Epidemiology of the sarcomas of the jaws in a Peruvian population

Primary Sarcoma of the Head and Neck: Three Years’ Experience in a Tertiary Care Cancer Center

Introduction Sarcomas are a heterogeneous group of malignancies originating from the transformed cells of mesenchymal lineage, representing only 1% of all the primary tumors arising within the head and neck region with a prevalence range of 4 to 10%. They are biologically different from the sarcomas of other sites because of the smaller size of the tumor at the time of presentation and higher chances of local recurrences. Due to the rarity in adults, there are very few studies on sarcomas of the head and neck. The aim of this study was to analyze the frequency and spectrum of primary sarcomas in the head and neck region.

Materials and Methods This is a retrospective descriptive study. The authors analyzed 40 cases of histologically and immunohistochemically proven primary sarcomas arising in the head and neck region according to three age groups, pediatric (<12 years), adolescent (12–19 years), and adults (> 19 years).

Results Primary sarcomas represented 0.06% and 2.4% of total cancer cases and total sarcoma cases, respectively. Embryonal rhabdomyosarcoma was the most common histologic type, and nasopharynx the most common location in the pediatric population. Osteoblastic osteosarcomas and Ewing’s sarcoma were typical variants in adolescent age, affecting the hemimandible predominantly. In adults, osteosarcomas were commonest followed by conventional grade 1 chondrosarcoma. Treatment was planned according to the stage and grade of the tumor. Out of the 40 patients, 19 (47.5%) had a disease relapse within a period of 6 months from the completion of therapy.

Conclusion Head and neck sarcomas are notorious to recur. A timely and accurate diagnosis, proper staging, and multidisciplinary treatment plan can yield good patient outcomes.

Chondrosarcoma of the Temporomandibular Joint: Systematic Review and Survival Analysis of Cases Reported to Date

The purpose of this systematic review was to summarize the available data on TMJ chondrosarcomas and to perform a survival analysis of cases reported to date. This review was conducted in accordance with the PRISMA. Two authors performed an electronic search of case reports of TMJ chondrosarcoma published until August 02, 2020. Forty-seven studies reporting 53 cases were included. Chondrosarcomas of the TMJ were more prevalent in women, with a male:female ratio of 1:1.4. Survival curves were significantly associated with histological diagnosis (p = 0.004), reconstructive surgery (p = 0.024), recurrence (p < 0.001), and distant metastasis (p = 0.001). Only distant metastasis was independently associated with survival (p = 0.017). TMJ chondrosarcomas presented with low recurrence and higher survival rates than other chondrosarcomas. Synovial subtype, absence of reconstructive surgery, and presence of local recurrence or distant metastasis were associated with poorer prognosis.

Classification and Clinicopathologic Study of Orofacial Mesenchymal Tumors: A Retrospective Study

Aim:

To determine the prevalence of orofacial mesenchymal neoplasms and classify them using the WHO criteria while appraising its applicability.

Materials and Methods:

This was a retrospective study involving a total sample of 192 entries diagnosed as mesenchymal tumors for the period 1990-2018 at the Oral Pathology Department, University College Hospital, Ibadan. The histopathology records were examined and clinicopathological data were obtained. Hematoxylin and Eosin slides of the cases were assessed to confirm the diagnosis. Tumors were classified using the WHO 2013 classification. Data were analyzed and presented using descriptive statistics.

Results:

Orofacial mesenchymal tumors constituted 7.9% of 2402 biopsies. There were 26 diagnoses in 161 tumors of the WHO classification. Male-to-female ratio was 1.1:1. Peak age group was in the third decade. Soft tissue tumors were 61.5%, while bone tumors were 38.5%. Benign tumors constituted 49.5%, while sarcomas and intermediate tumors were 45.8% and 4.7%, respectively. The mandibular region (29.7%) was the most commonly affected site. Adipocytic and osteogenic tumors were the most prevalent tumors in the soft tissue and osteoarticular series, respectively, representing 19.8% and 32.3% of all cases, while orofacial sarcomas constituted 3.6% of all lesions seen.

Conclusion:

The findings in this study are in line with those of previous studies. However, the WHO classification may not be suited for the orofacial region. Crafting of a classification system for mesenchymal tumors of the orofacial region would thus be necessary.

A multicenter study of oral sarcomas in Brazil

OBJECTIVES

The aim of this study was to investigate the prevalence of oral sarcomas from geographic regions of Brazil.

MATERIALS AND METHODS

A cross-sectional study was conducted on biopsies obtained from January 2007 to December 2016 at twelve Brazilian oral and maxillofacial pathology centres. Gender, age, evolution time, clinical aspects, tumour location, tumour size at diagnosis, radiographic aspects and histopathological diagnosis were evaluated. Data were analysed using descriptive statistical methods.

RESULTS

From 176,537, a total of 200 (0.11%) oral sarcomas were reported, and the most prevalent were osteosarcomas (74 cases; 37%) and Kaposi's sarcomas (52 cases; 26%). Males were more affected than females at a mean age of 32.2 years old (range of 3-87 years). The most common symptoms were swelling¸ localised pain and bleeding at a mean evolution time of 5.14 months (range <1-156 months). The lesions were mostly observed in the mandible (90 cases; 45%), with a mean tumour size of 3.4 cm (range of 0.3-15 cm). Radiographically, the lesions presented a radiolucent aspect showing cortical bone destruction and ill-defined limits.

CONCLUSIONS

Oral sarcomas are rare lesions with more than 50 described subtypes. Osteosarcomas and Kaposi's sarcomas were the main sarcomas of the oral cavity in Brazil.

Prevalence of Head and Neck Sarcoma in a Major Cancer Center in Iran- A 10-Year Study

INTRODUCTION

Sarcomas are rare malignancies with aggressive biological behavior. They are categorized into soft and hard tissue types. The main objective of this study was to analyze the prevalence of head and neck sarcomas (HNS) among the Iranian population.

MATERIALS AND METHODS

The pathology files derived from Iran National Tumor Bank of Cancer Institute in Imam Khomeini Hospital, affiliated to Tehran University of Medical Sciences, Tehran, Iran, served as the source of the materials for this study. All cases diagnosed with head and neck sarcoma were included in the study. The recorded data included the patient's age, gender, tumor location, and rates of recurrence and metastasis.

RESULTS

Investigation of the pathology files of the patients referring to the center under study during a 10-year period resulted in the identification of 183 HNS cases, 96.17% of which were primary. Generally, the prevalence of this disease was at its highest level in patients within the age range of 30-60 years with a male to female ratio of 1.4. The recurrence and metastasis rates of HNS were 32.38% and 5%, respectively. Osteosarcoma was detected as the most common type of sarcoma. Soft tissue sarcomas constituted 69.3% of the lesions with a male predilection. The patients afflicted with this type of sarcoma had a mean age of 45.88 years. Furthermore, hard tissue sarcomas comprised 30.68% of the sarcoma cases with a mean age of 36.22 years and a female predilection. The commonest lesion was osteosarcoma, and the most typical location was the mandible.

CONCLUSION

In the current study, head and neck sarcomas were most often observed in patients within the age range of 30-60 years with a male predilection. Osteosarcoma was identified as the most common type of sarcoma. Studies addressing rare lesions with a large sample size facilitate the recognition of the demographic data and histopathologic variation which may contribute to a correct diagnosis.

Clinicopathologic Study of Intra- Osseous Lesions of the Jaws in Southern Iranian Population

STATEMENT OF THE PROBLEM

It is necessary for surgeons and practitioners to know about relative incidence and clinicopathologic features of lesions for accurate diagnosis and approach of pathologic lesions. Data are limited about overall incidence of intra-osseous lesions of the jaws in Iranian patients.

PURPOSE

This study evaluated the clinicopathologic features of intra- osseous lesions of the jaws in an Iranian population, in a 22-year period.

MATERIALS AND METHOD

In this cross- sectional retrospective analytical study, 4500 specimens in a 22- year period were reviewed. Baseline data of all patients with intra- osseous lesions including type and location of lesions as well as patients' age and gender, were collected and analyzed by SPSS software using descriptive analysis and Chi-square test.

RESULTS

There were 1121 (25%) intra-osseous lesion. Odontogenic cysts and benign non- odontogenic bone lesions were the most common categories, respectively. The mean age of the patients was 30.1±16, the total male to female ratio was 1.1:1, and the most prevalent location of lesions was posterior of mandible.

CONCLUSION

The results showed baseline information of intra-osseous lesions that were essentially similar to other populations; however, there were a few geographical differences. Further comprehensive studies in other parts of country are required to make a more reliable source of reference for clinicians and surgeons for evaluating and managing their patients more properly.

One Year Audit of In Patient Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital

BACKGROUND

The world wide pattern of oral and maxillofacial surgical conditions has rarely been reported despite its significance in ensuring quality of care. A large number of patients are managed surgically in Oral and Maxillofacial Surgery department of Dhaka Dental College Hospital but there has been no surgical audit to identify the potential problems in patient care.

OBJECTIVES

The aim of this study was to identify the pattern of oral and maxillofacial conditions in patients of maxillofacial surgery of Dhaka Dental College Hospital, which would provide valuable information to build up the focus of attention, to develop a future strategy plan, to improve its clinical care and extend the academic and research field.

PATIENTS AND METHODS

A retrospective survey of oral and maxillofacial surgical cases managed at the inpatient Department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital. All admitted patients from 1st January, 2012 to 31st December, 2012 were included in this study. The patients' data were retrieved from the wards registers and patient records. The data were recorded as age, sex, occupation, geographic distribution, diagnosis, treatment done and operation name. These were studied to assess the prevalence of age, sex, diseases and the name of the treatment offered. Analysis of major groups of diagnosis on the basis of age and sex was also studied. Mortality was also recorded.

RESULTS

Between 1st January, 2012 and 31st December, 2012 a total of 768 patients were treated. Among them 494 patients were male while 274 were female, male female ratio was 1.80:1. The majority of the patients were from Dhaka division. The mean age of the patients was 33.20 years; peak age group was 15-30 years. The most common diagnosis was maxillofacial injuries (35 %), followed by oral squamous cell carcinoma (22 %) and odontogenic tumours and hamartomas (11 %). Maxillo-mandibular fixation or wiring was the main modality of treatment. The mortality rate was 0.26 % of total patients.

CONCLUSIONS

The department of Oral and Maxillofacial Surgery, Dhaka Dental College Hospital is a busy centre for specialized maxillofacial services in Bangladesh. A good number of patients with a wide range of oral and maxillofacial surgical conditions are managed here. Maxillofacial injury and oral cancer are the two most common conditions encountered here.

Epidemiological Evaluation of Head and Neck Sarcomas in Iran (the Study of 105 Cases Over 13 Years)

Background:

Head and neck sarcomas are exceedingly rare and they include 4% - 10% of all sarcomas and less than 1% of all neoplasm of head and neck.

Objectives:

The aim of this study is to evaluate the epidemiological characteristics of head and neck sarcomas of patients in Isfahan, Iran.

Patients and Methods:

In this retrospective study, from the 16000 patients whose files were evaluated, the total number of 105 head and neck sarcomas were collected. They were evaluated with due attention to age, gender of the patients and the most common location of the lesion.

Results:

From the total number of 105 (0.6%) patients with sarcomas, 56 were men (53.33%) and 49 women (46.66%). The most common head and neck sarcomas among this population were Osteosarcoma (32 cases, 30.47%), Chondrosarcoma (14 cases, 13.33%), and Ewing sarcoma (11 cases, 10.47%).The most common soft tissue sarcoma was Rabdomiosarcoma. Mandible was the most common location for these lesions.

Conclusions:

In this study, the hard tissue sarcomas were more prevalent than soft tissue ones. Hence, special attention should be paid to the patients when being diagnosed.

Appraisal of jaw swellings in a Nigerian tertiary healthcare facility

Introduction: The mandible and maxilla can be the site of myriads of lesions that may be categorized as neoplastic, cystic, reactive and infective or inflammatory. Literature reviewing jaw swellings in an amalgamated fashion are uncommon, probably because aetiologies for these swellings are varied. However, to appreciate their relative relationship, it is essential to evaluate the clinico-pathologic profile of jaw swellings. The aim of this appraisal is to describe the array of jaw swellings seen at our hospital from 1990 to 2011, to serve as a reference database. Material and Methods: Biopsy records of all histologically diagnosed cases of jaw swellings seen at the department of Oral Pathology, University College Hospital between January 1990 and December 2011 were retrieved, coded and inputted into SPSS version 20. Data on prevalence, age, sex, site and histological diagnosis were analysed descriptively for each category of jaw swellings. All patients below 16 years were regarded as children. Results: A total of 638 jaw swellings were recorded in the 22-year study period. The Non Odontogenic Tumours (NOT) were the commonest, accounting for 46.2% of all jaw swellings. Odontogenic Tumours (OT) formed 45% of all adult jaw swelling while it formed 25.2% in children and adolescents. Ameloblastoma was the commonest while the most common NOT was ossifying fibroma (OF). Chronic osteomyelitis of the jaws was about 6 times commoner in adult females than males and mostly involved the mandible. The most common malignant jaw swelling was Burkitts’ lymphoma (BL) that was about 7 times more in children than adults. Osteogenic sarcoma was the most common malignancy in adults. Conclusion: Jaw swellings are extensively varied in types and pattern of occurrence. This study has categorized jaw swellings in a simple but comprehensive fashion to allow for easy referencing in local and international data acquisition and epidemiological comparison.

Key words:Jaw swellings, odontogenic, Nigeria.