Challenges in the management of head and neck sarcomas in a resource scarce setting: A review of 54 cases

Abstract

Background: Sarcomas in the head and neck region are rare, the management can be challenging due to difficulty in making diagnosis, late presentation among others. Methods: A combined cohort study of all head and neck sarcomas seen in the Oral and Maxillofacial Surgery Department, University of Nigeria Teaching Hospital Enugu from 2010 to 2020. Result: Fifty-four cases of sarcomas of the oral and maxillofacial region were reviewed based on histopathologic subtypes, clinical presentation, treatment options, while factors considered as challenges were noted. Thirty (55.6%) occurred in males while 24 (44.4%) in females in a ratio of 1.3:1. The mean age of the patients was 35.1 ± 18.2 years (range 6 months–72 years). The duration of the tumours on first presentation was between 1 and 60 months (mean 9.8 ± 10.2 months). Seventeen histopathologic subtypes were found with osteosarcoma 14 (26%) as the most predominant. Surgical intervention alone or in combination with other modalities was used in 41 (76%). Recurrence of the lesion was recorded in 27 (66%) patients, (23 (85.2%) local and 4 (14.8%) regional). Only 4 (9.8%) patients continued follow-up visit after the first year.Conclusion: head and neck sarcomas are rare, management of this condition in resource scarce centers is fraught with lots of challenges.

Keywords

• Sarcoma
• Maxillofacial
• Recurrence
• Late presentation