Comparative Immunohistochemical Analysis of p53 and Alpha-SMA in Ameloblastoma, AOT and OKC.

OBJECTIVES: Ameloblastoma is a benign but highly infiltrative tumour, a behaviour that is lacking in adenomatoid odontogenic tumour but partly shared by the odontogenic keratocyst which possesses a unique intrinsic growth potential with marked ability for destroying bone and a high tendency recurrence. High frequency of stromal myofibroblasts (assessed with alpha smooth muscle actin (α-SMA) correlates with aggressive behaviour while p53-cell cycle regulation system is critical in odontogenic tumours with immunoreactivity signifying prognostic status. This study aims to determine and compare the immunoreactivity of these selected tumours to p53 and α-SMA in order to establish if a relationship exists between the frequency and pattern of distribution of myofibroblasts and the behaviour of these lesions. MATERIALS AND METHODS: 69 blocks of ameloblastoma, and 23 each of adenomatoid odontogenic tumor (AOT), and odontogenic keratocyst (OKC/KCOT) were retrieved. Immunohistochemistry technique was applied for evaluation of these two markers staining with primary antibodies to p53 and -SMA and the frequency and pattern of distribution of myofibroblasts and immunoreactivity to p53 analysed and compared using ANOVA. p was set at <0.05. RESULTS AND CONCLUSION: Immunoreactivity to p53 and α-SMA was highest in ameloblastoma (solid compared to unicystic) with highest mean positive cells to α-SMA (29.7±20.1) and p53 (28.3±24.5) in plexiform ameloblastoma. This suggests that ameloblastoma was the most aggressive of tumours studied. Different pharmacological agents that can regulate stromal MF are useful aids to decrease the need for radical surgery in extensive and aggressive odontogenic tumours.

ABSTRAIT OBJECTIFS: L'améloblastome est bénin mais untumeur mes infiltratif, un comportement qui fait défaut dans la tumeur odontogénique adénomatoïde mais en partie partagé par le kératocyste odontogène qui possède un potentiel de croissance intrinsèque unique avec une capacité marquée de destructionet une récidive à forte tendance. Haute fréquence de stromalmyofibroblastes (évalués avec de l'actine musculaire alpha lisse (α-SMA) est en corrélation avec un comportement agressif lors de la régulation du cycle des cellules p53 est essentiel dans les tumeurs odontogènes immunoréactives signifiant le statut pronostique. Cette étude vise à déterminer et comparer activité l'immunoré de ces tumeurs sélectionnées à p53 et α-SMA afin d'établir s'il existe une relation entre le fréquence et schéma de distribution des myofibroblastes et de la comportement de ces lésions. MATÉRIAUX ET MÉTHODES: 69 blocs d'améloblastome, et 23 chacun de tumeur odontogénique adénomatoïde (AOT) et odontogènedes kératocystes (OKC/KCOT) ont été récupérés. Immunohistochimiela technique a été appliquée pour l'évaluation de ces deux marqueurs de coloration avec des anticorps primaires dirigés contre p53 et α-SMA et la fréquence et schéma de distribution des myofibroblastes et de l'immunoréactivité àp53 analysé et comparé à l'aide de l'ANOVA. p a été fixé à <0,05. RÉSULTATS ET CONCLUSION: Immuno réactivité à p53 et α-SMA était la plus élevée dans l'améloblastome (solide par rapport α-SMA (29,7±20,1) et p53(28,3±24,5) dans l'améloblastome plexiforme. Cela suggère que L'améloblastome était la tumeur la plus agressive étudiée. Les agents pharmacologiques différentes peuvent réguler la MF stromale sont des aides utiles pour diminuer le besoin de chirurgie radicale en cas de chirurgie étendue et agressive tumeurs odontogènes. Mots-clés: Améloblastome, AOT, OKC/KCOT, p53, α-SMA, myofibroblastes, tumeurs odontogènes, immunoréactivité.

Association of Squamous Cell Carcinoma of the Tongue with Cigarette and Alcohol Exposure: A Retrospective Clinicopathological Study.

BACKGROUND: Squamous cell carcinoma of the oral tongue (SCCOT) has been linked to modifiable risk factors; such as tobacco use and excessive alcohol consumption. OBJECTIVE: To describe the clinical presentation of SCCOT as well as its association with history of tobacco and alcohol use. METHODS: A retrospective review of SCCOT at Oral Pathology Department from 1990 to 2012. Information retrieved from patients' medical records includes: age, gender, occupation, history of alcohol and tobacco use. Also, the first symptoms observed by patients at the onset of disease, and what was done for patients at the place of first consultation were documented. RESULTS: SCCOT accounted for 26% of all oral squamous cell carcinoma (SCC); mean age at presentation was 58.3 ±12.6 years. Two patients diagnosed of SCCOT before 40 years as well as female SCCOT patients denied exposure to either alcohol or tobacco; while about 80% and 70% of males with complete history were exposed to tobacco and alcohol respectively. At the onset of disease, 70.2% of patients noticed a lingual ulcer, 13% experienced pain, but at presentation, only one patient was not experiencing pain. About 85.3% of patients presented with stage III and IV disease. All patients but two were treated with antibiotics and analgesics at first presentation in a hospital. CONCLUSION: The most common symptoms at the onset of disease were ulceration and pain. Men above age forty years had exposure to alcohol and tobacco.

Expression of CD34 and maspin in ameloblastoma from a West African subpopulation.

Ameloblastoma is a locally invasive odontogenic tumor with a high recurrence rate. Its local invasiveness is aided by angiogenesis, which can be correctly estimated by CD34. On the other hand, maspin decreases the local invasive and metastatic capability of cancer cells and functions as an angiogenesis inhibitor. We aim to assess the association between maspin expression and microvessel density in ameloblastoma. Twenty-five formalin-fixed paraffin-embedded (FFPE) blocks of ameloblastoma cases were prepared for antibody processing to CD34 and maspin. Positive immunohistochemical staining was marked by brown cytoplasmic/membrane coloration for CD34 and by nuclear/cytoplasmic coloration for maspin. At the ×40 magnification, we counted blood vessels in two areas of dimension; 300 × 400 µm (area A) and 150 × 200 µm (area B) adjacent to the tumor region to assess relative dispersion of the vessels bordering the tumor. The overall approximate microvessel density (MVD) for area A = 11 (minimum 2, maximum 21) and that for area B = 5 (minimum 1, maximum 10). The MVD in the area A of plexiform ameloblastoma was similar to that of the unicystic, while the hemangiomatous variant had the highest MVD for area A. Maspin positivity was present only in the cytoplasm of ameloblast, stellate reticulum, and the fibrous connective tissue in varying proportions. There was no evidence of the anti-angiogenesis effect of maspin in ameloblastoma from this study. The significance of cytoplasmic localization of maspin in the ameloblasts and stellate reticulum cells needs further investigation.

HIV TESTING IN DENTAL PRACTICE: PERCEPTION AND ATTITUDE OF DENTISTS IN SOUTHWESTERN NIGERIA.

BACKGROUND: In recent times, the concept of routine HIV screening has been recommended to enhance early diagnosis and timely initiation of care thereby reducing morbidity and mortality among HIV infected persons. Dental practice has been identified as a unique venue of reaching at-risk individuals who may not otherwise access the conventional healthcare settings. AIM: To assess the perception and attitude of dentists in Southwestern Nigeria concerning integrating HIV testing into dental practice. METHODS: this descriptive cross- sectional study was conducted between January-March, 2014. Convenience sampling was used to select 113 practising dentists within Southwest Nigeria. Data collection was done using a self- administered questionnaire. RESULTS: Agreement to HIV testing in dental settings was in the order of 100% for private practitioners followed by 91.7% from teaching hospitals (91.7%) and least agreement was with state hospitals (76.5%). There was a strong association between participants' years of practice and support for HIV testing in dental settings with highest support among those between 7-9 years (p= 0.002). Significantly too (p= 0.013), all the specialists (100%) agreed to HIV testing in dental settings compared to general practitioners (84.0%). CONCLUSION: This study showed that most dentists in Southwest Nigeria acknowledged dental practice as being appropriate for expanded HIV testing and as well were willing to undergo training for HIV testing in their dental settings.

Oro-facial sarcomas: a review of 88 cases in a Tertiary Institution in Nigeria.

BACKGROUND: A sarcoma is a malignant tumour arising from connective tissue. The word sarcoma is derived from the Greek word, sarkoma meaning fleshy growth and presents either as a soft tissue or bony tumour. Sarcomas are rare in the oro-facial region compared to oral squamous cell carcinoma. The rarity of jaw sarcomas makes diagnosis sometimes challenging and the anatomy makes aggressive treatment difficult without causing unacceptable physiological, functional and cosmetic damage to the patient. The aim of this study was to examine the demographic pattern of patients with jaw sarcomas seen at the University College Hospital, Ibadan, Nigeria over a thirty year period. METHODS: All histologically diagnosed cases of sarcomas of the oro-facial region from the Cancer Registry of the University College Hospital Ibadan and the histology records of the department of Oral Pathology, University College Hospital Ibadan from 1980-2010 were reviewed. Data was analyzed using SPSS version 18. RESULTS: Eighty eight oro-facial sarcomas were seen consisting of sixteen different histological types. Osteogenic sarcoma was the most common type with 40 cases (45.5%). Osteogenic sarcoma occurred more in females than males with a male: female ratio of 13:27 and a mean age of 32.2 years (SD ± 15.7). Embryonal rhabdomyosarcoma had an equal male: female distribution with mean age of 7.0 years (SD ± 5.2) and peak age incidence in the first decade. CONCLUSION: The findings in this study were generally in agreement with reports from Europe, and though, at variance with some African studies, they are mostly in agreement with large African series.

Parental attitudes to the care of the carious primary dentition experience from a Nigerian tertiary hospital.

OBJECTIVE: To examine the factors associated with parents choices of dental care concerning carious primary teeth of their children. METHODS: A structured, self administered questionnaire was issued to parents of children attending the paediatric dental clinic of the University College Hospital (UCH) Ibadan. Items in the questionnaire included a section on the past dental visit(s) of parents, reason(s) for the clinic attendance and treatment(s) received, the second section contained items on parental treatment preferences under two different clinical scenarios of child dental health; scenario 1, asymptomatic carious primary tooth and scenario 2, symptomatic carious primary tooth. The last section contained items on determinants of parents' choice of treatment. RESULTS: Majority of the accompanying parent were mothers (75.8%) with a mean age of 39.3 +/- 6.81, fathers were 20.8% with a mean age of 45.1 +/- 5.24 while others were 3.4% with a mean age of 51.2 +/- 1.09. Under the two clinical scenarios, majority of the parents preferred the dentist to determine the treatment of their children (scenario 1 = 53.7%; scenario 2 = 62.5%). The accompanying parents and their socioeconomic status had no significant effect on parental preferences under the two clinical scenarios while past parental dental treatment had the greatest influence on parental choice (scenario 1:x2 = 12.93; p = 0.03 for past fillings experience and scenario 2: X2 = 6.881. = X 0.001 for past extraction experience). CONCLUSION: The reliance of parents on dentist for decision on the choice of their children dental treatment and the dependence of parents choice on their past dental treatment experience suggested the need for dental health education to both parents and children on dental caries.

Stages of delay in oral cancer care evaluated at a tertiary health centre.

BACKGROUND: To examine the stages of delay in presentation and management of oral cancer patients at University College Hospital Ibadan and compare findings with previous studies. METHODS: A 20-year retrospective analysis of the delay stages among oral cancer patients that utilized patient's biodata and clinical data. RESULT: 169 oral cancer cases consisting of 127 carcinomas, 25 sarcomas and 17 lymphomas were analyzed. There was significant difference in the mean evolution time (ET) according to histological type (oral carcinoma = 282.8 +/- 414, oral sarcomas = 219.2 +/- 247.3 and oral lymphomas 105.5 +/- 115 days; p = 0.001). Patient's delay was more than professional delay for all cancer types (65.9%, 59.1% and 60.1% for carcinomas, sarcomas and lymphomas respectively). There was a significant difference in the mean ET of the early stage cancers compared with the late stage cancers (mean = 137.2 +/- 99 and 266.4 +/- 355; p = 0.010). CONCLUSION: A combination of patients and professional delay negatively influenced the management of oral cancer patients but the patient's delay formed the bulk of this combination in our center.

Histological grading of oral squamous cell carcinoma patients in Ibadan using Bryne's and Broders' grading systems--a comparative study.

BACKGROUND: Several histological grading systems for oral squamous cell carcinoma (OSCC) have been used previously to guide treatment and prognostication, amongst which are the Broders and the Bryne's methods. The Bryne's invasive tumour front (ITF) protocol has been adjudged to have good prognostic significance. We compared the use of Bryne's ITF system and Broders' grading system in grading OSCC at our centre in relation to clinico-demographic profile of patients. METHODS: Thirty two formalin fixed paraffin embedded (FFPE) tissue samples of histologically diagnosed OSCC patients at the University College Hospital (UCH) Ibadan were selected, demographic data and site of lesions were retrieved from the medical records of the patients. The haematoxylin and eosin (H&E) slides of the 32 cases were prepared and evaluated using Bryne's ITF system and Broders classification. RESULTS: Using Bryne's system, 28% of the cases had a high malignancy score while 72% had a low malignancy score. The high malignancy score lesions were most commonly seen in the palate (15.5%). Also Broders classification showed that 31.3% of cases were well differentiated tumours, 50% were moderately differentiated while 18.7% were poorly differentiated. CONCLUSION: Either the Bryne's system or Broders classification can be used to grade OSCC with similar results being obtained.

Clinical presentation of oral squamous cell carcinoma.

AIMS AND OBJECTIVES: This study aims to present the symptoms first observed by patients diagnosed of oral squamous cell carcinoma (OSCC) presenting at the University College Hospital, Ibadan between January 1990 and December 2008 as well as the time lag between the observation and presentation in the hospital. PATIENTS AND METHODS: This is a retrospective review of patients that have been diagnosed histologically as squamous cell carcinoma of the oral cavity at the University College Hospital Ibadan, Nigeria between January 1990 and December 2008. RESULTS: Painful tooth/teeth which are not mobile were the most common symptom in these patients (27.5%). However, about 59.4% of patients had painless symptoms at the onset of the disease. The interval between onset of symptoms and clinical presentation ranged from 3 weeks to 36 months with a mean duration of 7 ± 6.3 months. Paradoxically, patients that experienced painful symptoms at the onset of disease presented later than those who had painless symptoms CONCLUSION: The first symptoms observed by these patients were not pathognomonic of oral cancer but are shared by several relatively more common oral diseases. Awareness of the populace about oral cancer should be increased as well as the index of suspicion of the medical practitioner for OSCC.

Attitude and perception of mouth odour in 213 respondents.

AIMS AND OBJECTIVES: To determine respondents' perception of their breath odour and their attitude to halitosis, a symptom with social, psychological and medical implications. PATIENTS AND METHODS: Cross-sectional survey of 213 participants at an oral health education programme organised by a female non-governmental organization, at Ibadan, Nigeria. Socio-demographic variables, individual assessment of breath odour, attitude, experience and knowledge of halitosis were evaluated using a structured questionnaire. RESULTS: About 67.1% (143) did not perceive foul odour from their oral cavity at any time of the day while one respondent perceived a persistently foul breath. 83.1% would like to be told if their breath smells foul and were of the opinion that such information was helpful. 25 respondents considered such remarks embarrassing/insulting, preferring not being told. Seventy-seven (36.2%) would consult the dentist, while 13% (27) would use agents such as chewing gums and candies to mask oral malodour if their breath odour was foul. 80 respondents had been in contact with individuals with foul breath but only 38.8% of them informed the individuals with malodour that their breath odour was foul. CONCLUSIONS: Most respondents had a good impression of their breath odour and would appreciate it when informed that their breath is offensive. A few individuals were reluctant to inform people with bad breath while some took exception to such information. To reduce the present stigma and reluctance to discuss bad breath, steps must be taken to re-orientate people through public enlightenment programmes on the aetiology, available remedy for halitosis and how to convey sensitive information to people.

The knowledge and experience of personal and professional oral care among secondary school students in Ibadan.

OBJECTIVE: Many developing nations of the world have experienced an increase in the incidence and prevalence of oral diseases in the last few decades. This study assessed the knowledge and attitude as well as the experience of personal and professional oral care of secondary school students in Ibadan, in order to understand how to promote a better oral health habit amongst them. PATIENTS AND METHODS: Questionnaires including items relating to knowledge, attitude as well as personal and professional oral care were administered to the subjects. RESULTS: A total of 267 students from Ibadan North Local government area of Ibadan, Oyo state participated in the study. Of these 71.5% clean their mouth twice daily, only 4.1% of the students have used dental floss at least once before. 55.5% of them have been to the dentist before. Only 16.2% of those that have been to the dentist before went for a check. 6.7% of the students know that dental floss is an interdental cleaning device. About 75 % of the students believe that routine dental check-up helps in maintaining a good oral health while about 22 % were of the opinion that it is not necessary or that it is burdensome. CONCLUSION: In conclusion, there is the need for oral health education and promotion that links healthy behaviours and habits to the general well being of individuals because as seen from this study, knowledge is not enough to motivate individuals to adopt a healthy behaviour.

Serum antioxidant vitamins and the risk of oral cancer in patients seen at a tertiary institution in Nigeria.

OBJECTIVES: Tobacco and alcohol are major risk factors of oral cancer, but nutritional deficiency may also contribute to development of oral cancer. This study compared serum antioxidant vitamin levels in oral cancer patients and controls in order to validate the role of vitamin deficiencies in the etiology of oral cancer. MATERIALS AND METHODS: Serum vitamin A, C, and E levels of 33 oral cancer patients and 30 controls at University College Hospital, Ibadan, Nigeria, were determined using standard methods. The data obtained were analyzed using the Student t-test, odds ratio, and logistic regression. RESULTS: Mean vitamin A, C, and E levels were significantly lower in oral cancer patients (P=0.022, P=0.000, and P=0.013 respectively). Risk of oral cancer was 10.89, 11.35, and 5.6 times more in patients with low serum vitamins A, C, and E, respectively. However, on logistic regression analysis, only low serum vitamin E independently predicted occurrence of oral cancer. CONCLUSIONS: The lower serum vitamin A, C, and E levels in oral cancer patients could be either a cause or an effect of the oral cancer. Further studies using a larger sample size and cohort studies with long-term follow-up of subjects are desirable.

A retrospective histopathological review of oral squamous cell carcinoma in a Nigerian teaching hospital.

This study was undertaken to describe the demographic pattern of oral squamous cell carcinoma (OSCC) in Ibadan, Nigeria and compare our findings with that of other countries. It involved a retrospective review of OSCC diagnosed at the University College Hospital Ibadan, Nigeria between 1990 and 2008. A review of studies from other countries was done with respect to the three most frequently affected sites by OSCC, as well as mean ages and gender ratios. OSCC comprised 181 (43.7%) of the 414 malignant neoplasms diagnosed in the oral cavity within the study period. The most frequently affected sites were the maxillary gingiva (24.9%) and mandibular gingiva (21.5%). There was a slight male preponderance; with a male to female ratio of 1.2:1. The peak age was in the eighth decade of life. About 17.7% of cases were diagnosed in patients below the age of 40 years and 1.1% of cases occurred in children. Worldwide, the tongue is the most frequently affected site by squamous cell carcinoma followed by the floor of the mouth. Males are also more frequently affected. In conclusion, OSCC remains an important cause of morbidity and mortality among middle aged individuals in our environment and worldwide, but sometimes affecting younger individuals.

Social profile and habits of oral cancer patients in Ibadan.

OBJECTIVES: The aim of this study was to compare the socioeconomic profile and social habits of oral cancer patients and those of control subjects in order to investigate the relative importance of these risk factors in the occurrence of oral cancer. STUDY DESIGN: Thirty-two histologically diagnosed oral carcinoma patients and 30 normal patients were recruited at the dental centre University College Hospital, Ibadan. A 33-item questionnaire was administered to the two groups. The data obtained was analyzed using student t test and chi square as appropriate as well as odds ratio. RESULTS: Incomes less than 50,000 naira per annum, absence of fruit in every diet and tobacco use, were associated with 5.7, 3.0 and 4.05 increased risk of oral cancer respectively. CONCLUSION: Low income, fruit depleted diet and tobacco use seems to be the most important risk factors for oral cancer development in the studied environment.

Agenesis of a mandibular canine: a case report.

BACKGROUND: Hypodontia is one of the most common developmental anomalies in man. The most frequently missing tooth is the third molar. Agenesis of canine in the secondary dentition is rarely reported . OBJECTIVE: To report a very rare form of missing tooth in the secondary dentition due to agenesis. METHODS: A 49-year Nigerian male consulted with a desire to have a dental check-up. Extra- and intr-oral exminations were carried out. Following observation of a a missing tooth orthopanthomograph was carried out. with a missing lower right canine. All other teeth were well formed and have all erupted into the oral cavity. RESULTS: There was no history of systemic disease or family history of oligodontia and was generally well. Systemic examination was essentially normal. Intra oral examination revealed that he had full complement of teeth but for a missing lower right canine. There was a gap of about 2mm between the lower right lateral incisor and the lower right first premolar and a buccal displacement of the upper left second molar as well as a carious lesion on the upper first left molar. The orthopanthomograph showed that the tooth was not within the mandible in this patient. CONCLUSION: The cause of the aplasia resulting in this rare condition is not clear but may be due to inadequate secretion of some of the signaling molecules or localized absence of their receptors in the ectomesenchye destined to differentiate into the right canine tooth.

Paediatric head and neck malignancies in Ibadan, Nigeria.

Studies on paediatric head and neck cancer are limited in the medical literature. Most studies have been restricted to specific histological types such as rhabdomyosarcoma, osteogenic sarcoma or Burkitt's lymphoma. This study describes the relative frequency of cancers seen in the head and neck region of children below 16 years of age at the University College Hospital, Ibadan, Nigeria. A total of 281 cases of paediatric head and neck tumours were diagnosed within the study period, out of which 84 cases were malignant. Fifty-four of these cases were males while 30 were females, giving a male to female ratio of 1.8:1. The age range for these cases was 3 days to 15 years with a mean age of 9.03 +/- 4.63 years. The most frequently diagnosed tumours were haematopoietic malignancies, accounting for 47.6% of cases, followed by sarcomas (27.4%) and carcinomas (21.4%). Burkitt's lymphoma constituted 28.6%, followed by rhabdomyosarcoma accounting for 17.9% of cases. Malignant neoplasms of the head and neck region are rare in the paediatric age group. The pattern of these neoplasms also differs from that in the adult population. However, malignant head and neck neoplasms in the paediatric age group also showed the male preponderance characteristic of head and neck malignancies in the adult population.

Knowledge and self-perception of breath odour amongst house officers at the University College Hospital, Ibadan, Nigeria.

OBJECTIVE: This study assessed the knowledge and perception of house officers on halitosis in the University College Hospital, Ibadan. PATIENTS AND METHODS: Questionnaires including items relating to knowledge of halitosis, awareness and timing of bad breath, oral hygiene habits and opinions on other issues related to bad breath were administered to the subjects. RESULTS: Only seventeen (15.5%) of the 110 respondents knew that halitosis refers to malodour originating from the oral and nasal cavities while five (5%) were of the opinion that halitosis is only a cosmetic problem. Furthermore, thirty nine (35.5%) preferred not being told by a friend or colleague if their breath smells badly. CONCLUSION: The knowledge and perception of the newly qualified doctors to halitosis in this study is unsatisfactory. Therefore, concerted efforts should be made to improve them. This could be achieved by more emphasis on this subject during their undergraduate training.

Dental caries experience among the elderly population in South East local government area in Ibadan, Nigeria.

OBJECTIVE: To determine the caries experience of the elderly people in South East Local Government Area (S.E.L.G.A) in Ibadan. SUBJECTS AND METHODS: A randomly selected sample of 690 elderly people from 23 wards in S.E.L.G.A were examined by two trained and calibrated examiners according to WHO criteria. RESULTS: Majority of them (85.5%) had no caries experience. Their mean DMFT was 0.46. More teeth in the mandible (160) than the maxilla were affected by caries or treated for caries. Their MNI was 25.5% and RI was 21%. CONCLUSION: The elderly in S.E.L.G.A have low caries experience and very high-unmet dental health needs.

Multiple malignant lesions involving the orofacial region: a case report.

We describe a rare finding in a 38 year old patient with previously undiagnosed prostate cancer who presented with multiple facial swellings, mental nerve neuropathy and paraplegia. While the co-existence of paraplegia and mental nerve neuropathy is a possible feature of metastatic prostate cancer involving the spine and mandible, the concomitant occurrence of multiple facial swellings involving the anterior mandible with its related gingival and lip mucosa, frontal bone and parotid glands is a rare finding. This raised a suspicion of two histologically different malignancies co-existing in this patient. Fine needle aspiration cytology (FNAC) of the parotid lesion and incisional biopsy of the gingival lesion were reported as Lymphoblastic lymphoma and Non Hodgkin's Lymphoma respectively. A Transrectal biopsy of the prostate gland confirmed adenocarcinoma of the prostate gland. The patient however died due to a number of intercurrent illnesses and rapid deterioration consequent on his disease condition. Unfortunately, all efforts to carry out an autopsy were unsuccessful due to strong objection of the relatives on religious grounds. Problem associated with the diagnosis and management of such a rare case in a developing economy was highlighted.

Intra-oral squamous cell carcinoma in Nigerians under 40 years of age: a clinicopathological review of eight cases.

Intra-oral squamous cell carcinoma (SCC) is a disease commonly seen in patients aged 50 and above. A recent report on intra-oral SCC in the Nigerian population placed the mean age of occurrence for the disease at 50.7 years for male and 49.6 years for females. Age is recognized to be an important factor in the onset and outcome of diseases like cancer. The focus of this study was to conduct a clinicopathological review on the incidence, pattern of presentation, management and outcome of the disease in patients aged 40 years and below seen at the University College Hospital Ibadan, between 1980-1995. During the period under review the total number of cases of SCC was 104, out of which 8 (7.7%) occurred in patients aged 40 years and below. The figure is higher than that of 1-3% obtained in Caucasian studies. The 5 year survival rate of our patients was nil.