Oral squamous cell carcinoma in human immunodeficiency virus positive patients: clinicopathological audit.

BACKGROUND: Most human immunodeficiency virus positive patients now have a longer life expectancy, with the advent of highly active antiretroviral therapy. However, they are now at increased risk of developing a malignancy during their lives. AIM: To investigate the age at which oral squamous cell carcinoma presents in patients infected with human immunodeficiency virus. STUDY DESIGN: Prospective, clinicohistopathological audit of patients infected with human immunodeficiency virus. RESULTS: Of 200 human immunodeficiency virus positive patients, 16 (8 per cent) presented with oral squamous cell carcinoma (nine women and seven men; age range 18-43 years, mean age 31.7 years). The majority of patients (62.5 per cent) had stage III and IV disease (tumour-node-metastasis staging). There was a predilection for poorly differentiated oral squamous cell carcinoma (using Broder's histopathological classification). CONCLUSION: Oral squamous cell carcinoma associated with human immunodeficiency virus infection appears to present at a relatively young age.

The pattern and occurrence of ameloblastoma in adolescents treated at a university teaching hospital, in Kenya: a 13-year study.

UNLABELLED: Ameloblastoma presenting in the adolescent age group is rare with few studies documenting their occurrence. AIM: The aim of this study was to carry out an analysis of the pattern and occurrence of ameloblastoma in those less than 20 years of age. MATERIALS AND METHOD: Patients from the University of Nairobi Dental teaching Hospital treated for ameloblastoma were included in the study over a 13-year period. The study highlights the demographic, clinic-radiographic and histologic features of benign locally aggressive lesions. RESULTS: A total of 127 patients were recorded of which, 27 (21.3%) were below the age of 20 years; no case was reported below the age of 10 years. 18.5% were below the age of 14 years and 81.5% were 15-19 years old. The gender predilection was ∼1:1. All of the tumours occurred in the mandible, with radiographic features of a multilocular radiolucencies (85.2%); and a fewer unilocular lesions (14.8%). The management is in a staged-wise approach: resection and/or disarticulation with temporary reconstruction using mandibular stainless steel or titanium plates and delayed bone grafting. CONCLUSION: The occurrence of ameloblastoma can mimic an odontogenic cyst, clinicians therefore need to be vigilant when examining adolescents so that conservative treatment is started early in order to reduce the subsequent morbidity.

Early outcome of three cases of melanotic neuroectodermal tumour of infancy.

Melanotic neuroectodermal tumour of infancy (MNTI)/progonoma is a rare lesion affecting infants. Although it is slow growing and appears benign, it may have malignant potential. Evidently, surgery is the main stay of treatment and close follow-up is recommended for all cases. The literature shows that radiotherapy and chemotherapy may be indicated especially in cases where total surgical extirpation is equivocal. This article contributes three more cases of MNTI surgically managed at our institution.

Pattern of head and neck malignant neoplasms in HIV-infected patients in Kenya.

HIV-infected patients face a greater risk of developing malignant disease. The most commonly reported neoplasms of the head and neck region include Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL). There is also an increased risk of oral squamous cell carcinoma (SCC). A descriptive cross-sectional study including HIV-infected patients with neoplastic and non-neoplastic lesions was conducted. Of the 200 participants, 116 (58%) were male and 84 (42%) female with an age range of 18-61 years (mean 37 years). The females were significantly younger (mean 33 years) than the males (mean 37 years) (t test; 2.57; P<0.05 [0.001]). The prevalence of neoplastic lesions in this study was 27%; 37 (68%) patients had KS, 9 (17%) had SCC, 7 (13%) had NHL and 1 (2%) had Burkitt's lymphoma. More females than males presented with lesions of KS and SCC compared with NHL. The youngest patient presented with SCC at 18 years (mean 35.7 years), followed by KS at 23 years (mean 36.3 years) and NHL at 33 years (mean 43.9 years). Most study participants (97%) were in stage III/IV of the disease and the remaining 3% in stage II. In this study, the most common malignant neoplasms were KS, SCC and NHL, manifesting in a younger age group than in the non-HIV group of patients.

Correlation of CD4 counts and CD4/CD8 ratio with HIV-infection associated oral manifestations.

BACKGROUND: The relationship between oral lesions arising from HIV infection and CD4/CD8 cell ratios is of relevance in clinical assessment of immune suppression. OBJECTIVE: To correlate the prevalence of oral manifestations arising from HIV infection and the levels of CD4/CD8 cell ratios. DESIGN: A cross-sectional study. SETTING: Kenyatta National Hospital, Nairobi, Kenya. SUBJECTS: Two hundred and seven HIV-infected patients in medical wards were recruited in the study. RESULTS: Seventy eight (37.7%) were male and 129 (62.3%) female, with an age range of 18-73 years (mean=34.81 years). Oral manifestations encountered with highest prevalence in the oral cavity included: hyperplastic candidosis (labial mucosa) 15%, erythematous candidosis (gingival) 5%, angular cheilitis 32.4%, herpes simplex (corner of the mouth) 0.5%, persistent oral ulceration (labial mucosa) 0.5%, Parotid enlargement 2% and Kaposis sarcoma (hard/soft palate) 2.9%. CONCLUSION: The prevalence of oral manifestations was higher with low CD4 count <200 cell/mm3 and mean CD4/CD8<0.39(95%CI 0.32-0.48).

Problems in diagnosing odontogenic myxoma: case report.

Tumours and tumour-like growths arising from odontogenic tissues constitute a heterogenous group of lesions whose diagnosis can be particularly challenging on the part of both surgeons and pathologists. In children, these lesions are even more difficult to clinically and histopathologically diagnose definitively because of the concurrent diverse embryologic differentiation of dental tissues. A case is presented of a 12 year-old boy who was subjected to inappropriate primary management of a left mandibular mass, due apparently to inadequate consultation to establish an accurate diagnosis.

Cheilitis glandularis progressing to squamous cell carcinoma in an hiv-infected patient: case report.

Cheilitis glandularis (CG), is a rare inflammatory minor salivary gland disease affecting the lower lip. The hallmarks of which include progressive enlargement and eversion of the lower labial mucosa resulting in the obliteration of the mucosal-vermillion interface. A case is presented of a 47-year-old HIV-infected woman who initially manifested clinical features of CG with a typical histopathology picture of a non-specific sialadenitis while a second biopsy performed six months later revealed well differentiated squamous cell carcinoma (SCC). She is symptom free one year following excision and radiotherapy treatment.