Abstract:
ABSTRACT
Background
The oro-facial region is made up of a complex anatomical relationship of structures of which
may be a source of development of malignant lesions. Often, patients present at the oral and
maxillofacial unit of Muhimbili National Hospital with a variety of malignant lesions in the
oro-facial region. Majority of these patients are referred cases from upcountry district/regional
hospitals and they present with advanced stages of disease with a wide range of
complications. Of recent there has been a dramatic change in the characteristics and
demography of some of the common malignant lesions of the oro-facial region. Such changes
might be attributed to predisposition or systemic changes following exposure to certain
external factors.
Objective
To determine the predisposing factors and clinico-pathological presentation of malignant
lesions of the oro-facial region among patients attending the Muhimbili National Hospital.
Study design
Cross sectional descriptive hospital based study.
Setting
Oral and maxillofacial surgery firm, Muhimbili National Hospital.
Methods
All admitted and outpatients with clinically suspected malignant lesions in the oro-facial
region who attended at the Muhimbili National Hospital, Oral surgery department from 1st
July 2010 to 31st March 2011.
Patients were interviewed using a specially designed questionnaire. Clinical examination was
done, followed by fine needle aspiration cytology and/or tissue biopsy. A total of 186 patients
with cytologically and/or histologically confirmed malignant lesions were included in the
study. Data were entered in a computer, cleaned and analyzed using SPSS for windows
version 13.
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Results
A total of 186 patients, 104 (56.0%) males and 82 (44.0%) females with a ratio 1.3:1 were
involved in the study. The age at the time of diagnosis ranged from 3 to 83 years with a mean
age of 48.4 ± 19.2 SD years. Sixty one (32.8%) patients were aged below 40 years. The
commonest observed oral and maxillofacial malignant lesion was Squamous cell carcinoma
96 (51.6%) patients followed by Kaposi’s sarcoma in 17 (9.1%) patients and carcinoma in 10
(5.4%) patients. Tobacco use was reported by 89 (47.8%) patients, of whom 62 (69.6%)
patients had used tobacco for more than 20 years while 96 (51.6%) patients reported alcohol
use, of whom 49 (51.0%) reported to have used alcohol more than 20 years. Thirty three
(17.7%) patients were HIV positive. All patients with Kaposi’s sarcoma were also HIV
positive. Malignant eccrine poroma and polymorphous low grade adenocarcinoma are rare
tumours in the maxillofacial region that were encountered.
Conclusion
Squamous cell carcinoma was the most common malignant tumour in the oral and
maxillofacial region. Use of tobacco and/or alcohol was the predisposing factors for
squamous cell carcinoma. There was an increased frequency of malignant tumours in the oral
and maxillofacial region among young patients. Patients presented rather late with advanced
tumours that many times could only be managed by palliative therapy. All patients with
Kaposi’s sarcoma were HIV positive.
