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Background: Locally advanced inoperable orofacial malignancies do present clinically, and constitute a significant public health burden worldwide., Objective: To determine the prevalence and clinical characteristics of Stage IV locally advanced inoperable orofacial malignancies for consecutive patients., Materials and Methods: A 24-year retrospective study was undertaken, and data obtained from hospital register, case files, and histopathological reports of patients were recorded in a proforma. The variables studied were age, sex, type of lesion and site, duration of lesion, tobacco/alcohol use, and socioeconomic status of the patients and clinical features of the lesions., Results: Twenty-six patients presented, giving a prevalence of 11.2%. The most common lesion was adenoid cystic carcinoma, 23.1%. Males accounted for 18 (69.2%) cases and females, 8 (30.8%) giving a male to female ratio of 2.3:1. The ages ranged from 21 to 65 years, mean (SD) 48.6 (7.3) years. The gender distribution was clinically and statistically significant in favor of the males (P = 0.001). The patients were in the low socioeconomic class and 20 (76.9%) indulged in chronic use of tobacco and alcohol. The duration of the lesions ranged from 1.8 to 3.1 years. The maxilla/facial skin was the commonest site (46.2%). Clinically and statistically, the relativity of site distribution of lesions was significant (P = 0. 002). The clinical features occurred in combination resulting in an average of 10 symptoms and signs in each patient., Conclusion: The synopsis of these lesions shows that all have undergone metastasis; salivary gland malignancies were most common with maxilla as the commonest site., Competing Interests: None

Introduction: Dermatofibrosarcoma protuberance (DFSP) is in general a rare low grade malignant sarcoma and possesses a tendency for local recurrence. It has a site predilection for the trunk. Occurrence in the facial area is extremely rare. Ample knowledge of its clinical, histological and biologic characteristics is vital for accurate and prompt recognition., Methods: Over 13 years, clinicohistologic information of cases was retrieved. Histological and immunohistochemical re-evaluation were performed to re-confirm diagnosis. Data collected and analyzed with SPSS Statistics version 20 were presented as frequency tables, charts and proportions as appropriate., Results: Of 191 soft tissue sarcomas, a total of 28 cases were diagnosed as DFSP (14.7%). Facial types occurred in 3 cases (1.6%). Tumour had age and site predilections for the 4 th decade and trunk respectively. There was an equal gender distribution among cases. Most common clinical presentation was in form of painless protruding nodular mass. General histologic presentation revealed cellular lesions composed of spindle to oval neoplastic cells arranged in a storiform pattern. Mitotic figures were rare. All cases showed positive expressions to CD34., Conclusion: Facial DFSP is rare among Nigerians. Its clinical appearance may mimic other common benign lesions of the head and neck region often resulting in misdiagnoses. A comprehensive knowledge of its clinical and histologic presentations and biologic behavior, combined with its identification with the aid of advanced histologic and radiographic techniques results in prompt confirmatory diagnosis. Appropriate treatment should include adequate surgical excision techniques combined with adjuvant radiotherapy or chemotherapy., Competing Interests: The authors declare no competing interest.

Objective: This study aims to determine the incidence, age, gender, orofacial sites and histological pattern of paediatric orofacial tumours in a Nigerian population. The yearly findings will be analysed to identify the interval for increase in the incidence of paediatric orofacial tumours., Patients and Methods: A 21-year (1990 to 2010) retrospective analysis of paediatric orofacial tumours in children younger than 16 years was carried out in the Department of Oral Pathology/Oral Medicine, University of Benin Teaching Hospital, Benin City, Nigeria., Results: Of the 1013 diagnosed lesions within the study period, there were 137 (13.5%) paediatric orofacial tumours, among which 71 (51.8%) cases occurred within the last 6 years (2005 to 2010). There was male predilection for the lesions (78 males to 59 females, ratio = 1.3:1). The mean age was 9 + 4.3 years, with peak age group of 11 to 15 years (n=60, 43.8%). The mandible (n=44, 32.1%), followed by the maxilla (n=42, 30.7%) and orofacial soft tissue (n=19, 13.9%) were the most common sites. The benign tumours (n=72, 52.6%) were slightly more than the malignant tumours (n=65, 47.4%). There were more malignant tumours (n=23, 16.8%) than benign tumours (n=20, 14.6%) within the last 3 years (2008 to 2010) under review. Burkitt's lymphoma (n=38, 27.7%) was the commonest malignant lesion., Conclusion: This study showed a recent increase in the incidence of paediatric orofacial tumours, particularly due to a higher incidence of Burkitt's lymphoma.

Background: This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Nigerian population., Methods: A retrospective analysis of the medical records and histological reports of patients with oral and maxillofacial tumors and cystic lesions who presented to the Maxillofacial Unit of our institution over an eleven year period was undertaken. Information on demographics, histological diagnosis and clinical presentation were obtained and analyzed. A p value of less than 0.05 was considered significant., Results: A total o:f 146 patients, aged 5-70 years (mean 30.5± 12.9) were seen over the period of study. There were 96 males (65.8%) and 50 females (34.2%) giving a male to female ratio of almost 2:1. Benign tumors accounted for 124, 86.3% and malignant tumors (22, 13.7%). Ameloblastoma was the most prevalent benign tumor observed (53, 36.3%) while squamous cell carcinoma was the most common malignant tumor. The peak age of ameloblastoma was the fourth decade and squamous cell carcinomas the sixth and seventh decades of life. Jaw swellings were the most common presentation (98, 67.1%), followed by pain (23, 15.9). The duration of symptoms on presentation ranged from 1 to 96 months (mean 23.32 ±15.72) and this was not different for malignant or benign tumors (P=0.886)., Conclusion: Late presentation still remains the main challenging factor in the early detection and management of maxillofacial tumors in our environment. More awareness campaign is necessary, especially at the primary health care level, to educate the populace on the need for early presentation at treatment centers.

Objective: The aim of this study was to evaluate the relative frequencies, types and site distribution of oro-facial lesions in a North-Eastern Nigerian tertiary centre., Materials and Methods: The records of the Departments of Oral-Dental Surgery and Pathology of a tertiary hospital in Nigeria were reviewed and analyzed for patients with oro-facial lesions during a seven year period (January, 2001 - December, 2007). The main outcome measures were patients' age and sex, histology assessment, tissue type and location., Results: A total of 102 (51.3%) benign lesions, 59 (29.6%) malignant lesions and 38 (19.1%) inflammatory/reactive lesions were seen. The common benign neoplasms were ameloblastoma (23.5%), fibrous dysplasia (15.7%) and pleomorphic adenoma (13.7%). The malignant lesions were mainly well differentiated squamous cell carcinomas (28.8%) and terminal duct carcinoma (11.9%). Inflammatory lesions comprised mainly of chronic osteomyelitis (15.8%) and non-specific chronic inflammatory lesions; giant cell granulomas, granulation tissues which constituted 10.5% each. [corrected] There were 104 (52.3%) males and 95 (47.7%) females giving a male: female ratio of 1.1:1. The mean age of the patients was 36.1(SD ± 18.9) years with a range of 1 to 85 years. Most tissue specimens were soft tissues (61.3%), while bone specimen accounted for 15.6% of all specimens analysed. There were 62 (31.2%) mandibular lesions, 24 (12.1%) palatal lesions and 15 (7.5%) parotid lesions, while maxillary antral lesions were the least, constituting only 0.5% of all lesions studied. [corrected]., Conclusion: The range of diagnosed lesions from our study was diverse, though our results do not represent the actual prevalence of orofacial lesions within the general population, but simply reflect the frequency of histologically diagnosed lesions at a health center in North-East Nigeria. This survey has shown that most oro-facial lesions studied were benign neoplasms and that most of these neoplasms were from the mandible.

Rhabdomyosarcoma (RMS) is a malignant soft tissue neoplasm, with varying degrees of striated muscle cell differentiation and a relative predilection for the head and neck region. The objectives of this study were to determine the clinical and histological patterns of RMS, to assess the sociodemographic profile of reported RMS cases, and to highlight the management challenges and outcomes of these cases in a country lacking resources such as Nigeria. Patients diagnosed with RMS, based on clinical and histological evaluation, and recorded in the cancer registry of two maxillofacial centres in Nigeria were reviewed. 21 patients met the inclusion criteria for this study. Their ages ranged from 24 days to 42 years. In all of them multiple anatomical sites were involved. The primary site of the lesion could not be determined. Embryonal and alveolar subtypes were mainly found in the maxilla. There was no statistically significant association between the site of the lesion and the histological type (p=0.39). The patients' age was statistically significantly associated with the histological type (p=0.008). Most patients reported at an advanced stage, contributing to the poor prognosis and management outcome of cases evaluated.

Objective: The aim of the study was to determine the relative frequency of orofacial malignant neoplasm in children and adolescents., Methods: A retrospective review of malignant orofacial tumours in children and adolescents

A retrospective review of cases histologically diagnosed as malignant lesions of the orofacial region in 1992-2003 from the records of the Department of Oral Pathology and Biology, Lagos University Teaching Hospital, Nigeria was carried out. All cases were subjected to analysis of age, gender, site distribution and histologic types. Malignant tumours constituted 18% of all the biopsies of orofacial lesions seen within the period. The mean age of patients was 42.2+/-21.5 years (range: 2.5-85). There were 177 (69%) epithelial tumours of which squamous cell carcinoma was predominant, 47 (18%) sarcomas and 32 (13%) lymphomas. Squamous cell carcinoma (44%) was the most common malignant orofacial tumour. Osteosarcoma (32%) and Burkitt's lymphoma (56%) was the predominant sarcoma and lymphoma, respectively. Patients with a histologic diagnosis of carcinoma were older than those with sarcomas and lymphomas (P<0.01), and those with a histologic diagnosis of malignant lymphoma were significantly younger than those with sarcomas (P<0.01). Almost 25% of patients with carcinomas were below the age of 40 years. Malignant orofacial tumours are not uncommon in the studied environment, with a sizable proportion of carcinomas occurring before the age of 40 years.

Objectives: To analyse general differences in age, gender, anatomic location of the various histological types of malignant neoplasm involving the oral and maxillofacial region at a tertiary referral centre in Nigeria and to compare this with reports in the literature., Design: Retrospective analysis., Setting: A tertiary referral centre in Lagos, Nigeria., Subjects: All patients with a histological diagnosis of malignancy were included provided the final surgical histology reports as well as the biopsy reports were available for review., Results: Squamous cell carcinoma (SCCA) with a peak age incidence in the 6th decade of life and a male to female ratio of 1.65 to 1 was the most common cancer (42.8%). Males with SCCA (mean = 48.7 years) were relatively younger than females (mean = 58.8 years). Eighteen percent of patients with SCCA were below 40 years at presentation and males were predominantly affected at a ratio of 5.2:1. Majority of the SCCA (75%) were well/moderately well differentiated. However, in patients below 40 years, 45.9% had poorly differentiated SCCA. The Most commonly affected sites for SCCA were the maxillary antrum (36.7%), mandibular gingiva/ alveolus (23.0%) and tongue (12.04%). Patients who presented with antral SCCA were relatively younger (mean = 48.9 years) than those who had SCCA involving the mandibular gingiva/ alveolus (mean = 57.1 years) as well as floor of mouth (mean = 56.3 years). Furthermore, males with antral SCCA were younger than their female counterparts. Similarly, males who had mandibular gingiva/ alveolus SCCA (mean = 48.4 years) were younger than their female counterparts (mean = 62.8 years). Majority of the glandular carcinomas (GLDCAs) arose from minor salivary glands (63.0%). Thirty seven per cent of these patients were below 40 years at presentation. Females who had antral GLDCA (mean = 32.4 years) were relatively younger than their male counterparts (mean = 49 years). Most of the patients who presented with sarcoma were below 40 years (77.4%) and males were younger (22. 8 years) than females (mean = 35.4 years)., Conclusions: The proportion of orofacial cancers that is SCCA in Nigerians is relatively low because of a relatively high proportion of GLDCA and Burkitt's lymphoma. A relatively high proportion of patients with SCCA were below 40 years at presentation. They were predominantly males who presented with poorly differentiated tumours.

We report the type and distribution of orofacial tumours in south-western Nigerian children and adolescents. The 512 records of patients with oral and maxillofacial tumours in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, from 1991 to 2001, were searched and the 146 records (28%) of patients aged 19 years and less were reviewed. Their mean age was 10 years (female:male ratio 1:1.4). Of the 146 tumours 74 (51%) were malignant and 72 (49%) were benign. Of the latter 31 were from soft tissue and 41 were from the jaw (20 odontogenic and 21 non-odontogenic). The most common benign soft tissue and jaw tumours were gingival epulis and ameloblastoma respectively. Of the malignant tumours 67 were lymphomas, 5 sarcomas and 2 carcinomas.

Purpose: In this study, we sought to determine the occurrence of primary non-Hodgkins lymphoma (NHL) in the oral and maxillofacial region among Nigerians., Patients and Methods: We retrospectively studied hospital records that included radiographs of all patients with a histopathologically confirmed diagnosis of NHL in the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, between January 1992 and December 1997. Data were expressed as mean +/- SD or number (%)., Results: During the study period, 66 cases of NHL were recorded. Seventeen patients had concomitant extranodal lymphomas involving the gastrointestinal tract, nasopharynx, skin, lungs, kidney, and thyroid, in descending order. Three patients (4.5%) presented primarily with extranodal oral and maxillofacial disease. The ages of these patients ranged from 18 to 50 years (mean +/- SD, 32.3 +/- 16.3 years; median, 29 years). Within the same period, there were 121 cases of Burkitts lymphoma. The onset of lesions varied from 6 to 20 weeks. Two patients had intermediate-grade lesions; the remainder had low-grade lesions. Two presented with stage II disease, and the remainder were stage I. All of the patients had chemotherapy with remission of their lesions but were followed up to 6 months. Most of them did not complete the treatment cycles due to financial and social constraints., Conclusions: The rarity of primary NHL of oral and maxillofacial region has been aptly shown in this study. The need for the establishment of an effective oncology policy with the active collaboration of voluntary agencies is emphasized. This would ensure ready availability of the required chemotherapeutic agents and hospital care at affordable costs.

Purpose: This study evaluated the type and distribution of tumors in the orofacial tissues of black African children., Patients and Methods: The hospital records of all patients aged 15 years or younger, who presented at the Lagos University Teaching Hospital (a tertiary referral center) with a histologically confirmed orofacial tumor over a 13-year period were analyzed., Results: One-fifth of all orofacial tumors during the study period occurred in the pediatric age-group. The male-female ratio was 1.4 to 1 and 11- to 15-year-olds were most frequently affected. Benign tumors (59.8%) were more prevalent than malignant tumors (40.2%). Overall, 18.4% of the tumors were of odontogenic origin, 42.5% were benign nonodontogenic tumors, and 39.1% were malignant nonodontogenic tumors. The anterior part of the mandible was frequently involved by ameloblastoma, which was the most common odontogenic tumor (6.3%). Most of the benign nonodontogenic tumors were of mesenchymal origin (46%), and most were located in soft tissues (59.5%). Burkitt's lymphoma (22.4%) was the most common malignant nonodontogenic tumor., Conclusion: The observed differences in tumor type and distribution in this study compared with previous studies may be attributable to genetic and geographic differences in the populations studied.

The absolute incidence of melanoma at all sites in blacks is higher than is commonly credited. There is a shift in site incidence to less pigmented areas including the mucosae but oral melanoma is still rarely reported in Africans. An unusual case of facial melanoma arising in a childhood naevus, and two oral melanomas, all in Nigerians, are described. The salient clinical features and the treatment of these cases are discussed, and the possible relationship between pigmented patches and melanomas in the mouths of blacks is examined.

A clinical and histopathological review of 200 oral and maxillofacial tumours seen at the Maxillofacial Unit at Kaduna, Nigeria during a five-year period is presented. A large number of these were odontogenic tumours, bone tumours and tumours of the maxillary antrum. Some of the unusual histological features seen are discussed. One feature of particular interest was the large number of osteosarcomas, chondrosarcomas, fibrous dysplasias and ossifying fibromas of the jaw bones, as opposed to the long bones.