Orofacial Cysts: A Single Institution Experience of 85 Cases in Enugu, Nigeria

BACKGROUND

Orofacial cysts are pathologic cavities that could be symptomatic and may cause facial disfigurement. The only epidemiologic report of such lesions in Southeast Nigeria studied jaw cysts from 1987 to 1996. New studies reflecting recent research findings and classifications on the subject in Southeast Nigeria are lacking.

AIM

To determine the prevalence and distribution of orofacial cysts in a tertiary hospital in Enugu, Southeast Nigeria.

METHODS

A 10-year retrospective study of patients with orofacial cysts diagnosed by histology was carried out.

RESULTS

Orofacial cysts constitute 9.5% (85) of 897 orofacial lesions identified. The male-to-female gender ratio was 1.2:1. The mean age (± standard deviation) at the onset of the cystic lesion was 28.58 (±16.98) years. Developmental odontogenic cysts 52.9% (45) and salivary cysts 18.8% (16) were the most common group of orofacial cysts. The most prevalent orofacial cysts were odontogenic keratocysts at 25.9% (22), mucoceles 16.5% (14), and dentigerous cysts 14.1% (12). Straw-colored aspirates 34.8% (16) and dark brown aspirates 28.3% (13) were the predominant cystic contents. The mandible 45.9% (39) and maxilla 27.1% (23) were the commonest sites for orofacial cysts, while the lip 9.4% (8) was the most frequent soft tissue site. A significant association exists between anatomical site and cyst type at a 95% confidence interval with P = 0.000, X2 = 247.17. Unilocular radiolucency 62.5% (20) and multilocular radiolucency 34.4% (11) were the most common radiographic features.

CONCLUSION

Developmental odontogenic cysts particularly odontogenic keratocysts were most prevalent while mucocele was the most common soft tissue cyst.

Benign Orofacial Vascular Anomalies: Review of 47 Cases in Enugu, Nigeria

BACKGROUND

A study of oral vascular anomalies has not been conducted in Nigeria to provide baseline data for comparison with reports in the literature.

AIMS

To study the prevalence and distribution of benign orofacial vascular anomalies at a tertiary hospital in Enugu.

MATERIALS AND METHODS

This is a 10-year retrospective observational study of consecutive patients with orofacial vascular anomalies, diagnosed by histology. The clinic-pathologic information was obtained from records archived in the department, and descriptive analysis was used to determine the frequency, tables for categorical variables, and a Chi-square test to determine the statistical significance.

RESULT

There were 47 cases of benign vascular anomalies out of 897 orofacial lesions giving a prevalence of 5.2%. There were 35.4% (17) male and 64.6% (31) female patients. The mean age in this series was 37.4 ± 19.8 (range: 1 to 76 years). Pyogenic granuloma was the most common vascular lesion 78.7% (37), followed by hemangioma 14.9% (7) and lymphangioma 6.4% (3). The gingiva was the most frequent site of oral occurrence 65.9% (31), especially maxillary gingivae 48.9% (23). The type of orofacial vascular anomalies was significantly associated with the anatomical site of occurrence, P = 0.00. The mean ages for the occurrence of pyogenic granuloma, hemangioma, and lymphangioma were 37.7 ± 18.3, 50.7 ± 16.9 years, and 3.3 ± 3.2 years, respectively. Pain was a frequent occurrence in 36.2% (17) of anomalies.

CONCLUSION

Oral vascular anomalies predominantly presented as pyogenic granuloma on the gingivae, while oral hemangioma was observed in adults, and lymphangioma was infrequent.

Oral mucosal melanoma in four Nigerian teaching hospitals

Background

Oral mucosal melanoma (OMM) is a malignant lesion of melanocytes of oral epithelium. The prevalence in four Nigerian teaching hospitals is reported.

Aims

This study shows the hospital based prevalence and the clinicopathologic features of OMM in four Nigerian teaching hospitals.

Subjects and Methods

A retrospective study of patients diagnosed with OMM in four teaching hospitals in Nigeria was carried out. All records of patients with orofacial lesions from 1969 to 2016 were identified and retrieved from the archives of four oral pathology departments. The biodata and relevant clinicopathologic information of those diagnosed with OMM were reviewed. Data analysis was done with SPSS for Windows, version 20.

Results

There were 10,877 orofacial lesions managed during the period. Oral malignant lesions constituted 14.4% (1,552/10,877). OMM was diagnosed in ten patients with prevalences of 0.09% and 0.6% of all orofacial lesions and oral malignancies, respectively. There was a male predilection of 4:1 and a mean age of occurrence of 53.8 (±12.6) years. The palate was the most frequent site, 40.0% (4/10). Regional lymph nodes were hard, fixed, or matted in 50.0% (5/10) of patients and distant metastases observed in 20.0% (2/10). Among those followed up, only one was documented alive after 6 months. Amelanotic OMM, 20.0% (2/10) did not show ulceration or regional and distant metastasis.

Conclusions

OMM has a low prevalence but with poor prognosis. Amelanotic OMM showed less clinical aggression. Early diagnosis and prompt treatment are recommended.

Prevalence of mandibular and palatine tori among the Ibos in Enugu, South-East Nigeria

CONTEXT

Torus mandibularis (TM) and torus palatinus (TP) are believed to occur commonly among black Africans. There is a dearth of literature on Nigerians. The few reported studies were done in the South-West Nigeria. This is the first report of the prevalence of tori among the Ibo-speaking ethnic group in the South-East Nigeria.

SETTINGS AND DESIGN

This is a prospective cross-sectional study of 3000 subjects of Ibo ethnic extraction attending a dental clinic in Enugu, South-East Nigeria.

MATERIALS AND METHODS

Three thousand subjects were examined for the isolated and concurrent occurrence of TM and TP. The subjects were seen over a 4-year period. The age, sex, ethnic group, type of tori based on location, and symptomatic awareness of tori presence were documented.

STATISTICAL ANALYSIS USED

The data were analyzed with Statistical Package for Social Sciences (SPSS) version 17. The level of significance was P< 0.05. The Chi-square test showed no statistically significant difference between gender and type of tori (P = 0.34). Similarly, there was no statistically significant difference between the age groups and type of tori (P = 0.38).

RESULTS

Two hundred and ninety-two subjects were clinically diagnosed with tori, of which females constituted 88%, and males constituted 12%. Isolated TM occurred in 56.8% (166 of 292) subjects, isolated TP in 17.5% (51 of 292) subjects, and concurrent tori (TM and TP) in 25.7% (75 of 292) subjects. The peak occurrence was in the fifth decade. The overall prevalence was 9.7%. The prevalences of TM (isolated and concurrent) and TP (isolated and concurrent) were 8.0% and 4.2%, respectively.

CONCLUSIONS

The prevalence values are within the range of values reported in other Nigerian studies but differ widely with values from other ethnic groups from other countries.

Clinicohistopathological analysis of 5 Nigerian cases of malignant fibrous histiocytoma of the jaws

BACKGROUND

Malignant fibrous histiocytoma (MFH), is a soft tissue sarcoma that occurs predominantly in the soft tissue of the extremities. It rarely occurs in facial bones. Few cases in the jaws have been reported.

OBJECTIVE

To report and review the relevant clinicopathologic features of 5 cases of jaw MFHin Nigerians.

METHODS

All cases in the records of the Department of Oral Pathology of the Lagos University Teaching Hospital which were histologically diagnosed as MFH were retrieved. Hematoxylin and eosin slides of cases were re-examined to confirm diagnosis. Information retrieved included age, sex, location, x-ray, estimated duration, recurrence, and histological presentation. Data was analyzed using SPSS statistical package.

RESULTS

Age ranged between 12-42 years with a male sex predilection (3 cases/60.0%) and sole maxillary site predilection (5 cases/100.0%). Estimated duration of lesion ranged from 2 -12 months. Two cases recurred post surgical treatment. All cases presented as the storiform-pleomorphic type with one case presenting with a delicate/scanty connective tissue stroma. Chronic inflammation was scanty in the two cases that recurred.

CONCLUSION

MFH of the jaws is rare among Nigerians. Its clinico radiological presentation maymimick other more aggressive or less benign lesions of the jaws thereby resulting in misdiagnosis and in appropriate patient management.