Tumors and Tumor – Like Lesions of the Oro – Facial Region at Mayo Hospital, Lahore – A Five Year Study

Abstract

The oro-facial region including the oral cavity, the maxilla and mandible and related tissues can be the site of a multitude of neoplastic conditions. These tumours have a predilection for the entire facial re-gion; however, odontogenic tumours tend to affect the mandible more than the maxilla. We report results from a retrospective study spanning five years on the frequency, clinical presentation, sites and character of oro-facial tumors seen in the main referral hospital of Pakistan.

Patients and Methods:  Records of consecutive pati-ents of all age and sex seen by the author's team at the Department of Oral and Maxillofacial Surgery, Mayo Hospital with tumours affecting the oro-facial region from January 2005 to December 2009 were retrieved, coded and entered into a database. The data were then analyzed by age, sex, presenting signs and symptoms, site of lesion, and their histology.

Results:  A total of 237 patients with oro-facial swel-lings were retrieved from the registry. The complete data set was obtained for 189 patients, comprising 108 (57.9%) males and 81 (42%) females. The most common clinical presenting features were mandibular facial swelling (63%), intra-oral swelling (55%), and ulceration (29%). The tumors were found in the man-dible 67 (35%), buccal mucosa 33 (17%), floor of the mouth 22 (11%) and tongue 29 (15%). The re-mainder making up almost 20% was found in the palate, submandibular region, preauricular region and lips. Ninety three (49.2%) of the patients presented with lesions that were classified as malignant of which 64 (69%) were diagnosed as squamous cell carcinoma (SCC). seventy (37.0%) had benign odontogenic tumors and twenty six (13.7%) had non-odontogenic tumor - like lesions. Sixty - four (69%) of malignant tumors were squamous cell carcinoma; sixty four (86.4%) of the benign odontogenic tumors were clas-sified as ameloblastoma. The mean age at presentation of all lesions was 40.4 years with over 50% of benign lesions in patients aged between 30 and 40 years. Malignant tumors were more commonly detected in patients between 41 and 70 years (63%).

Conclusion:  Tumors and tumor - like lesions of the oro-facial region comprising the mandible tongue and adjacent structures are a diverse group of neoplasm and are seen commonly in practice of maxillofacial surgery. Both malignant and benign tumours are seen. In the present study, SCC and ameloblastoma were the commonest malignant and benign odontogenic tumo-urs seen respectively; the two representing more than 65% of all tumors.