CHARACTERIZATION OF ALVEOLAR SOFT PART SARCOMA OF THE TONGUE: A CLINICO-PATHOLOGIC STUDY AND SCOPING REVIEW.

BACKGROUND: Alveolar soft part sarcoma (ASPS) is a rare malignant soft tissue tumour. There is a dearth of literature analyzing its features on the tongue. OBJECTIVE: This study aims to conduct a scoping review to describe the essential clinico-pathologic features, treatment modalities and outcome of previously reported tongue ASPS (TASPS) and new cases at our center. METHODS: A search of databases (PubMed, Medline, Cochrane and Google Scholar) and the internet for articles on TASPS written in English was conducted. Information extracted included clinico-pathological and demographic data. Descriptive statistics was used for analysis. RESULTS: A total of 49 articles were eligible for this study. In all, 81 cases were utilized. Asian studies accounted for most cases 35(43.2%) and a slight female preponderance of 1.1 was seen. Most cases - 38 (46.9%), occurred in the 1st decade and the base of tongue was the most common location in 19 (39.6%) cases. Also, tumour metastasis was present in 14 (25.9%) cases. Transcription Factor E3 (TFE3) - 8 (24.2%) and Neuron Specific Enolase (NSE) - 8 (24.2%) were the most common immunohistochemical stains used and were both expressed 7 out of 8 cases (87.5%). Most common treatment modality was surgery and 42 (82.4%) cases managed by surgery alone were free of disease at ≤ 5 years of follow up. CONCLUSION: TASPS slightly affected the female gender and tongue base more commonly. It occurred more in the first two decades of life. Use of standard investigative tools for management will allow for better appraisal of research findings.

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.

A Study of 31 Patients with Primary Complaint of Halitosis in a Tertiary Hospital in South-Western Nigeria.

BACKGROUND: Halitosis is a common cause of dental consulta-tion. Patients presenting with primary complaint of halitosis consist of dissatisfied people with genuine and pseudo-halitosis. OBJECTIVES: To assess the demographic and clinico-pathologic features of patients presenting with primary complaint of halitosis as well as evaluate the treatment outcome. METHODS: Consenting patients presenting with primary complaint of halitosis from 1st of March to 31st August, 2015 were recruited. All had intraoral examination, were screened for psychiatric morbidity and halitosis using the organoleptic method. Data concerning the complaint of halitosis was retrieved from all through an interviewer-administered structured questionnaire. All the patients were educated on the aetiology of halitosis, those with oral disease were treated and all had scaling and polishing, oral hygiene instruction/motivation in addition to hydrogen peroxide mouth rinse for two weeks. Patients' opinions were sought concerning the presence/intensity of halitosis at two weeks and six months post treatment. RESULTS: Thirty-one patients with a mean age of 38.48 years and male:female ratio of 1.3 were recruited. Intraoral pathology was observed in 48.4% of patients. None of the patients smoked cigarette or pipe. Twenty patients (64.5%) had been informed of the foulness of their breath by at least one person in the past; the information generated negative feelings in 19 of them. Six patients had psychiatric morbidity which was significantly associated with female gender and presence of body odour. At two weeks post treatment, 54.8% of patients were free of halitosis, while at six months only 25.8% were free. CONCLUSION: The patients who complained of halitosis were non-smokers with a mean age of 38.48±14.0 years. Intraoral pathologies were found in fifteen (15) patients, while six (6) had psychiatry morbidity. About half of the patients and about a quarter were free of halitosis following scaling and polishing and two weeks' hydrogen peroxide mouth rinse at 2 weeks and 6 months' reviews, respectively.

Association of Squamous Cell Carcinoma of the Tongue with Cigarette and Alcohol Exposure: A Retrospective Clinicopathological Study.

BACKGROUND: Squamous cell carcinoma of the oral tongue (SCCOT) has been linked to modifiable risk factors; such as tobacco use and excessive alcohol consumption. OBJECTIVE: To describe the clinical presentation of SCCOT as well as its association with history of tobacco and alcohol use. METHODS: A retrospective review of SCCOT at Oral Pathology Department from 1990 to 2012. Information retrieved from patients' medical records includes: age, gender, occupation, history of alcohol and tobacco use. Also, the first symptoms observed by patients at the onset of disease, and what was done for patients at the place of first consultation were documented. RESULTS: SCCOT accounted for 26% of all oral squamous cell carcinoma (SCC); mean age at presentation was 58.3 ±12.6 years. Two patients diagnosed of SCCOT before 40 years as well as female SCCOT patients denied exposure to either alcohol or tobacco; while about 80% and 70% of males with complete history were exposed to tobacco and alcohol respectively. At the onset of disease, 70.2% of patients noticed a lingual ulcer, 13% experienced pain, but at presentation, only one patient was not experiencing pain. About 85.3% of patients presented with stage III and IV disease. All patients but two were treated with antibiotics and analgesics at first presentation in a hospital. CONCLUSION: The most common symptoms at the onset of disease were ulceration and pain. Men above age forty years had exposure to alcohol and tobacco.

PERCEPTION AND UTILIZATION OF ORAL HISTOPATHOLOGY SERVICES BY GENERAL PRACTICE DENTIST IN SOUTHWEST NIGERIA.

BACKGROUND: Oral histopathology services are oral diagnostic procedures. General Dental Practitioners (GDPs) are routinely exposed to oral lesions that require biopsies. Hence, the study's objective of assessing the perception and the utilization of oral histopathology services by GDPs. METHOD: This was a cross-sectional study conducted at dental clinics distributed across Southwest Nigeria. A self-administered questionnaire consisting of sections addressing the socio-demographic/professional aspects; the beliefs of GDPs and their utilization of oral histopathology services was used to collect data. A modified 5-point Likert rating scale was used to indicate the extent of agreement or disagreement with statement constructs. Analysis was done using SPSS for windows version 20.0. Significance was assessed at 5%. RESULTS: There were 56.1% males and 43.9% females. The peak age range was 30-39 years (35.4%), while 58.5% had ≤ 10 years of practice and 79.3% work in government dental centres. Many of the respondents (61.0%) thought suspicious lesions should be biopsied, 47.6% thought that specialists' skills were not required for biopsy. Furthermore, 53.7% had poor perception scores while 81.1% of those who had seen oral lesions that required biopsies, had poor utilization scores. CONCLUSION: The GDPs had a poor perception and utilization of oral histopathology services. Continuous medical education is needed to increase awareness amongst dentists.

PREVALENCE OF COEXISTING DIABETES MELLITUS AND HYPERTENSION AMONG DENTAL PATIENTS IN A TERTIARY CARE HOSPITAL.

BACKGROUND: Diabetes mellitus and hypertension are quite important in dental settings as may present as an emergency during dental treatment or may necessitate a modification in the patient's management. OBJECTIVES: To determine the prevalence of coexistence of diabetes mellitus and hypertension among a group of dental outpatients and to assess the relationship between these medical conditions and a cross-section of factors. METHODOLOGY: A cross sectional survey of 203 outpatients presenting in a Dental Clinic within a Tertiary hospital was undertaken. The capillary blood glucose of respondents was measured using a glucometer. Patients with a random blood glucose (RBS) ≥ 200 mg/dl were considered diabetic. Their blood pressure (BP) was assessed using a digital sphygmomanometer and a systolic BP of <120-139 and diastolic BP of <80-89 mmHg was taken as normal. Relationship between the two parameters was tested using Chi-square and p-value <0.05 was taken as statistically significant. RESULTS: The age range of respondents was 16-75 years with a mean of 40.4 ±13.1 years and most (56.2%) of them were females. Their mean blood glucose was 108.7± 43.1 mg/dl, mean systolic blood pressure was 121.2 ± 14.9 mm Hg and mean diastolic blood pressure was 76.8 ± 13.3 mm Hg. Twenty-seven (13.3%) had high systolic BP, while 37 (18.2%) had high diastolic BP. Nine (4.4%) had their blood glucose in the range of diabetes. There was a co-existence of high blood glucose and diastolic blood pressure in 6 (3.0%) of the respondents and statistically significant association (p = .000) between the blood glucose and diastolic blood pressure. CONCLUSION: Dentists should note that co-existence of diabetes mellitus and diabetes in a dental patient is an index of increased morbidity and mortality and should always screen for these medical conditions.

Periapical lesions of the jaws: a review of 104 cases in ibadan.

BACKGROUND: Periapical lesions (PLs) occur as a result of pulpal inflammation and may rarely be seen in the absence of pulpal diseases. They are the most common pathological lesions affecting the alveolar bone. OBJECTIVE: This study aims to describe the clinicopathological features of PLs of the jaws with emphasis on the two most common types. METHODS: Histopathology records of PLs diagnosed from January 1990 to December 2012 at the Department of Oral Pathology, University College Hospital Ibadan, were examined and categorized into periapical cysts (PCs); periapical granuloma (PGs) and others. Clinical data and histopathological features of these PLs were reviewed and analyzed. RESULTS: One hundred and four lesions met the criteria for this study and consisted of PGs with 71 (68.3%) cases and PCs with 31 (29.8%) cases and one case each of apical scar and pleomorphic adenoma. Age range of cases was 9 to 80 years (mean=35.6 ± 15.8years) with a peak at age group of 20-29 years. Females were more frequently affected with 51.9% of cases. PLs were most frequently diagnosed in the anterior maxillary region with 58 (56.9%) cases, while the most frequently involved tooth was the left maxillary central incisor with 23 (22.1%) cases. CONCLUSION: Findings in this study are consistent with those of previous studies. It is important for all periapical pathological specimens to be submitted for histological examination to establish an accurate diagnosis and aid in the identification of sinister lesions that may present in the Periradicular region of teeth.

HIV TESTING IN DENTAL PRACTICE: PERCEPTION AND ATTITUDE OF DENTISTS IN SOUTHWESTERN NIGERIA.

BACKGROUND: In recent times, the concept of routine HIV screening has been recommended to enhance early diagnosis and timely initiation of care thereby reducing morbidity and mortality among HIV infected persons. Dental practice has been identified as a unique venue of reaching at-risk individuals who may not otherwise access the conventional healthcare settings. AIM: To assess the perception and attitude of dentists in Southwestern Nigeria concerning integrating HIV testing into dental practice. METHODS: this descriptive cross- sectional study was conducted between January-March, 2014. Convenience sampling was used to select 113 practising dentists within Southwest Nigeria. Data collection was done using a self- administered questionnaire. RESULTS: Agreement to HIV testing in dental settings was in the order of 100% for private practitioners followed by 91.7% from teaching hospitals (91.7%) and least agreement was with state hospitals (76.5%). There was a strong association between participants' years of practice and support for HIV testing in dental settings with highest support among those between 7-9 years (p= 0.002). Significantly too (p= 0.013), all the specialists (100%) agreed to HIV testing in dental settings compared to general practitioners (84.0%). CONCLUSION: This study showed that most dentists in Southwest Nigeria acknowledged dental practice as being appropriate for expanded HIV testing and as well were willing to undergo training for HIV testing in their dental settings.

Clinical presentation of oral squamous cell carcinoma.

AIMS AND OBJECTIVES: This study aims to present the symptoms first observed by patients diagnosed of oral squamous cell carcinoma (OSCC) presenting at the University College Hospital, Ibadan between January 1990 and December 2008 as well as the time lag between the observation and presentation in the hospital. PATIENTS AND METHODS: This is a retrospective review of patients that have been diagnosed histologically as squamous cell carcinoma of the oral cavity at the University College Hospital Ibadan, Nigeria between January 1990 and December 2008. RESULTS: Painful tooth/teeth which are not mobile were the most common symptom in these patients (27.5%). However, about 59.4% of patients had painless symptoms at the onset of the disease. The interval between onset of symptoms and clinical presentation ranged from 3 weeks to 36 months with a mean duration of 7 ± 6.3 months. Paradoxically, patients that experienced painful symptoms at the onset of disease presented later than those who had painless symptoms CONCLUSION: The first symptoms observed by these patients were not pathognomonic of oral cancer but are shared by several relatively more common oral diseases. Awareness of the populace about oral cancer should be increased as well as the index of suspicion of the medical practitioner for OSCC.

Oro-facial sarcomas: a review of 88 cases in a Tertiary Institution in Nigeria.

BACKGROUND: A sarcoma is a malignant tumour arising from connective tissue. The word sarcoma is derived from the Greek word, sarkoma meaning fleshy growth and presents either as a soft tissue or bony tumour. Sarcomas are rare in the oro-facial region compared to oral squamous cell carcinoma. The rarity of jaw sarcomas makes diagnosis sometimes challenging and the anatomy makes aggressive treatment difficult without causing unacceptable physiological, functional and cosmetic damage to the patient. The aim of this study was to examine the demographic pattern of patients with jaw sarcomas seen at the University College Hospital, Ibadan, Nigeria over a thirty year period. METHODS: All histologically diagnosed cases of sarcomas of the oro-facial region from the Cancer Registry of the University College Hospital Ibadan and the histology records of the department of Oral Pathology, University College Hospital Ibadan from 1980-2010 were reviewed. Data was analyzed using SPSS version 18. RESULTS: Eighty eight oro-facial sarcomas were seen consisting of sixteen different histological types. Osteogenic sarcoma was the most common type with 40 cases (45.5%). Osteogenic sarcoma occurred more in females than males with a male: female ratio of 13:27 and a mean age of 32.2 years (SD ± 15.7). Embryonal rhabdomyosarcoma had an equal male: female distribution with mean age of 7.0 years (SD ± 5.2) and peak age incidence in the first decade. CONCLUSION: The findings in this study were generally in agreement with reports from Europe, and though, at variance with some African studies, they are mostly in agreement with large African series.