Orofacial tumours and tumour-like lesions: a 10-year retrospective study in a Nigerian tertiary hospital.
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BACKGROUND: Orofacial tumours and tumour-like lesions encompass a diverse spectrum of benign and malignant conditions. Understanding their demographic distribution is essential for early diagnosis and optimal treatment planning. This study aimed to evaluate the prevalence and histopathological spectrum of OT/TLL in a Nigerian tertiary hospital and to compare findings with reports from other regions of the country. METHODS: Histopathology records of all orofacial lesions diagnosed between January 2015 and December 2024 were reviewed. Data on demographics, anatomical sites, and histological diagnoses were analyzed. Lesions were categorized as benign or malignant and Chi-square tests, logistic regression, and odds ratios were calculated using SPSS version 26. RESULTS: A total of 588 patients were studied. Benign lesions predominated (84.0%) and reactive follicular hyperplasia was the most common diagnosis (47.0%) peaking in childhood. Ameloblastoma (8.6%) was the leading benign odontogenic neoplasm, especially in the 10-19 age group. Malignancy rates increased progressively by odds of 9.6% with each additional year of age (OR = 1.096, 95% CI: 1.067-1.126, p < 0.001). Squamous cell carcinoma (59.6%) as the most frequent with 73.2% of cases occurring in patients aged ≥ 50 years (χ²=112.4, p < 0.0001). Benign tumours showed a slight female predominance, whereas males had significantly higher malignancy rates than females (χ²=7.82, p = 0.005) and independently conferred 86% higher odds (OR = 1.86, 95% CI: 1.16-2.98, p = 0.010). The mandible was the main site for ameloblastoma, while SCC often involved the larynx and nasopharynx. CONCLUSION: Benign orofacial lesions are highly prevalent, with reactive follicular hyperplasia being most common. Ameloblastoma and SCC represent the most significant benign and malignant neoplasms, respectively with age and male gender independent predictors of malignancy. These findings highlight the need for improved diagnostic services, oral health interventions, and strengthened cancer screening programs for early detection at high-risk sites.