional study conducted among tobacco users from identified pockets of areas in the Local government area famous for tobacco use. Data collection tools included interviewer administered questionnaires and clinical examination.Results: Respondents were aged between 22-62years; the mean age was 35.51years [SD-8.5]. Prevalence of oral lesions was 34%, of these 5% were premalignant. Chronic periodontitis was the most common oral lesion [24.3%] while Leukoplakia was the least common [2.8%]. Majority (89.8%) of respondents agreed that tobacco was dangerous to health; however, the knowledge of the specific diseases associated with tobacco was low. Almost all (91%) respondents support a ban on smoking in public places.Conclusion: Prevalence of oral lesions was relatively high while knowledge of specific diseases associated with tobacco use was low. Targeted health education initiatives should be developed for tobacco users and regular dental visits to aid early detection of premalignant lesions is also recommended.Keywords: Oral lesions, Tobacco users, Nigeri

Basal Cell Carcinoma of the Upper Lip in a Nigerian: A Case Report

A case of a 75 year old community health worker and part time farmer that presented at the Burns and Plastic Unit of the Lagos University Teaching Hospital, Lagos Nigeria was reported. The lesion commenced as a nodular mass on the upper lip which later progressed into an ulcer. The patient wasmanaged by surgical excision and reconstruction. Keywords: Basal cell, Carcinoma, Upper lip

Challenges sssociated with Learning Oral Diagnostic Sciences: A multicenter study in Nigeria

Introduction: Oral diagnostic sciences (ODS) comprise the subjects, oral pathology, oral medicine, oral radiology and the functional integration of these into the oral  diagnostic services. Oral diagnostic science has peculiar challenges with learning  and training in sub-Saharan Africa. Several barriers that may impede effective clinical teaching include inadequate institutional financial support and lack of access to appropriate educational space and resources. The aim of this study was to categorize challenges of learning ODS in Nigeria.Methods: This was a cross sectional survey of undergraduate dental students (UDS) and resident doctors (RDS) in dentistry in five institutions in Nigeria. The study included 286 participants comprised of 199 UDS and 87 RDS. Information about challenges of trainer, trainee and facilities was obtained by using pretested  structured questionnaires. Data was analyzed using SPSS version 23 and tests of associations between variables were determined using Chi-square. The level of significance was set at p < 5%. Results: The mean age of the study participants was 27.2 (± 4.6) years and 60.6% were males. The majority, 72.4% of RDS and 64.3% of UDS, indicated that getting a good ODS education was important to them. Few, 19.5% of RDS and 8.5% of UDS indicated that they would consider ODS as a career. While 37.9% of RDS decided that their examinations are fair and  objective, 50.8 % of UDS agreed that their examinations were fair and objective (p < 0.05). The percentage of RDS and UDS which felt that ODS consultants sometimes give contrary information to textbook material were 26.4% and 29.1% respectively, however 28.7% of RDS and 34.2% of UDS were undecided about this issue. Thirty-eight (43.7%) specified that lack of a structured postgraduate curriculum in ODS caused their challenge with learningConclusions: Trainee level affected the participants' perceived challenges of learning ODS. Despite the differences, the results showed that most of the challenges were common to both undergraduate and postgraduate training