Ahmed Oluwatoyin Lawal

A review of 413 salivary gland tumours in the head and neck region

Objectives: Salivary gland tumours (SGTs) are a group of heterogeneous lesions with complex clinico-pathological characteristics and distinct biological behaviours. Previous studies have reported geographic variations in site distribution, incidence and histological types of SGTs. The aim of this study was to describe the demography of SGTs seen at a tertiary health centre and compare findings with previous studies. Study design: Data on SGTs from archives of the Department of Oral Pathology and the Department of Pathology, University College Hospital Ibadan were retrieved. Information about histological types, age, sex and location were analyzed using SPSS for Window (version 20.0; SPSS Inc. Chicago, IL). Reactive and tumor-like lesions such as sialometaplasia, benign lymphoepithelial lesion, lymphoepithelial cyst, mucocele, mucous extravasation phenomenon, ranula, and sialosis were excluded from the study. Results: 413 SGTs consisting of 221 (53.5%) malignant and 192 (46.5%) benign lesions were seen. SGTs occurred more in females (50.6%) than males (49.4%) with a mean age of 43.7 (±16.9) years and peak age in the fifth decade of life. The parotid with 171 (41.4%) cases was the commonest site, followed by palate with 89 (21.5%) cases, while only 7(1.7%) cases were seen in sublingual gland. Pleomorphic adenoma with 169 (40.9%) was the most frequent SGT followed by adenoid cystic carcinoma with 93 (22.5%) cases which also was the most frequent malignant SGT while only 3 (0.7%) cases of Warthin’s tumour were seen. Conclusion: This report is one of few that showed a higher occurrence of malignant SGTs compared to their benign counterparts. The findings were essentially similar to findings in Africa but showed SGTs to be more common in females. The reason(s) for high occurrence of malignant SGTs in minor salivary glands and the rarity of Warthins tumour in this study and other African series compared to those from America needs further investigation. Key words:Salivary gland tumours, parotid gland, pleomorphic adenoma, adenoid cystic carcinoma, warthin’s tumour.

Non-doctor consultations and self-medication practices in patients seen at a tertiary dental center in Ibadan

AIM The aim of this study was to determine the prevalence of self-medication practices among dental out patients presenting at a tertiary health care center in Ibadan, and to determine factors that are associated with these practices. MATERIALS AND METHODS All patients presenting over a 4-month period, who consented to participate in the study, had a semi-structured questionnaire, highlighting age, sex, income and educational qualification, history of past practice of self-medication, substances used and reasons for resorting to self-medication administered to them. Data obtained were analyzed with the SPSS 12.0.1 software. Frequency tables were generated and statistical relationship between the variables was analyzed using the Chi-square test. Statistical significance was set at P>0.05. RESULTS There were 108 (38.03%) males and 176 (61.97%) females. A total of 139 (48.9%) of the respondents claimed that they have been involved in self-medication. 54.7% of the people involved in self-medication were female, while 41.7% were male. There was a statistically significant difference in self-medication between males and females (P=0.001). 71.2% of the respondents had post-secondary education and only 28.8% had secondary education or less. CONCLUSION Self-medication practices were quite high in this study, and these practices were also prevalent among the educated people. Drug control enforcement needs to be intensified and dental public health education needs to be given greater priority in the overall public health campaigns.

Odontogenic tumours: A review of 266 cases

Objectives: The aim of this study was to examine the relative frequency of odontogenic tumours at a tertiary hospital in Ibadan, as well as to study the various histologic types based on WHO 2005 classification and to compare results from this study with those of previous studies. Study design: The records of the Oral Pathology Department of University College Hospital were reviewed. Lesions diagnosed as odontogenic tumours were categorized into four groups based on WHO 2005 classification and were analyzed for age, sex and site using SPSS for Window (version 18.0; SPSS Inc. Chicago, IL) and frequency tables were generated. Results: Two hundred and sixty six (41.7%) cases of odontogenic tumours were seen. The mean age of occurrence was 32.6 (±15.815) years (range3-82 years) and peak age was in the third decade of life. Eleven (4.1%) malignant odontogenic tumours were seen. Ameloblastoma with 65.4% of cases was the most common odontogenic tumour followed by fibromyxoma (14.7%), no case of odontoma was seen in this series. Conclusion: The findings were mostly similar to those of African and Asian series and showed variations from reports from the Americas. The reason for the disparity in African and American series needs further investigations. Key words:Odontogenic tumour, classification, Nigeria.

A retrospective study of 21 cases of malignant odontogenic tumours from two tertiary health centres in Nigeria

Introduction Malignant odontogenic tumours (MOTs) are relatively rare tmours and only few cases have been reported in the sub-Sahara African literature. The aim of this study was to describe the demographic distribution of malignant odontogenic tumours in two tertiary health centres based on the current WHO 2005 classification scheme. Methods We reviewed 21 malignant odontogenic tumours out of a total of 374 odontogenic tumours from two Tertiary Health Centres. Information regarding histology, location, patients age and gender for MOTs were analysed using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Results Twenty one (5.6%) MOTs out of a total of 374 odontogenic tumours were seen from the two institutions over the study period. The median age for MOTs was 42.0 (±19.0) years (range = 16-66 years). The male: female ratio was 2.5:1 and 85.7% occurred in the mandible. Ameloblastic carcinoma (AC) with 13 (61.9%) cases was the most common MOT. AC had a mean age of 37.5 (±11.9) years. AC had a mandible: maxilla ratio of 5.5:1 with majority (84.6%) occurring in the posterior mandible. Conclusion This study showed that MOTs are rare lesions. AC was the most common MOT and majority of MOTs occurred in the posterior mandible of male patients. The study helps to better elucidate the demography of MOTs in sub-Sahara Africans.

A review of 640 Oral squamous cell carcinoma cases in Nigeria

Background Oral squamous cell carcinoma (OSCC) is the most prevalent malignant neoplasm in the oral cavity and accounts for 70% to 90% of all oral malignant neoplasms. The aim of this study was to examine the demographic distribution of OSCC in five Tertiary Health centres in Nigeria. Material and Methods All cases diagnosed as OSCC during the period from 1970 -2014 were retrieved from the records of five teaching hospitals in Nigeria. Hematoxylin and eosin stained histological slides of all cases that had a diagnosis of OSCC were reviewed for confirmation and inclusion. Data from all the centers was collated at the University College Hospital, Ibadan by 2 researchers. The data was entered into and analyzed with the SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Simple descriptive and comparative analyses were done, with the test of statistical significance set at p ≤ 0.05. Results A total of 640 cases of OSCC were seen out of 1560 oral malignant neoplasms representing 41% of all the oral malignancies seen. The mean age of occurence of OSCC was 55.5 (±17.0) years and a peak age incidence in the sixth and seventh decades of life. OSCC occurred more in males (60.9%) than females (39.1%) with a male: female ratio of 1.6:1. The well differentiated OSCC with 309 (48.3%) cases, was the most common grade, while the moderately differentiated and poorly differentiated OSCC accounted for 232 (36.2%) and 92 (14.4%) cases respectively. Conclusions This study showed that OSCC is more common in males, most commonly seen in the 60-69 age group and the commonest site of occurrence was the mandibular mucosa. The well differentiated OSCC was the most common histology sub-type. Key words:Oral squamous cell carcinoma, tongue, palate, mandible.

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%) extra-osseous 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.

Malignant salivary gland tumours of the head and neck region: a single institutions review

Introduction Malignant salivary gland tumours (MSGTs) comprise about 3% of all head and neck cancers; they demonstrate an unpredictable clinical course. The purpose of this study is to review MSGTs seen at a tertiary Health centre, and compare findings with those of previous studies. Methods The records of the Department of Oral Pathology and the Department of Pathology, University College Hospital Ibadan were reviewed over a 19 year period and lesions diagnosed as MSGTs according to 2005 WHO histological classification were analysed for age, gender and site using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Results MSGTs were more common in males (55.2%) than females (44.8%). The mean age of was 47.9 (±17.0) years and peak age was the fifth decade. The parotid gland was the commonest site with 62 (28.1%) cases. The palate was the commonest intraoral site with 61(27.6%). The nose with 19 (8.6%) was the commonest minor extra-oral site. Conclusion The findings were essentially similar to reports from Europe and America. Adenoid Cystic Carcinoma was the most common MSGT in this series. A high proportion of salivary gland tumours in sublingual gland were malignant. The reason(s) for high proportion of MSGTs in sublingual glands requires further investigation.

PTCH-1 and MDM2 expression in ameloblastoma from a West African sub-population: implication for chemotherapeutics

Introduction Ameloblastoma is a slow growing, painless odontogenic swelling which can attain sizes that result in severe deformities of the craniofacial complex. It is the most commonly encountered odontogenic tumor in Nigeria. Surgical intervention is currently the method of treatment; however identification of altered molecular pathways may inform chemotherapeutic potential. The Protein Patched homolog 1 (PTCH-1) is overexpressed in ameloblastoma. Also, mutation in the MDM2 gene can reduce the tumor suppressor function of p53 and promote ameloblastoma growth. No study however has characterized the molecular profile of African cases of ameloblastoma with a view to developing chemotherapeutic alternatives. The objective was to characterize the PTCH-1 genetic profile of Ameloblastoma in Nigerian patients as a first step in investigating its potential for chemotherapeutic intervention. Methods Twenty-eight FFPE blocks of ameloblastoma cases from Nigerian patients were prepared for antibody processing to PTCH-1 (Polyclonal Anti-PTCH antibody ab39266) and MDM2 (Monoclonal Anti-MDM2 antibody (2A10) ab16895). Cytoplasmic brown staining was considered as positive for PTCH while nuclear staining was positive for MDM2. Results Moderate and strong expressions for PTCH in ameloblast and stellate reticulum were 78.6% and 60.7% respectively. Only 3 (10.7%) cases expressed MDM2. Conclusion The importance of our study is that it supports, in theory, anti-PTCH/SHH chemotherapeutics for Nigerian ameloblastoma cases and also infers the possible additional use of anti-p53 agents.

Review of thirty-one cases of salivary gland tumours in children and adolescents seen in a tertiary health care centre in Nigeria

Introduction. Salivary gland tumours (SGTs) are rare neoplasms. When compared to salivary gland inflammatory lesions, SGTs are relatively rare in children/adolescents with estimated annual incidence for all juvenile age groups of 1-2 tumours per 100,000 persons. This study reviewed SGTs in children/ adolescents seen at a reference tertiary hospital in Nigeria. Material and methods. This was a review of all SGTs in subjects aged 19 years and below from archival records of the University College Hospital Ibadan. All lesions were analysed for age, gender and site using SPSS for Windows (version 20.0; SPSS Inc. Chicago, IL). Inflammatory and non-neoplastic swellings were excluded from the study. Result. Out of a total of 413 SGTs that were diagnosed over the study period, 31 (7.5%) were seen in children/adolescents. The male:female ratio was 2.1:1. The mean age was 14.2 (±3.4) years (range = 6-19 years) and majority (93.5%) occurred at the age of 10 years and above. There were 19 benign cases (61.3%) while 12 (31.8%) were malignant. Pleomorphic adenoma in 16 (51.6%) cases was the most common lesion seen followed by mucoepidermoid carcinoma with 7 (22.6%) cases. Malignant SGTs in children occurred more often in the minor salivary glands (50.0%) compared with five (41.7%) cases that occurred in the parotid gland. Conclusion. This study showed that SGTs are relatively rare in children/adolescents and benign SGTs are more commonly seen than their malignant counterparts in