Predisposing Factors and Clinico-Pathological Presentation of Malignant Lesions Of the Oro-Facial region in Dar es Salaam, Tanzania

Abstract

Background: The oro-facial region is made up of a complex anatomical relationship of structures which may be a source of development of malignant lesions. Majority patients who present at the oral and maxillofacial unit of MNH with a variety of malignant lesions are referred cases from upcountry district/regional hospitals and present with advanced stages of disease often with a wide range of complications. Of recent, there has been a dramatic change in the characteristics and demography of some of the common malignant lesions of the oro-facial region. Such changes mightbe attributed to predisposition or systemic changes following exposure to certain external factors.
 Objective: To determine the predisposing factors and clinico-pathological presentation of malignant lesions of the oro-facial region among patients attending the Muhimbili National Hospital.
 Methodology: This was a cross-sectional descriptive hospital-based study carried out in the Department of Oral and Maxillofacial Surgery at the Muhimbili National Hospital. A sample of 186 patients with malignant tumours in the oro-facail region attended at MNH during the study period.For every patient, demographic details were recorded and history, clinical examination and laboratory investigations, including biopsy were done.
 Results: A total of 186 patients, 104 (56.0%) males and 82 (44.0%) females with a ratio of 1.3:1 were included in the study. The age ranged from 3 to 83 years with a mean age of 48.4 ± 19.2 SD years. Thirty-three percent of the patients were aged below 40 years. The commonest reported oral and maxillofacial malignant tumour was SCC with 96 (51.6%) patients followed by KS which had 17 (9.1%) patients and non-specific carcinoma 10 (5.4%) patients. Tobacco use was reported by 89 (47.8%) among whom 62 (69.6%) had used tobacco for more than 20 years. Ninety-six (51.6%) patients reported alcohol use among whom 49 (51.0%) reported to have used alcohol for more than 20 years. Thirty-three (17.7%) patients were HIV positive. All patients with KS were also HIV positive. MEP and PLGA were among very rare tumours occurring in the maxillofacial region that were encountered in this study.
 Conclusion: There was an increased frequency of malignant tumours in the oral and maxillofacial region among young patients. Tobacco use and HIV infection seemed to have influence on the occurrence of SCC and KS respectively. Majority of patients reported late with advanced disease and over 95% of patients with SCC presented with stages III or IV tumours.