Abstract
Introductionodontogenic 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.Methodsthis 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.Resultsfrom 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.Conclusionusing a multi-centre approach is a robust way to reduce diagnostic challenges associated with rare maxillofacial lesions such as MOTs.
Highlights
Odontogenic tumours (OTs) constitute a wide range of lesions that are derivatives of tooth forming apparatus via neoplastic transformation of remnants of odontogenesis and odontogenic cyst [1]
A total of 1550 (LUTH, Lagos), 261 ( UCH, Ibadan), 157 (0AUTHC, Ife), 118 (NAUTH, Enugu) and 113 (LASUTH, Lagos) odontogenic tumours were documented during the period under study from a total biopsy of 10446 cases of oral and jaw lesions which were seen from all study centres within the 25-year study period. 2199 (21.05%) cases of OTs were found, out of which 63 were cases of malignant odontogenic tumours (MOTs)
We have reviewed information on MOTs by identifying important characteristics of patients with malignant odontogenic tumors in terms of incidence and analysis of demographic with clinical presentation of these lesions from five tertiary health institutions representing the southern and eastern part of the country
Summary
Odontogenic tumours (OTs) constitute a wide range of lesions that are derivatives of tooth forming apparatus via neoplastic transformation of remnants of odontogenesis and odontogenic cyst [1]. Similar to the classification of benign OTs, malignant odontogenic tumours (MOTs) are classified based on their histogenesis They can emerge from epithelial components of odontogenesis; ectomesenchymal/mesenchmal remnants; or from mixed origin, consisting of both the epithelial and mesenchymal aspect [8]. MOTs are believed to constitute between 0-6.1% of OTs [9], they are extremely rare lesions that are exclusively located in the jaws They arise within the jaws either as a primary lesion (de novo); from epithelial cystic linings; or via malignant transformation of a benign OTs, even though reports of malignant transformation of odontogenic cystic lining is rare [10]. MOTs can be carcinomas, sarcomas or carcinosarcomas; the most common types are the carcinomas [8, 9]
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