A retrospective study of oral and maxillofacial pathology lesions diagnosed at the Faculty of Dentistry, King Abdulaziz University

Oral Potentially Malignant Disorders and Oral Cancer in Saudi Arabia: An Epidemiological Review of the Literature

Background: Oral potentially malignant disorders (OPMDs) are a group of chronic oral mucosal diseases associated with an increased risk of malignant transformation. Multiple studies have investigated the prevalence of these conditions in multiple regions; however, there are limited data about the prevalence of OPMDs in the Kingdom of Saudi Arabia (KSA). This paper aims to review the prevalence of OPMDs in the KSA, to ensure better understanding of the population risk and propose a more standardised approach to the diagnosis and management of this group across the KSA. In addition, this review will discuss the prevalence of oral cancer in the KSA, considering independent risk factors for oral cancer development. Methods: Electronic databases including PubMed, Medline, Medscape, ScienceDirect, StatPearls, BMC Oral Health and the Cochrane Library were searched with the keywords "Oral Potentially Malignant Disorders"; "Saudi Arabia"; and "Oral Cancer". Identified articles were reviewed independently by 2 reviewers against defined inclusion and exclusion criteria. Results: 16 studies were included in this review. The prevalence of OPMDs in KSA varies significantly depending on age, gender, social habits, background disease and dental status. Conclusions: This review highlights the need for up-to-date data on the prevalence, distribution, and characteristics of OPMDs in KSA. The diverse prevalence rates and distinct characteristics of various OPMDs emphasise the necessity for targeted preventive measures. As the data on OPMDs in KSA remains limited, future research efforts should prioritise the establishment of comprehensive epidemiological studies to inform effective public health interventions in this region.

Spectrum of Oral and Maxillofacial Tissue Biopsies at the Foremost Tertiary Institution in The Gambia: A Retrospective Review

Introduction

Sub-Saharan Africa has a heavy burden of oral diseases and cancers. Also, there is a dearth of published records of oral pathology services in The Gambia. Therefore, this review aimed to determine the prevalence of biopsied oral and maxillofacial lesions in order to ascertain the uptake of oral histopathology services at the foremost tertiary institution in The Gambia.

Materials and Methods

This was a retrospective study performed at the Pathology Department of Edward Francis Small Teaching Hospital. Reports of all oral and maxillofacial biopsies submitted for the period 2012 to 2021 were reviewed and data were extracted. Descriptive analysis was done using SPSS software, version 26.

Results

Total number of biopsy reports was 158 representing 0.02% over the study period. The mean age of patients was 34.3 ± 19.7 years, the 3rd decade was the peak age of presentation and male-to-female ratio was 1:1.6. Majority (65/41.1%) of the cases were benign neoplastic lesions, and the mandible was the most (21/13.3%) common site of biopsy. Reactive lesions were the predominant (34/21.5%) group and squamous cell carcinoma had the highest (24/15.3%) number of lesions while odontogenic tumours constituted six cases only (3.8%).

Conclusion

The findings of this study showed low uptake of oral histopathology services while biopsied oral and maxillofacial lesions were prevalent in female patients in the third decade of life. Also, the mandible was the most affected site whereas benign neoplastic diagnoses were most common. However, this study recorded a higher proportion of malignancies than some previous studies.

Expression of Syndecan-1 and Cyclin D1 in Salivary Gland Tumors in Relation to Clinicopathological Parameters

Background

Salivary tumors have various morphological features and might share some histopathological findings. They are considered a problematic area in diagnosis due to complex clinicopathological features and different biological behavior.

Objective

To identify the pathological behavior of salivary tumors immunohistochemically.

Methodology

This retrospective study involved thirty formalin-fixed paraffin-embedded blocks of salivary gland tumors. These tumors were stained immunohistochemically with syndecan-1 and cyclin D1. Chi-Square test was used to relate immunoscoring, intracellular localization, intensity, and invasion to different salivary tumors. The correlation of these two markers was done by spearman's rho test. P-value <0.05 was considered statistically significant.

Results

The mean age of the patients was 48.69 ± 17.7. The parotid gland was the most commonly reported site in benign tumors, and regarding malignant tumors, maxilla was the most prevalent site. Syndecan-1 in benign tumors showed a predominate score 3, most widely detected in pleomorphic adenoma. Malignant salivary tumors showed 89.4% positive expression with a more frequent score 3, most commonly found in adenocystic carcinoma. Cyclin D1 expressed in all benign salivary tumors, with prominent diffuse mixed intracellular localization in pleomorphic adenoma. Malignant tumors revealed an expression of 94.7%. Moderate scoring with mixed intracellular localization was recorded in adenocystic carcinoma, followed by mucoepidermoid carcinoma. There was a significant correlation between the two markers in response to the distribution of immunostaining in different cell compartments.

Conclusion

Syndecan-1 and cyclin D1 showed a significant combined role in salivary tumor progression. Interestingly notable ductal-myoepithelial cells affect epithelial morphogenesis, and growth of pleomorphic adenoma was observed. Furthermore, basophilic cells of cribriform adenocystic carcinomas might control the aggressiveness and proliferation rate of these tumors.

Oral biopsies in a Portuguese population: A 20-year clinicopathological study in a university clinic

Background

Performing a biopsy is very important in oral medicine and the anatomopathological examination is fundamental to obtain or to confirm the diagnosis in oral and maxillofacial pathology. The purpose of this study is to analyse the frequency and characteristic patterns of biopsied oromaxillofacial lesions in a Portuguese population.

Material and Methods

A descriptive statistical analysis of the data from the anatomopathological reports of the biopsies performed between 1999 and 2019 at the university clinic of the Faculty of Dental Medicine of the University of Lisbon was performed, regarding the patient's gender and age, type of biopsy, location of lesions, clinical and histological diagnosis, and the results were obtained. Association relationships were studied using the chi-square test and the Kruskal-Wallis test to correlate variables. P<0.05 was considered statistically significant.

Results

From a total sample of 1448 patients, 826 (57.1%) were female, 610 (42.1%) were male, and 12 (0.8%) had no gender information, with a mean age of 50.14 years (standard deviation ± 17.61). The preferred location was the buccal mucosa, vestibule fundus and alveolar mucosa (20.7%). Benign lesions (BL) were the most common, in 82,8% of the cases, followed by oral potentially malignant disorders (OPMD) in 15,5%, and finally, malignant lesions (ML) in 1.7%. Focal fibrous hyperplasia was the most frequent diagnosis in the total sample (25.6%). In the young group, the most common entity was mucocele (34.0%), with a predominance of the lower lip (32.9%). In OPMD, leukoplakia was the most frequently diagnosed (48,7%). The most common ML was squamous cell carcinoma (92.0%), appearing mainly in the tongue (34.8%). A statistically significant relation between ML and older age was found.

Conclusions

This study included biopsies analysed over a period of 20 years, being BL the main pathology to affect the oral cavity. Although less frequent, OPMD and ML should not be neglected and must be correctly diagnosed and treated. Key words:Oral biopsies, Oral and maxillofacial pathology, Oral medicine, Clinicopathological analysis, Epidemiological study, University clinic.

A retrospective analysis of oral and maxillofacial pathological lesions in a group of Egyptian children over 21 years

Objectives

The goal of the current study was to evaluate the relative frequency of oral and maxillofacial pathological lesions among Egyptian children.

Materials and methods

Records of biopsies submitted to the department of oral and maxillofacial pathology from the year 1999 to 2019 were retrieved and reassessed for all cases under the age of 18 years. Information on age, sex, location of the lesion, and the histopathologic diagnosis was analyzed.

Results

Over the course of twenty-one years, 1108 specimens were analyzed where reactive soft tissue lesions, which accounted for 397 (35.8%) of all cases ranked the highest presented category, followed by inflammatory odontogenic cysts, which accounted for 213 cases (19.2%). With 208 cases, the inflammatory radicular cyst was on the top of the most common 20 lesions, followed by pyogenic granuloma (160 cases). Malignancy was found in 19 cases, with soft tissue tumors (10 cases) being the most common, followed by salivary gland (5 cases) and bone pathologies (4 cases).

Conclusions

The frequency of oral and maxillofacial pathological lesions among Egyptian children increased over the years but remained consistent with global trends.

Clinical relevance

This is the first study evaluating the relative frequency of oral and maxillofacial pathological lesions among Egyptian children and provides an insight into the most commonly encountered pediatric pathologies. This may aid in the understanding of the most prevalent oral lesions that impact the pediatric population, as well as providing the key to early detection of lesions.

Oro-facial malignancy in north of Iraq: a retrospective study of biopsied cases

Background

Identifying the prevalence of orofacial malignancies is essential to provide health-care programs and services for a specific population. This study aimed to specify the prevalence, clinical and histopathological features of oral malignancies in Sulaimani for over 12 years.

Methods

All archived reports for orofacial specimens from 2008 to 2019 were collected from three major centers in Sulaimani governorate. The demographic data, date, type of surgery, lesion's site, and diagnosis were recorded. The ICD-10 coding was specified for each case. A Chi-square test was used to assess differences between genders. A one-way ANOVA test was applied to analyze the differences in mean age distributions among different sites of oral malignancies and oral squamous cell carcinoma histopathological grades. P < 0.05 was considered significant.

Results

Orofacial malignant lesions account for 14.53% of the total sample. Patients' mean age was (55.46 ± 18.48) years, and they were predominantly males (M: F ratio = 1.15:1). The tongue was the frequently affected site (14.8%). A Chi-square test showed no significant difference between genders concerning age (P = 0.118), years of registration (P = 0.28), and site (P = 0.29). The C06 (represents; cheek mucosa C06.0, the vestibule of mouth C06.1, retromolar area C06.2, and other unspecified parts of mouth C06.8) was the most frequent topographical ICD-code (18.1%). Carcinoma was a frequent malignancy (63.2%). OSCC was the most common lesion (56.4%). It commonly affects males, and the tongue was the frequent site (24.1%) followed by lip (17.8%).

Conclusions

There is a slight increase in the registered oral malignancies in Sulaimani city over 12 years; they were predominated in males, in 61–70 years old patients, and being oral squamous cell carcinoma types.

Trend Analysis of Head and Neck Neoplasms between 2012-2018 in Patients Residing in Al-Madinah, Saudi Arabia: A Retrospective Study

Objectives  This study sought to present a view of head and neck neoplasms (HNN) prevalence with specific focus on sociodemographic determinants in Al-Madinah Province, Saudi Arabia.

Materials and Methods  This was a hospital-based retrospective study based on retrieval of histopathological data for a period of 6 years between 2012 and 2018. Data was collected from the archives of the Oral and Maxillofacial Pathology Laboratory at King Fahad Hospital (the only referral center for biopsy services) in Al-Madinah City.

Statistical Analysis  An independent t -test and/or nonparametric (Mann–Whitney U test, chi-squared test) tests were used to determine the differences between groups. Statistical significance was set at the p -value < 0.05.

Results  Out of 96 patients, a total of 58 patients had valid biopsy data with preoperative diagnosis. Over three quarters of the cases ( n = 44) were benign with only 24% were malignant. Males were more likely to be diagnosed with a benign tumor than females (54.5 vs. 45.6%, respectively), and malignancy was also more common in males (64.3 vs. 24.1). A significant difference was found in relation to mean age of older patients who were more likely to be diagnosed with malignant tumors ( p = 0.001).

Conclusions  The findings suggest that most of biopsied HNN cases are benign neoplasms. Age is a significant risk factor for head and neck malignancy in this region. Delays in diagnosis of HNN need to be explored.