A multi-centre evaluation of malignant odontogenic tumours in Nigeria

Abstract

Introduction odontogenic tumors originate from neoplastic transformation of the remnants of tooth forming apparatus. There are varying degrees of inductive interactions between odontogenic ectomesenchyme and epithelium during odontogenesis, leading to lesions that vary from benign to malignant. Malignant odontogenic tumours (MOTs) are very rare and are classified according to embryonic tissue of origin. Recently, there has been a few changes to the classification of MOTs according to the World Health Organization's (WHO) classification in 2017. This study aims to evaluate and reclassify MOTs, using a multi-centre approach in some major tertiary dental hospitals in Nigeria. Methods this study reviewed the clinicopathological data on 63 cases of MOT diagnosed over 25 years in five major tertiary dental hospitals in Nigeria. All MOT cases were reclassified according to the recent revision to the 2017 WHO classification of odontogenic tumours. Results from a total of 10,446 biopsies of oral and jaw lesions seen at the 5 study centres over the 25-year study period, 2199 (21.05%) cases were found to be odontogenic tumours (OTs), of which 63 were MOT. MOTs constituted 0.60% of the total biopsy cases and 2.86% of OTs. Odontogenic carcinomas presented with a mean age higher than odontogenic sarcomas. According to our 2017 WHO reclassification of MOTs, odontogenic carcinomas, ameloblastic carcinomas and primary intraosseous carcinomas were found to be the top three lesions, respectively. Carcinosarcomas were found to be extremely rare. Conclusion using a multi-centre approach is a robust way to reduce diagnostic challenges associated with rare maxillofacial lesions such as MOTs.

Clinico-pathological study of malignant odontogenic tumours from a national referral centre

“…The mean age for patients with AC was even lower at 47.0 years (SD ± 17.83) similar to the findings of the systematic review by Deng et al [ 20 ]. The male predominance seen in our study is also in line with most other published works, though there are some studies that have reported either no sex predilection or a female preponderance [ 7 – 9 , 12 , 17 – 19 , 21 , 22 ]. Interestingly, when looking at the different MOTs, a striking male preponderance was seen in ACs whilst all the patients diagnosed with CCOC were females.…”

“…The two most frequently encountered MOTs as reported in the literature are ameloblastic carcinoma (AC) and primary intra-osseous carcinoma NOS (PIOC-NOS) [ 6 , 7 , 9 , 19 , 21 , 22 ]. Ameloblastic carcinoma has been considered to be the malignant counterpart of the ameloblastoma characterized by cytological atypia and the ability to metastasize and is the most frequently encountered MOT.…”

Oral Pathological Lesions in the Aegean Region: A 30-Year Retrospective Study

“…Most of the oral pathological lesions were seen in the posterior mandible, in coordination with other studies (2)(3)(4)(6)(7)(8)(9)12,13,16,(19)(20)(21)(22)(23). This finding could possibly be associated with the presence of adjacent anatomical structures such as tongue, cheek mucosa and salivary glands in the lower jaw (2).…”

“…Since the odontogenic tumors are generally asymptomatic, patients do not notice until it reaches large sizes. Odontogenic tumors are more commonly seen in the 4 th decade of life (12,16,18,20,23). However, our findings show that odontogenic tumors are more commmon in the third decade of life.…”

“…Odontogenic tumors constitute a heterogeneous group of pathological lesions, arising from dental mesenchymal cells or its remnants. Biologically, some of these lesions present as hamartomas with varying degrees of differentiation, while the rest are benign or malignant neoplasms with variable aggressiveness and potential to develop metastasis (12,16,18,20,23). Since the odontogenic tumors are generally asymptomatic, patients do not notice until it reaches large sizes.…”