Occurrence, clinicopathological characteristics and treatment modalities of orofacial tumours and tumour-like lesions in children treated at Muhimbili national hospital, Dar es salaam, Tanzania

Abstract

Background Children with orofacial tumours and tumour-like lesions who were treated at the Oral and Maxillofacial Surgery department Muhimbili National Hospital (MNH) were often seen to have huge swellings which caused marked facial deformity and at times functional difficulties. The clinical presentation, pathological characteristics and treatment modalities of these lesions were quite diverse and warranted an investigation to assess their burden in Tanzanian children. It’s envisaged that the data obtained will help the clinicians at the Oral & Maxillofacial department MNH and other healthcare institutions in early detection and appropriate management of children with these lesions.

Objective: To determine the occurrence, clinicopathological characteristics and treatment modalities of orofacial tumours and tumour-like lesions in children who were treated at Muhimbili National Hospital, Dar es Salaam, Tanzania during the period from September 2016 to March 2017. Methods: This cross-sectional hospital-based study was conducted in the Oral and Maxillofacial Surgery and Otorhinolaryngology departments at MNH. Children aged below 18 years with orofacial tumours and tumour-like lesions or their parents/guardians were interviewed using a structured questionnaire and clinical examination of the patients were done and the details recorded in the clinical form. Data analysis was done using statistical package for social sciences (SPSS) version 20.0. Level of statistical significance was considered at a P-value of < 0.05. Results: A total of 121 children aged 4 days old to 17 years (mean= 8.56 years ±5.5 SD) participated in the study, of whom 52.1% were males. The age groups 0-5 years (38%) and 11-15 years (28.1%) were most affected by orofacial tumours and tumour-like lesions. Majority 86% of the lesions were benign whereby haemangioma was the most common benign tumour encountered (16.4%), followed by lymphangioma (13.6%). The most frequent tumour-like lesion observed was the dentigerous cyst (7.8%), followed by the dermoid cyst and fibroma in 4.1% of participants. Burkitt’s lymphoma and squamous cell carcinoma were the most common malignant lesions encountered in 23.5% participants in that category. All the lesions in this study presented with swelling as a common clinical feature in both benign and malignant tumours and tumour-like lesions. Surgery was the most common modality of treatment employed. Conclusion: Orofacial tumours and tumour-like lesions were relatively common in children seen in this study. Delay and late reporting for treatment was noted in many children with orofacial tumours and tumour-like lesions. Benign orofacial lesions are more common than malignant tumours in children in this study. Due to overlapping of clinical presentation between benign and malignant lesions, clinicians must establish histological diagnosis of every tumour before initiating definitive treatment. Surgery was the main treatment modality used for orofacial tumours and tumour-like lesions in this study.