Clinico-histopathologic types of maxillofacial malignancies with emphasis on sarcomas: a 10-year review.

Background: Sarcomas are malignant neoplasms that occur anywhere in the human body. Though their occurrence in the head and neck region is rare vis-a-vis other malignancies, their presence is of tremendous concern due to their often grave prognosis.

Objective: To determine the pattern of occurrence, histopathologic types of maxillofacial sarcomas and their proportion to other malignant neoplasms of this region based on archival material accumulated over 10 years (2000-2009).

Design: A combined retrospective and prospective cross-sectional study.

Setting: The University of Nairobi Dental Hospital (UNDH).

Subjects: All cases with a diagnosis of sarcoma registered between 2000-2009 were evaluated.

Results: Of the 528 malignancies recorded over the ten-year period, 427 (80.9%) were of epithelial origin while 101 (19.1%) 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. Osteosarcoma was the most commonly occurring sarcoma (29.7%), followed by Kaposi's sarcoma (KS) (28.7%), fibrosarcoma (FBS) (18.8%), and rhabdomyosarcoma (RMS) (9.9%). Sarcomas peaked in the third 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 personel about nine months after noticing the lesion with the most frequent complaint having been swelling.

Conclusion: The present study confirms the relative rarity of maxillofacial sarcomas. It also provides data on the histopathologic types and demographic characteristics of maxillofacial sarcomas in a select Kenyan population. This information is a contribution 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.