ABSTRACT
Background: Maxillofacial sarcomas are rare constituting between 4-8% of all malignancies in the region. A few case reports of individual tumours are available while reviews of significant series is lacking. This report presents 80 cases of sarcoma collected over 23 years at a tertiary oral care centre in Kaduna, Nigeria. Method: Retrospective study of all maxillofacial sarcomas in northern Nigeria. Results: There were 406 maxillofacial malignancies of which 80 (20%) were sarcomas. Fourteen histopathologic types were found of which osteosarcoma (28%), chondrosarcoma (17%), rhabdomyosarcoma (12%) and fibrosarcoma (12%) were predominant. The male to female ratio was roughly equal (1.3:1). Patients with sarcoma were between 24 days and 90 years old (mean age 31±15 years) with most patients (26%) in the third decade of life. Cases presented with symptoms such as swelling (100%), pain (54%) and tissue ulceration (26%). Surgery was performed for 46% of cases treated while radiotherapy was used for 26%. Some cases refused hospital treatment because of poverty and ignorance while poor medical infrastructure limited treatment options in several cases regarded as advanced lesions. Conclusion: In Northern Nigeria, sarcomas account for 20% of all maxillofacial malignancies with the osteosarcoma as the predominant type. Most affected were people in the third decade of life. Surgery was the main modality used for treatment while some patients had no treatment due to self-discharge and late presentation. The need for improved medical awareness and upgrading of infrastructure was stressed
Subject(s)
Jaw Neoplasms/diagnosis , Jaw Neoplasms/physiopathology , Nigeria , Sarcoma/diagnosis , Sarcoma/therapyABSTRACT
Entre as neoplasms malignas dos seios paranasais, o carcinoma espinocelular é o tipo histológico mais freqüente; e o seio maxilar, a estrutura anatômica mais afetada. Os sintomas são insidiosos e confundidos com processo inflamatório crônico, levando a um atraso no diagnóstico e um aumento nos casos avançados na primeira consulta. Objetivo: Avaliar as características clinicas dos pacientes e os fatores que retardam o diagnóstico, propondo medidas para um diagnóstico mais precoce. Material e método: Os autores apresentam um estudo retrospectivo com 60 pacientes examinados e tratados no Serviço de Cirurgia de Cabeça e Pescoço do Hospital Heliópolis, no período de 1977 a 1993, e analisados em tabelas e gráficos. Resultados: Em relação à profissão, 16,7% eram alfaiates e costureiros. Sinusite crônica era observada em 10%. As queixas mais comuns foram: inchaço na face (36,7%), obstrução nasal (23,3%) dor e/ou amolecimento dentário (21,7%).O tempo de queixa variou de dois a oito meses (81,7%) e o período entre diagnóstico e tratamento variou de duas a quatro semanas (20%) e até duas semanas (43,3(/o). Como causa do atraso, 61,7% não valorizaram os sintomas iniciais, e em 20% houve falta de orientação do dentista. Paciente com queixa de inchaço na fase levou até quatro meses para procurar o especialista (37,9%) e aqueles com obstrução nasal (29%), dor e/ou amolecimento dentário (25,8%) apresentaram um tempo superior a quatro meses. Conclusão: A incidência foi maior entre pessoas do sexo masculino e profissionais que manipulam tecidos. Obstrução nasal, dor e/ou amolecimento dentário foram as queixas que retardaram a procura ao médico especialista. O ensino da oncologia aos profissionais de saúde e a ampliação do serviços especializados contribuirá para diminuir o retardo no tratamento, levando ao melhor prognóstico.
From among malign neoplasms in paranasal sinus, the squamous cell carcinoma is the more frequent histological kind of carcinoma, and the maxillary sinus is the more affected anatômical structure. The symptoms are insidious and confused with chronic inflammatory process, leading to a delay of diagnosis and an increase in advanced cases in first attendance. Purpose: To evaluate the patients' clinical caracteristics, the factors that delay the diagnosis and to propose measures for and earlier diagnosis. Material and method: The authors present a retrospective study of 60 patients examined and treated in the Surgery of Head and Neck Center of the Heliópolis Hospital from 1977 to 1993 and analyze it in tables and charts. Results: In terms of their professions,16,7% were tailors and dressmakers. Chronic sinusites was observed in 10% of the patients. The most common complaints were: face swelling (36,7%), nasal obstruction (23,3%) dental weakening and/or pain (21,7%). The elapsed time of complaint varied from two to eight months (81,7%) and the period between diagnosis and treatment varied from two to four weeks (20%), and even two weeks (43,3%). As a reason for delay, 61,7% didn't took the initial symptoms into account and in 20% there was lack of dentist's orientation. Patients complaining about face swelling spent four months to see a specialist physician (37,9%) and those complaining about nasal obstruction (29%), dental weakening and/or pain (25,8%) reported more than four months. Conclusion: The incidence was wider among male and textile workers. Nasal obstruction, dental weakening and/or pain were the complaints which made the patients delay in seeing a physician. Oncology teaching to professionals of health and improvement of specialized health services will contribute to decrease the delay in treatment, leading to the best prognostic.