Multidisciplinary approach to improving concordance in diagnosis of odontogenic tumors

Abstract

Background: The diagnosis of benign odontogenic tumors (BOTs) may occasionally be fraught with problems. Diagnosis of BOTs includes joint consideration of clinical features observed, appearance on radiographs and histopathologic slides. Aim: The aim of this study therefore is to ascertain the level of concordance between preoperative and postoperative histopathological diagnoses of surgically treated BOT and highlight modalities that improve it. Materials and Methods: A retrospective review of all cases with postoperative histopathological reports of BOT seen at the Dental and Maxillofacial Surgery Department of Aminu Kano Teaching Hospital, Kano, Nigeria, from January, 2012 to December, 2013 was done. Demographic information, clinical, radiological (plain radiographs), preoperative incisional biopsy and postoperative excisional biopsy results were collated. The preoperative incisional biopsy and postoperative excisional biopsy results were analyzed for concordance. Results: Thirty-three cases of BOT were reviewed (male:female = 1.4:1). Age ranged from 11 to 70 years (mean = 32 ± 18.1 years). An overall concordance of 78.8% was observed between preoperative and postoperative biopsy results. Twenty-eight histology request cards were reviewed and this showed that 14.3% of specimens were <1 cm while complete clinical information was provided in 50% of cases. Conclusion: The interaction between the pathologist and other relevant specialties that are required for effective management of BOT may be best nurtured when clinico-pathologic conferences are made a routine practice.