Bamidele Kolude

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.

Immunohistochemical expression of MMP-2 and MMP-8 in oral squamous cell carcinoma.

Background Matrix metalloproteinases (MMPs) are endopeptidases that can degrade extracellular matrix components and affect invasiveness and aggressiveness of oral squamous cell carcinoma (OSCC). The aim of this study was to examine the immunohistochemical expression of MMP-2 and MMP-8 in OSCCs in patients presenting at the Tertiary Health facility in Nigeria. Material and Methods Formalin-fixed, paraffin-embedded (FFPE) OSCC samples diagnosed between the years 2010 and 2012 were used for his study. The FFPE were processed for MMP-2 and MMP-8 using the specifications of the manufacturer. Two investigators reviewed the slides scoring the pattern and intensity of staining as negative (0), weakly positive (+1), moderately positive (+2) and strongly positive (+3). The data were analysed using version 20 of the SPSS. The level of significance was set at P < 0.05. Results Twenty-five OSCC consisting of 14 (56%) males and 11 females (44%) were used. The mean age was 54.6 ± 17.9 years. A higher proportion (100%) of poorly differentiated OSCC strongly expressed MMP-2 compared with the well differentiated and moderately differentiated OSSC. There was no significant difference in the expression of MMP-2 amongst the three grades of OSCC (X2 = 2.87; p= 0.17). Only 5 (20%) OSCC cases positively expressed MMP-8. Moderate expression of MMP-8 was only seen in well-differentiated OSCCs. Conclusions This study showed that a higher proportion of poorly differentiated OSSC strongly expressed MMP-2. Eighty percent of cases that express MMP-8 were females and moderate expression of MMP-8 was seen only in well differentiated OSCC. Key words:Oral squamous cell carcinoma, MMP-2, MMP-8, immunohistochemistry.

Ethnic and gender comparison of rugae patterns among clinical dental trainees in Ibadan, Nigeria

Introduction This study was conducted to compare the rugae patterns between two major ethnic groups in Nigeria to establish any peculiarities. This will serve as basis for population identification especially in mass disasters involving individuals of different races or ethnicities. Methods One hundred consenting participants, 50 of south-western Yoruba ethnicity and 50 of south-eastern Igbo ethnicity were recruited; impressions of the upper jaws were taken and cast with dental stone. Two blinded investigators then delineated and recorded the rugae pattern of individual casts. The rugae patterns for the two groups were then analysed using the SPSS version 16. Results The Yorubas had more of wavy and straight patterns while there were more of curve and circular among the Ibos, however, there was no significant differences between the two groups in the mean incidence of the various rugae shapes of wavy, circular, curve and straight (p = 0.843, p = 0.711, p = 0.309 and p = 0.292 respectively). There were more secondary rugae in the Igbo than the Yoruba group and the differences in the mean incidences were significant. Conclusion The study observed several rugae similarities and no significant differences in the primary rugae shapes of the Igbos and Yoruba ethnicities, however, there were significant differences in the sum of secondary and unclassified rugae between the two groups; therefore, rugoscopy may be useful in ethnic differentiation.

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.

Palatal rugae as a tool for human identification

OBJECTIVE This study was conducted to assess the accuracy of palatal rugae as a tool for human identification and to determine factors that may limit accuracy. This will serve as a potential basis for advising national health policy formulation on human identification as forensic rugoscopy is unexplored in sub-Saharan Africa. MATERIALS AND METHODS One hundred consenting participants were recruited; impressions of the upper jaws were taken and cast with dental stone. All the teeth on the models were trimmed off to prevent identification by tooth morphology and the models were coded. Five uncalibrated dentists independently pair-matched the models based on the pattern of the palatal rugae. RESULTS The overall accuracy for all 50 paired models ranged from 72 to 96%, while the percentage correct match for each of the 50 paired models range from 40-100%. All the examiners properly matched 60% of the models. CONCLUSION Rugoscopy is a useful technique for human identification due to the unique rugae pattern in every individual. However, without the aid of ancillary aids, visual inspection alone can be challenging. CLINICAL RELEVANCE This study provides useful information on an additional clinical technique relevant for human identification.

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