Clinical and Histological Patterns of Oropharyngeal Tumors in Selected Health Institutions in North Western Nigeria
Author(s)
Kufre Robert Iseh*,
Mohammed Abdullahi,
Daniel Jiya Aliyu,
Stanley Amutta,
Stephen Semen Yikawe,
Joseph Hassan Solomon
ABSTRACT
Background: Tumors of the oropharynx affect a common pathway for deglutition, respiration and speech and therefore pose a challenge to both the patient and clinician. This paper attempts to present clinical and histologic patterns, and therapeutic challenges of oropharyngeal tumors from three selected health facilities in North Western Nigeria. Materials and Methods: The medical records of patients seen in the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Federal Medi- cal Centre Birnin Kebbi and Shepherd Specialist Hospital, Sokoto with oropharyngeal tumors over a fourteen-year period were reviewed (January 2000 to December 2013). Results: A total of 36 patients were seen. Twenty (56%) were males and 16 (44%) were females, making the male:female ratio, 1.3:1, (P value of 0.004 for the null hypothesis). The age range was 3 to 80 years, with a mean age of 45.5 years. Majority of patients were in their 5th decade of life (33%). Nineteen (53%) patients presented with dysphagia, 11 (28%) with mass in the mouth (soft palate), 7 (17%) with neck swelling, while 3 patients (7%) presented with upper airway obstruction. Twenty-six patients (72%) presented at an advanced stage. Squamous cell carcinoma accounted for 31% of the cases, followed by lymphoma 14%, adenoid cystic carcinoma 8%, pleomorphic adenoma 5%, mucoepidermoid carcinoma 5%, peripheral nerve sheath tumour 3%, alveolar rhabdomyosarcoma (3%), tuberculoma (3%) and inflammatory polyp (3%). Surgery was carried out in 31 cases (86.1%) for the purpose of obtaining biopsy and removal of tumour, followed by chemotherapy (5.5%) and radiotherapy (5.5%) where histologic diagnosis was malignant. Five (13.9%) did not consent for any intervention. Conclusion: Oropharyngeal tumours are varied in presentation. Squamous cell carcinoma (31%) was the commonest histologic type followed by lymphoma (14%) and adencystic carcinoma (8%). About 72% of the cases were in advanced stages (T4). More than half of the tumours (53%) were of soft palate origin.
Background: Tumors of the oropharynx affect a common pathway for deglutition, respiration and speech and therefore pose a challenge to both the patient and clinician. This paper attempts to present clinical and histologic patterns, and therapeutic challenges of oropharyngeal tumors from three selected health facilities in North Western Nigeria. Materials and Methods: The medical records of patients seen in the Usmanu Danfodiyo University Teaching Hospital, Sokoto, Federal Medi- cal Centre Birnin Kebbi and Shepherd Specialist Hospital, Sokoto with oropharyngeal tumors over a fourteen-year period were reviewed (January 2000 to December 2013). Results: A total of 36 patients were seen. Twenty (56%) were males and 16 (44%) were females, making the male:female ratio, 1.3:1, (P value of 0.004 for the null hypothesis). The age range was 3 to 80 years, with a mean age of 45.5 years. Majority of patients were in their 5th decade of life (33%). Nineteen (53%) patients presented with dysphagia, 11 (28%) with mass in the mouth (soft palate), 7 (17%) with neck swelling, while 3 patients (7%) presented with upper airway obstruction. Twenty-six patients (72%) presented at an advanced stage. Squamous cell carcinoma accounted for 31% of the cases, followed by lymphoma 14%, adenoid cystic carcinoma 8%, pleomorphic adenoma 5%, mucoepidermoid carcinoma 5%, peripheral nerve sheath tumour 3%, alveolar rhabdomyosarcoma (3%), tuberculoma (3%) and inflammatory polyp (3%). Surgery was carried out in 31 cases (86.1%) for the purpose of obtaining biopsy and removal of tumour, followed by chemotherapy (5.5%) and radiotherapy (5.5%) where histologic diagnosis was malignant. Five (13.9%) did not consent for any intervention. Conclusion: Oropharyngeal tumours are varied in presentation. Squamous cell carcinoma (31%) was the commonest histologic type followed by lymphoma (14%) and adencystic carcinoma (8%). About 72% of the cases were in advanced stages (T4). More than half of the tumours (53%) were of soft palate origin.
Cite this paper
Iseh, K. , Abdullahi, M. , Aliyu, D. , Amutta, S. , Yikawe, S. and Solomon, J. (2015) Clinical and Histological Patterns of Oropharyngeal Tumors in Selected Health Institutions in North Western Nigeria. International Journal of Otolaryngology and Head & Neck Surgery, 4, 55-60. doi: 10.4236/ijohns.2015.42010.
Iseh, K. , Abdullahi, M. , Aliyu, D. , Amutta, S. , Yikawe, S. and Solomon, J. (2015) Clinical and Histological Patterns of Oropharyngeal Tumors in Selected Health Institutions in North Western Nigeria. International Journal of Otolaryngology and Head & Neck Surgery, 4, 55-60. doi: 10.4236/ijohns.2015.42010.
References
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[1] Bradley, J.P. (2008) Oropharyngeal Tumours. In Gleeson, M., Browning, G.C. and Burton, M.J., et al., Eds., Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery, 7th Edition, Hodder Arnold, London, 2577-2593. http://dx.doi.org/10.1201/b15118-212 [2] Gassner, G.H. and Sabri, A.N. (2005) Oropharyngeal Malignancy. In Cummings, C.W., Flint, P.W., Lund, V.J., et al., Eds., Cummings Otolaryngology Head & Neck Surgery, 4th Edition, Elsevier Mosby, Amsterdam, 1717-1754. [3] Pitchers, M. and Marthin, C. (2006) Delay in Referral of Oropharyngeal Squamous Cell Carcinoma to Secondary Care Correlates with a More Advanced Stage at Presentation, and Is Associated with Poor Survival. British Journal of Cancer, 94, 955-958. http://dx.doi.org/10.1038/sj.bjc.6603044 [4] Dhooge, I.J. and Albers, F.W. (1996) Clinical Characteristics and Diagnostic Delay of Head and Neck Cancer: Results from a Prospective Study in Beligium. European Journal of Surgical Oncology, 22, 354-358. http://dx.doi.org/10.1016/S0748-7983(96)90220-6 [5] Homer, J. and Rees, G. (2012) Pharynx: Oropharynx. In Watkinson, J.C. and Gilbert, R.W., Eds., Stell & Maran’s Textbook of Head and Neck Surgery and Oncology, 5th Edition, Hodder Arnold, London, 612-617. http://dx.doi.org/10.1201/b13389-37 [6] Garandawa, H.I., Abdullahi, I., Haruna, A.N., Sandabe, M.B. and Samdi, M.T. (2012) Oropharyngeal Cancers in Maiduguri, Nigeria: A Ten Year Review of Clinical Profile. Online Journal of Medicine and Medical Science Research, 1, 116-121. [7] Otoh, E.C., Johnson, N.W. and Danfillo, I.S. (2004) Primary Head and Neck Cancers in North Eastern Nigeria. West African Journal of Medicine, 23, 305-313. [8] Lilly-Tariah, O.B., Nwana, E.J.C. and Okeowo, P.A. (2000) Cancers of the Ear, Nose and Throat. Nigerian Journal of Surgical Sciences, 10, 52-56. [9] Ologe, F.E., Adeniji, K.A. and Segun-Busari, S. (2005) Clinicopathological Study of Head and Neck Cancers in Ilorin, Nigeria. Tropical Doctor, 35, 2-4. http://dx.doi.org/10.1258/0049475053001949 [10] Iseh, K.R. and Malami, S.A. (2006) Pattern of Head and Neck Cancer in Sokoto. Nigerian Journal of Otorhinolaryngology, 3, 77-83. [11] Abiose, B.O., Ogunniyi, J. and Oyejide, O. (1991) Oral Soft Tissue Malignancies in Ibadan, Nigeria. African Journal of Medicine Medical Sciences, 20, 107-113. [12] Parkin, D.M., Bray, F., Ferlay, J. and Pisani, P. (2005) Global Cancer Statistic. CA: A Cancer Journal for Clinicians, 55, 74-108. http://dx.doi.org/10.3322/canjclin.55.2.74 [13] Gillison, L.M., Koch, M.W., Capone, B.R., Spafford, M., Westra, H.W. and Wu, L. (2000) Evidence of Causal Association between Human Papillomavirus and a Subset of Head and Neck Cancer. Journal of the National Cancer Institute, 92, 709-720. http://dx.doi.org/10.1093/jnci/92.9.709 [14] Gillison, M.L. (2007) Current Topics in the Epidemiology of Oral Cavity and Oropharyngeal Cancers. Head & Neck, 29, 779-792. http://dx.doi.org/10.1002/hed.20573 [15] D’Souza, G., Kreimer, A.R., Viscidi, R., Pawlita, M., Fakhry, C., Koch, W.M., et al. (2007) Case-Control Study of Human Papillomavirus and Oropharyngeal Cancer. New England Journal of Medicine, 356, 1944-1956. http://dx.doi.org/10.1056/NEJMoa065497 [16] McKaig, R.G., Baric, R.S. and Olshan, A.F. (1998) Human Papillomavirus and Head and Neck Cancer: Epidemiology and Molecular Biology. Head and Neck, 20, 250-265.
http://dx.doi.org/10.1002/(SICI)1097-0347(199805)20:3<250::AID-HED11>3.0.CO;2-O [17] Iseh, K.R., Essien, E. and Bilbis, L.S. (2013) Demographic Characteristics and Food Consumption Pattern of Head and Neck Cancer Patients in a Tertiary Health Institution North West Nigeria. Pakistan Journal of Nutrition, 12, 897-902. http://dx.doi.org/10.3923/pjn.2013.897.902 [18] Silas, O.A. and Adoga, A.A. (2012) Histopathologic Patterns of Malignant Tumours of the Oropharynx of the Jos University Teaching Hospital. Journal of Clinical Pathology and Forensic Medicine, 3, 9-11. [19] Psyrri, A., Prezas, L. and Burtness, B. (2008) Oropharyngeal Cancer. Clinical Advances in Hematology and Oncology, 6, 604-612. [20] Blot, W.J., McLaughlin, J.K., Winn, D.M., Austin, D.F., Greenberg, R.S., Preston-Martin, S., et al. (1988) Smoking and Drinking in Relation to Oral and Pharyngeal Cancer. Cancer Research, 48, 3282-3287. [21] Brugere, J., Guenel, P., Leclerc, A. and Rodriguez, J. (1986) Differential Effect of Tobacco and Alcohol in Cancer of the Larynx, Pharynx and Mouth. Cancer, 57, 391-395.
http://dx.doi.org/10.1002/1097-0142(19860115)57:2<391::AID-CNCR2820570235>3.0.CO;2-Q [22] Talamini, R., Favero, A., Franceschi, S., La Vecchia, C., Levi, F. and Conti, E. (1998) Cancer of the Oral Cavity and Pharynx in Nonsmokers Who Drink Alcohol and in Nondrinkers Who Smoke Tobacco. Journal of the National Cancer Institute, 90, 1901-1903. http://dx.doi.org/10.1093/jnci/90.24.1901 [23] Adoga, A.A., Nimkur, T.L. and Silas, O.A. (2011) Clinicopathological Profile of Malignant Tumors of the Oropharynx at the Jos University Teaching Hospital, Jos, Nigeria. Journal of Medicine in the Tropics, 13, 36-40. http://dx.doi.org/10.4314/jmt.v13i1.69331