Squamous cell carcinoma of the oral cavity. A clinico-pathological study of 106 Nigerian cases.

A total of 106 patients with squamous cell carcinoma of the oral cavity and maxillary sinus in Nigerians were studied and analysed clinicopathologically for sex, age, site distribution as well as histological differentiation. The lesion was commoner in males than females (ratio 1.3 to 1.0) and was recorded in the age range 14 to 80 years. The mean age at presentation was 49 +/- 15.2 years, median age 49.5 years and a mode value at 51-60 years. The mandibular gingiva was the commonest anatomical site for the lesion, accounting for 28.6% of the total. Almost half of the cases (47.2%) presented histologically as well differentiated squamous cell carcinoma. Poorly differentiated squamous cell carcinoma was seen at a lower mean age 43 +/- 16 years when compared to other histological types.

Odontogenic carcinoma with dentinoid.

An unusual case of odontogenic carcinoma with dentinoid is presented and discussed. This case is the first reported to show this peculiar histologic picture. The lesion recurred following what was deemed adequate surgical excision from both the clinical and histologic viewpoints. Adequate therapy and follow-up for such lesions is thus stressed.

Histoenzymological features of epithelial cells in lesions of oral mucosa in cysts and ameloblastomas of jaws.

A histoenzymological study was carried out on 41 tissue specimens removed at biopsy and for surgical operations of the following lesions: benign hyperkeratosis, lichen planus, severe epithelial dysplasia, carcinoma in situ, epidermoid carcinoma, radicular cyst, odontogenic keratocyst and ameloblastoma. The purpose of this study was to study some possibly significant variations in levels of activities of oxidative enzymes, diaphorases, acid phosphatases and Naphthol esterases in such lesions (normal oral mucosa and epidermis serving as controls). In the lesions of the oral mucosa, these histoenzymological variations were not sufficiently characteristic to contribute to histological diagnosis. In lichen planus, some vacuolated or necrotic basal cells lacked enzyme activities, whereas in the upper layers, enzyme activities were irregularly present. Benign hyperkeratosis showed enzymatic activities similar to those of the normal epidermis, namely high oxidative activities particularly prominent in basal cells and in granular layer, and esterase activity beneath the keratinized layer. In severe epithelial dysplasia, carcinoma in situ and epidermoid carcinoma, numerous variations of activities of oxidative enzymes, esterases and acid phosphatase were seen from one cell to the other. In cystic diseases of jaws, enzymatic activities were equally nonspecific in the epithelial lining of the radicular cyst and the odontogenic keratocyst (activities similar to those of normal oral epithelium and epidermis, respectively). But in common ameloblastoma, there was diffuse uniformly low oxidative enzymatic activities in the epithelium and high widespread activity of alkaline phosphatase in the stroma. The latter may be useful in differentiating the cystic acanthomatous variety of ameloblastoma from odontogenic keratocysts of the jaws.

Oral anomalies in Nigerian children.

A total of 2203 Nigerian school-age children (10-19 yr) were examined clinically for the presence of oral anomalies. The following prevalence figures were found: commissural lip pits (2.9%), ankyloglossia (0.2%), geographic tongue (0.3%), fissured tongue (0.8%), torus palatinus (4.5%), torus mandibularis (1.9%), snowcap type amelogenesis imperfecta (0.2%), localized enamel hypomaturation (11.7%), missing lateral incisors (0.7%), and peg lateral incisors (1.5%). None of the following conditions was found: cleft chin, cleft lip, double lip, medium rhomboid glossitis, bifid tongue, macroglossia, cleft palate or cleft lip and palate.

Focal epithelial hyperplasia. Report of three cases from Nigeria, West Africa.

The first cases of focal epithelial hyperplasia from Nigeria and West Africa are presented. Although cases of this disease have been reported in Coloureds from South Africa, the three cases in this report represent the first in black Africans. The probability that the etiologic agent is a communicable agent, perhaps a virus, is reinforced by the clinical histories of the two related patients in this report.

[Histoenzymological characteristics of epithelial cells in oral mucosal lesions and jaw cysts. Diagnostic significance]. / Caractères histoenzymologiques des cellules épithéliales dans les lésions de la muqueuse buccale et dans les kystes des maxillaires. Intérêt diagnostique.

An histoenzymological study (including oxidative enzymes, diaphorases, acid and alkaline phosphatases and naphtolesterases) of 41 biopsy and operation specimens revealed interesting factors in the diagnosis of some lesions of the buccal mucosa, and also of cysts and ameloblastomas of the jaw. When compared with normal buccal mucosa and epidermis, the enzymatic activities found in the oral lesions, fell into three different types. In non dysplasic leukoplakia, enzymatic activities were found that were similar to those of the epidermis (high oxidative activities, particularly prominent in basal cells and in the granular layer and esterasic activity beneath the keratinised layer). In lichen planus, some vacuolized or necrotic basal cells occurred which lacked enzymatic activity. In the upper layers, the distribution of the enzymes was irregular. In severe dysplasia and epidermoid carcinoma, numerous variations of oxidative, esterasic and acid phosphatase activities were seen from one cell to another. Among the lesions of the jaws, radicular cysts as well as dentigerous cysts, had low enzymatic activities, similar to those of normal buccal epithelium. The epidermoid cysts (keratocysts), because of their highly differentiated keratinization, like leukoplakia, had the same enzymatic activities as epidermis. The enzymatic activities of common ameloblastoma differed from those of malpighian tissues (low oxidative activities without decreasing gradient). Besides round epithelial nests, the stroma showed a high and widespread alkaline phosphatase activity, which indicated a low degree of odontogenic induction. Thus, this peculiar stromal activity may be useful in differentiating between cystic epidermoid varieties of ameloblastoma and the other epidermoid cysts of the jaws.

Crown dimensions of deciduous teeth from pre-Columbian Peru.

The mean mesiodistal and buccolingual diameters are presented for the deciduous teeth from Pre-Columbian Peru. Generally, the deciduous teeth from Pre-Columbian Peru are larger in most dimensions than the deciduous teeth of modern populations of European descent and smaller than those of modern Australian aboriginals. Differences in crown dimensions between the Pre-Columbian Peruvian deciduous teeth and those from Prehistoric Inamgaon and Mesolithic Europe are inconsistent. However, the maxillary and mandibular second molars are larger in the Peruvian population while the incisors are smaller. Since comparative data for prehistoric deciduous teeth are rare, this paper adds valuable data to the growing literature on deciduous crown dimensions.

Effects of tobacco smoking and age on the keratinization of palatal mucosa: a cytologic study.

Cytologic smears of palatal mucosa were evaluated for degree of keratinization in 217 healthy men ranging in age from 30 to 74 years. Two slides were prepared for each participant, and each slide was read by two different pathologists. Three separate high-power fields were examined on each slide, and the percentage of orange-brown cells, either without nuclei or with pyknotic or fragmented nuclei, was recorded. A mean value was obtained for each participant. Each participant had an extensive medical and dental work-up as part of the Veterans Administration Longitudinal Study of Oral Health in Healthy Veterans. Nonsmokers and smokers were divided into five age groups. Smokers at all ages presented a greater degree of palatal keratinization than nonsmokers, but age differences in keratinization were not statistically significant.

Adenomatoid odontogenic tumour (adenoameloblastoma).

Two cases of adenomatoid odontogenic tumour affecting the jaws of two young Nigerian Africans are described. One was diagnosed clinically as a cyst, the other as an ossifying fibroma, but their true nature was later unmasked by histopathological studies. Although considered rare, the adenomatoid odontogenic tumour should be borne in mind in the differential diagnosis of radiolucent lesions of the jaws since an incorrect diagnosis may lead to mutilating surgery whereas the lesion is amenable to a conservative surgical approach. It is also important to examine histologically all excised specimens from the jaws even in the so-called 'obvious cases.

Ossifying (odontogenic) fibroma of the maxilla. A case report.

A case of grossly disfiguring ossifying fibroma of the left maxilla is presented. The lesion expanded the left maxilla, the left zygomatic bone and it filled the left maxillary antrum to the partial obstruction of the nares. The lesion was completely excised under general anesthesia. About a year post-operatively, patient was fitted with a denture obturator. Further cosmetic osteotomy contemplated on the zyomatic bone which was flayered out could not be carried out because the patient was lost to follow-up.

In vitro metabolism of testosterone-4-14 C by canine salivary glands.

Testosterone-4-14C (2430 pmol, 0.48 muM) was incubated aerobically in 67 mM phosphate buffer pH 7.4 with homogenates and minces of salivary glands from male dogs. Extracted radiosteroids were resolved by thin-layer chromatography on silica gel, removed and quantitated. Substantially higher NAD+-dependent 17beta-hydroxy-C19-steroid oxidoreductase activity was found in submaxillary gland homogenates than in similar parotid-gland preparations. Preliminary evidence is presented that the enzyme activity per unit wet weight of the minced submaxillary gland is decreased in the 2-week male castrate, in the absence of any recognizable histologic changes in the gland. Testosterone metabolism by canine salivary glands is thus oxidative, contrasting with the reductive 17 beta-hydroxysteroid pathway characteristic of androgen-dependent organs such as the prostate, and is more extensive than in this accessory sex tissue. Our findings suggest that the canine salivary glands are not target organs for circulating male hormone.

Tumors, cysts and allied lesions of the jaws and oral mucosa in Lagos, Nigeria, 1969-74.

Tumors, tumor-like lesions and cysts of the oral cavity and jaw bones seen over a 5-year period, 1969-1974, in the Department of Oral Surgery and Pathology, Lagos University Teaching Hospital, Lagos, Nigeria, are reviewed using the World Health Organization's guidelines for histologic classifications. The histopathologic distribution of the 286 lesions seen over this period was as follows: tumors of non-odontogenic tissues, 180 cases (62.9%); tumors of odontogenic tissue, 37 cases (12.9%); cysts and periapical granulomas, 67 cases (23.4%) and tumors of debatable odontogenic origin, two cases (0.8%). On the strength of available evidence, this report does not share the view that jaw tumors are more common among Africans; instead, the report's conclusion agrees with the "harvesting" theory: that jaw tumors, which are generally slow-growing, painless and non life-threatening, are "showing up" more at treatment centres throughout Africa, thus giving a clinician the chance to see many cases of jaw lesions over a relatively short time.