Descriptive epidemiology of salivary gland neoplasms in Nigeria: An AOPRC multicenter tertiary hospital study.

OBJECTIVES: Accurate diagnosis of salivary gland neoplasms (SGN) in many centers in Africa is limited by poor diagnostic resources and ancillary services. Hence, we have carried out a multicenter epidemiological study to understand the true burden of SGN in Nigeria. METHOD: In this descriptive cross-sectional study, we have deployed resources available to members of the African Oral Pathology Consortium (AOPRC) to examine the burden of salivary gland lesions in Nigeria, using a multicenter approach. Data from seven major tertiary health institutions in northern, western, and southern Nigeria were generated using a standardized data extraction format and analyzed using the Epi-info software (Version 7.0, Atlanta, USA). RESULT: Of the 497 cases examined across the seven centers, we observed that SGN occurred more in females than males. Overall, pleomorphic salivary adenoma (PA) was found to be the most common. PA was found to be the commonest benign SGN while adenocystic carcinoma (ADCC) was the commonest malignant SGN. Regional variations were observed for age group, diagnosis, and gender distribution. Significant statistical differences were found between males and females for malignant SGNs (p-value=0.037). CONCLUSION: We found regional variation in the pattern of distribution of SGN in Nigeria. This is the largest multicenter study of SGN in Nigeria, and our findings are robust and representative of the epidemiology of this neoplasm in Nigeria.

Distribution and Frequency of Salivary Gland Tumours: An International Multicenter Study.

BACKGROUND: Salivary gland tumours (SGT) are a relatively rare group of neoplasms with a wide range of histopathological appearance and clinical features. To date, most of the epidemiological studies on salivary gland tumours are limited for a variety of reason including being out of date, extrapolated from either a single centre or country studies, or investigating either major or minor glands only. METHODS: This study aimed to mitigate these shortcomings by analysing epidemiological data including demographic, anatomical location and histological diagnoses of SGT from multiple centres across the world. The analysed data included age, gender, location and histological diagnosis from fifteen centres covering the majority of the world health organisation (WHO) geographical regions between 2006 and 2019. RESULTS: A total of 5739 cases were analysed including 65% benign and 35% malignant tumours. A slight female predilection (54%) and peak incidence between the fourth and seventh decade for both benign and malignant tumours was observed. The majority (68%) of the SGT presented in major and 32% in the minor glands. The parotid gland was the most common location (70%) for benign and minor glands (47%) for malignant tumours. Pleomorphic adenoma (70%), and Warthin's tumour (17%), were the most common benign tumours whereas mucoepidermoid carcinoma (26%) and adenoid cystic carcinoma (17%) were the most frequent malignant tumours. CONCLUSIONS: This multicentre investigation presents the largest cohort study to date analysing salivary gland tumour data from tertiary centres scattered across the globe. These findings should serve as a baseline for future studies evaluating the epidemiological landscape of these tumours.

Oral squamous cell carcinoma: a clinicopathologic review of 233 cases in Lagos, Nigeria.

PURPOSE: The aim of this study is to present the clinicopathologic characteristics of histologically diagnosed squamous cell carcinoma (SCC) of the oral cavity in Lagos, Nigeria, with a view toward analyzing the age, gender, site distribution, and histological differentiation. PATIENTS AND METHODS: All cases that were histologically diagnosed as SCC of the oral cavity between January 1995 and December 2005 were retrieved from the records of the Department of Oral Pathology and Biology, Lagos University Teaching Hospital and the Oral Pathology Service, Lagos State General Hospitals. All the cases were subjected to analysis of age, gender, site of occurrence, symptoms at presentation, and histological differentiation of tumors. RESULTS: Oral SCC constituted 10.8% (n = 233) of the 5,124 biopsy specimens obtained in all of the centers during the study period. The mean age (+/- standard deviation) of patients at presentation was 45.3 +/- 19.6 years (range, 3 to 86 years), with a male:female ratio of 1.4:1; 40% of these patients were under age 40 years. Peak incidence was found in the 20 to 29-year and 40 to 49-year age groups. Males were significantly younger than females (P = .00). Poorly differentiated SCC was the most common subtype (47.6%), followed by well-differentiated (32.6%) and moderately differentiated (19.7%) subtypes. The mandibular gingiva was the most commonly affected site (31.8%), followed by the maxillary gingiva (23.3%) and tongue (17.6%). The least commonly affected site was the floor of the mouth. CONCLUSIONS: Oral SCC is most common in the mandibular gingiva and in males in our environment, with 40% of cases occurring in patients under age 40 years. The poorly differentiated subtype is the most common histological differentiation.

Immunohistochemical study of salivary gland tumors in a tertiary institution in South-South Region of Nigeria.

AIM: The aim of this study was to see the usefulness of immunohistochemistry in diagnosing salivary gland tumors found in a tertiary health institution. MATERIALS AND METHODS: Twenty-six formalin-fixed paraffin embedded salivary gland tumors were accessioned, and 2 µm were sectioned and processed using Streptavidin-Biotin immunoperoxidase method. RESULTS: Adenoid cystic carcinoma (ADCC) was positive to alpha-smooth muscle actin (α-SMA) while mucoepidermoid carcinoma (MEC), polymorphous low-grade adenocarcinoma (PLGA), squamous cell carcinoma (SCC) and oncocytic carcinoma (OCC) were all negative to it. MEC, PLGA, ADCC and the only pleomorphic adenoma (PA) were positive to Ki-67 while both SCC and OCC were negative to it. All the tumors except PA were positive to p63. CONCLUSION: It appears that α-SMA may be used to distinguish ADCC from MEC and PLGA, but Ki-67 cannot be used for this purpose. Furthermore, p63 cannot help in the diagnosis of ADCC, MEC or PLGA. It was concluded that immunochemistry can be used as adjunct to routine H and E stain in the diagnosis of the various salivary gland tumors.

Malignant orofacial neoplasms in children and adolescents: a clinicopathologic review of cases in a Nigerian tertiary hospital.

OBJECTIVE: The aim of the study was to determine the relative frequency of orofacial malignant neoplasm in children and adolescents. METHODS: A retrospective review of malignant orofacial tumours in children and adolescents

A multi-centre evaluation of oral cancer in Southern and Western Nigeria: an African oral pathology research consortium initiative.

INTRODUCTION: Oral cancer is a leading cause of cancer deaths among African populations. Lack of standard cancer registries and under-reporting has inaccurately depicted its magnitude in Nigeria. Development of multi-centre collaborative oral pathology networks such as the African Oral Pathology Research Consortium (AOPRC) facilitates skill and expertise exchange and fosters a robust and systematic investigation of oral diseases across Africa. METHODS: In this descriptive cross-sectional study, we have leveraged the auspices of the AOPRC to examine the burden of oral cancer in Nigeria, using a multi-centre approach. Data from 4 major tertiary health institutions in Western and Southern Nigeria was generated using a standardized data extraction format and analysed using the SPSS data analysis software (version 20.0; SPSS Inc. Chicago, IL). RESULTS: Of the 162 cases examined across the 4 centres, we observed that oral squamous cell carcinomas (OSCC) occurred mostly in the 6th and 7th decades of life and maxillary were more frequent than mandibular OSCC lesions. Regional variations were observed both for location, age group and gender distribution. Significant regional differences was found between poorly, moderately and well differentiated OSCC (p value = 0.0071). CONCLUSION: A multi-centre collaborative oral pathology research approach is an effective way to achieve better insight into the patterns and distribution of various oral diseases in men of African descent. The wider outlook for AOPRC is to employ similar approaches to drive intensive oral pathology research targeted at addressing the current morbidity and mortality of various oral diseases across Africa.

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.