Clinico·histopathologic Study Of Maxillofacial Sarcomas Seen At The University Of Nairobi Dental Hospital: A 10-year Review

Abstract

Background: Sarcomas are malignant neoplasms of mesenchymal origin with no site predilection. Though their occurrence in the head and neck region is rare vis-a-vis other malignancies, their presence is of tremendous concern due to the often grave prognosis. Objective: To determine the pattern of occurrence, histopathologic types of maxillofacial sarcomas and their proportion in relation to other malignant neoplasms of this region based on archival material accumulated over 10 years (Jan 2000-Dec 2009). Study methodology: A retrospective cross-sectional study executed using histopathology records of patients at the University of Nairobi Dental Hospital (UNDH). All cases with a diagnosis of sarcoma registered between 2000-2009 were evaluated. The data were collected using a special chart. Results: Of the 527 malignancies recorded over the 10-year period, 427 (81.02%) were of epithelial origin while 100 (18.98%) were sarcomas. Patients with epithelial malignancies were older (54.16 ± 15.94 years) than patients with sarcomas (31.73 ± 16.78) with the differences having been statistically significant {P<0.01 (O.OOO)}. Osteosarcoma and Kaposi's sarcoma (KS) were the two most commonly occurring sarcomas (59%) followed by fibrosarcoma (FBS) (19%), and rhabdomyosarcoma (RMS) (10%). Sarcomas peaked in the 3rd decade with 70% occurring below the age of 40 years. The maxilla and the mandible were the most afflicted sites in the maxillofacial region accounting for 52%. The patients, on average, presented to medical personnel about 9 months after noticing the lesion with the most frequent complaint having been swelling. Conclusion: The present study confirms the relative rarity of maxillofacial sarcomas compared with epithelial malignancies. It also provides data on the histopathologic types and demographic characteristics of maxillofacial sarcomas in a select Kenyan population. The information contributes to the comprehensive documentation of sarcomas that occur globally and is useful in the provision of baseline data upon which future prospective analytical protocols may arise. Recommendations: 1: Development of a central data bank to provide for efficient storage as well as retrieval of critical medical information that provides the essential baseline information upon which prospective analyses can be based on. 2: Further studies are required to capture the disease pattern in the Kenyan National population as a whole.