Evaluation of consistency rate between clinical and histopathological diagnosis of oral soft tissue lesions
DOI:
https://doi.org/10.22122/cdj.v7i4.416Keywords:
Clinical Laboratory Techniques, Histopathology, Oral Soft Tissue LesionsAbstract
BACKGROUND: Some of the oral lesions including malignant tumors of mesenchymal and epithelial origin have same clinical features. Most of them are white or red patches with undermined edge. Also, in some cases, the microscopic view of histopathologic examination is not diagnostic. So, the integration of clinical and pathological information leads to the correct diagnosis. The aim of this study was the evaluation of consistency rate between clinical and histopathological diagnosis of oral malignant tumors of mesenchymal and epithelial origin.
METHODS: This cross-sectional retrospective study was performed in four centers of oral pathology of Hamedan University of Medical Sciences, Hamedan, Iran, during January to June, 2016. The data were collected using the archived files of patients. Collected data from the files included age, sex, lesion location, lesion type, and first and second clinical and histopathologic diagnosis. Finally, histopathological findings were compared with the first and second clinical diagnosis. Data were analyzed using SPSS software.
RESULTS: Ninety-one and seventy-nine of studied files were related to men and women, respectively. Most frequent malignant lesion was related to squamous cell carcinoma (SCC) (52.9%), followed by melanoma (29.4%). The consistency rate of first and second clinical and histopathologic diagnosis was 68.2% and 15.2%, respectively. Higher consistency rate was observed in melanoma, SCC, and fibrosarcoma lesions.
CONCLUSION: High inconsistency rate between clinical and histopathological diagnosis was found in some cases which may have originated from low diagnostic knowledge of clinicians or their misconception from misdiagnosis. Therefore, the improvement of knowledge and awareness of clinicians by conducting retraining courses is necessary.
References
Molania T, Nahvi A, Delrobaee M, Salehi M. Frequency of oral mucosal lesions and awareness of these lesions in patients attending oral and maxillofacial clinic in Sari Dental School, Iran. J Mazandaran Univ Med Sci 2017; 26(1446): 80-7. [In Persian].
Shirani S, Kargahi N, Razavi SM, Homayoni S. Epithelial dysplasia in oral cavity. Iran J Med Sci 2014; 39(5): 406-17.
Shiva A, Mousavi SJ. Epidemiologic study of oral and paraoral malignancies in Sari, Iran. J Mashad Dent Sch 2014; 38(4): 337-46.
Shiva A, Sobouti F. Comparative Study of Histopathological Reports and Clinical Diagnosis of Oral Biopsies. J Mazandaran Univ Med Sci 2017; 26(144): 57-64. [In Persian].
Shahsavari F, Fereidouni F, Farzane Nejad R. The prevalence of oral mucosal lesions and associated factors in pathology department of Tehran Cancer Institute of Imam Khomeini Hospital since 2000 to 2010. J Res Dent Sci 2012; 9(2): 111-5. [In Persian].
Zare Mahmoodabadi R, Salehinejad J, Khajehahmadi S, Saghafi S, Javan A, Taherymoghadam S. Consistency Rates of Clinical and Histopathologic Diagnoses of Mucocutaneous Lesions in Oral Cavity. J Mashad Dent Sch 2012; 36(4): 309-16. [In Persian].
Ghaznavi A, Abdal K, Abbasi L, Mostafazadeh S. Consistency rates of clinical and radiological diagnosis with histopathological reports of intraosseous lesions in maxillofacial region in patients referred to Imam Khomeini Hospital since 2010 to 2016. J Urmia Univ Med Sci 2017; 28(6): 373-80. [In Persian].
Hoseinpour Jajarm H, Mohtasham N. A comparative study on the clinical diagnosis and pathology report of patients undergone biopsy at department of Oral Medicine of Mashhad Dental School from 2002 until 2004. J Mashad Dent Sch 2006; 30: 47-54. [In Persian].
Saghravanian N, Hosseinpour Jajarm H, Salehinejad J, Afzal Aghaie M, Ghazi N. A 30-year comparison of clinical and histopathological diagnoses in salivary gland lesions, odontogenic cysts and tumors in Mashhad Dental School-Iran. J Mashad Dent Sch 2010; 34(4): 299-308. [In Persian].
Shiva A, Giahpur A. Awareness of dentists and final-year dental students on transport and processing of oral biopsies. J Mazandaran Univ Med Sci 2016; 26(142): 231-21. [In Persian].
Mortazavi H, Safi Y, Baharvand M, Rahmani S. Diagnostic features of common oral ulcerative lesions: An updated decision tree. International Journal of Dentistry 2016; 2016: 7278925.
Musavi A, Bagheri A, Hamzeheil Z, Soruri M, Varkesh B, Razavi A, et al. Assessment of agreement between clinical diagnosis and pathologic report in the soft tissue lesions of the patients referring to pathology department of dental school, Tehran and Shahid Beheshti University of Medical Sciences During 2005-2008. J Shaheed Sadoughi Univ Med Sci 2013; 20(5): 639-47. [In Persian].
Ali M, Baughman RA. Maxillary odontogenic keratocyst: A common and serious clinical misdiagnosis. J Am Dent Assoc 2003; 134(7): 877-83.
Jones AV, Franklin CD. An analysis of oral and maxillofacial pathology found in adults over a 30-year period. J Oral Pathol Med 2006; 35(7): 392-401.
Lopez-Graniel CM, Ochoa-Carrillo FJ, Meneses-Garcia A. Malignant melanoma of the oral cavity: Diagnosis and treatment experience in a Mexican population. Oral Oncol 1999; 35(4): 425-30.
Hollows P, McAndrew PG, Perini MG. Delays in the referral and treatment of oral squamous cell carcinoma. Br Dent J 2000; 188(5): 262-5.
Nascimento AF, McMenamin ME, Fletcher CD. Liposarcomas/atypical lipomatous tumors of the oral cavity: a clinicopathologic study of 23 cases. Ann Diagn Pathol 2002; 6(2): 83-93.
Yan B, Li Y, Pan J, Xia H, Li LJ. Primary oral leiomyosarcoma: A retrospective clinical analysis of 20 cases. Oral Dis 2010; 16(2): 198-203.
Fowler CB, Hartman KS, Brannon RB. Fibromatosis of the oral and paraoral region. Oral Surg Oral Med Oral Pathol 1994; 77(4): 373-86.
Peters E, Cohen M, Altini M, Murray J. Rhabdomyosarcoma of the oral and paraoral region. Cancer 1989; 63(5): 963-6.
Neville BV, Damm DD, Bouquot J, Allen CM. Oral and Maxillofacial Pathology. Philadelphia, PA: Elsevier Science Health Science p. 316-497; 2015.
Wenig BM. Laryngeal mucosal malignant melanoma. A clinicopathologic, immunohistochemical, and ultrastructural study of four patients and a review of the literature. Cancer 1995; 75(7): 1568-77.
Hashemipoor M, Morad M, Mojtahedi A. Comparative evaluation of clinical and histological findings in oral and maxillofacial diseases. J Dent Shiraz Univ Med Sci 2009; 10(1): 31-7. [In Persian].
Deyhimi P, Ferdowsi M. Correspondence of clinical diagnosis with histopathologic diagnosis of oral lesions in patients referring to oral pathology department of Isfahan Dentistry School from 1991 to 2000. J Dent Sch Shahid Beheshti Univ Med Sci 2004; 22(1): 38-48. [In Persian].
