Metastatic choriocarcinoma presenting as advanced renal cell carcinoma: A case report

Choriocarcinoma is an aggressive tumour arising as a malignant transformation of the gestational trophoblastic disease or rarely from the germ cells in the ovary and from testicular mixed germ cell tumour. Renal involvement due to Choriocarcinoma is rare we report here one of such rare cases. A 26yr old woman presented with painful right sided loin swelling with painless total haematuria of 3weeks duration .Abdominal Ultrasound and CT scan showed a solid Right kidney mass with a cystic component. She had right radical nephrectomy.Histopathological examination revealed metastatic choriocarcinoma. The challenges we faced in her management is highlightedand a brief review of literature on the subject is presented

Pancreatic Cancer in Nigeria: a Study of Incidence in O.A.U.T.H.C, Ile-Ife

Cancer of the pancreas is one of the most rapidly fatal of all cancers and most cases are first recognized at a far advanced clinical stage. The American Cancer Society estimates that there will be 33,730 new cases of pancreatic cancer in 2006 and 32,300 deaths. Only cancers of the lung, colon and breast cause more deaths than pancreatic cancer each year1. Over the last few decades, the study of pancreatic cancer has assumed a position of growing importance because of its increasing incidence and poor prognosis. Approximately 170,000 new cases of pancreatic cancer or around 2.1% of all cancers occur worldwide every year 2.The lifetime risk of pancreatic cancer in developed countries is approximately 1% IFEMED Journal Vol. 14 (1) 2008: pp. 49-5

Clinical Pattern Of Male Breast Cancer In Ile-Ife, Nigeria

Background: Carcinoma of the breast in males is of interest because it is relatively uncommon and because presentation of the disease in hospitals is usually late owing to poor awareness and neglect. This study aimed to describe the pattern of the disease in our hospital. Method: Consecutive cases of male breast cancer presenting at the Ife Hospital Unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria between January 1993 and December, 2003 were studied noting the manifestation, duration of symptoms, diagnoses, treatment and outcome in the patients. Results: Of 249 histologically proven cases of breast cancer managed during the study period, 8(3.2%) were males, giving a male to female ratio of 1:31. They were aged 51-80 years with a mean of 64.7 +SD9.7 years. Mean duration of symptoms before presentation was 9 months. Painless breast mass and ulceration were the commonest symptoms. All patients presented in the late disease stage, 3(37.5%) in AJCC stage III and 5(62.5%) presented with stage IV disease. Histopathology in 6(75%) confirmed invasive ductal carcinoma, the two others had only fine needle aspiration cytology diagnosis. Three of the patients had simple mastectomy while others due to advanced disease could only be offered adjuvant chemotherapy and radiotherapy. After 2 years of follow-up, 3(37.5%) patients had died, one patient had re-presented with recurrence at the site of operation while the other 4 patients (50%) had been lost to follow up. Conclusion: The study underlined the uncommon occurrence of male breast cancer and late presentation, low survival rate and poor follow up of cases in our environment. Keywords: Male breast cancer, Presentation, OutcomeSahel Medical Journal Vol. 11 (1) 2008: pp. 24-2

Early experience with stapled gastrointestinal anastomoses in a Nigerian hospital

Background: Hand-sewn gastrointestinal anastomoses has been the traditional approach to gastrointestinal anastomosis in Nigeria while stapled anastomoses are infrequently performed in few centers. Objectives: To describe the outcome of our initial experience with stapled gastrointestinal anastomoses in a semi-urban patient population. Patients and Methods: Consecutive patients who had stapled gastrointestinal anastomoses between January 2011 and June 2014 in a Nigerian tertiary hospital were prospectively evaluated. Indications for operation, procedures performed and anastomoses constructed and postoperative outcome of each patient were documented. Results: Nineteen patients including seven males and 12 females had stapled anastomoses within the period. Their ages ranged between 41 and 68 (mean 52.5) years. Six (31.6%) Roux-en-Y gastrojejunostomies, 6 (31.6%) ileo-colic, 3 (15.8%) ileo-ileal, 2 (10.5%) colo-colic, and 2 (10.5%) colo-anal anastomoses were performed. Indications include antral gastric cancer in 4 (21.1%), right colon cancer 4 (21.1%), ileal perforations in 3 (15.8%) while 2 (10.5%) each had left colon cancer, common bile duct obstruction, rectal cancer and ruptured appendix. Mean duration of operation was 108 ± 46 min and mean duration of postoperative stay was 5 ± 2.6 days. No intraoperative complications were recorded and no anastomotic leakage occurred. At a median follow-up of 5 months no staple related stricture had occurred. Conclusions: Stapled gastrointestinal anastomoses are associated with a good outcome in our center. We propose a prospective, large-population randomized comparison of the technique with hand-sewn anastomoses

Early Experience with Stapled Gastrointestinal Anastomoses in a Nigerian Hospital

Background: Hand‑sewn gastrointestinal anastomoses has been the traditional approach to gastrointestinal anastomosis in Nigeria while stapled anastomoses are infrequently performed in few centers. Objectives: To describe the outcome of our initial experience with stapled gastrointestinal anastomoses in a semi‑urban patient population.Patients and Methods: Consecutive patients who had stapled gastrointestinal anastomoses between January 2011 and June 2014 in a Nigerian tertiary hospital were prospectively evaluated. Indications for operation, procedures performed and anastomoses constructed and postoperative outcome of each patient were documented. Results: Nineteen patients including seven males and 12 females had stapled anastomoses within the period. Their ages ranged between 41 and 68 (mean 52.5) years. Six (31.6%) Roux‑en‑Y gastrojejunostomies, 6 (31.6%) ileo‑colic, 3 (15.8%) ileo‑ileal, 2 (10.5%) colo‑colic, and 2 (10.5%) colo‑anal anastomoses were performed. Indications include antral gastric cancer in 4 (21.1%), right colon cancer 4 (21.1%), ileal perforations in 3 (15.8%) while 2 (10.5%) each had left colon cancer, common bile duct obstruction, rectal cancer and ruptured appendix. Mean duration of operation was 108 ± 46 min and mean duration of postoperative stay was 5 ± 2.6 days. No intraoperative complications were recorded and no anastomotic leakage occurred. At a median follow‑up of 5 months no staple related stricture had occurred. Conclusions: Stapled gastrointestinal anastomoses are associated with a good outcome in our center. We propose a prospective, large‑population randomizedcomparison of the technique with hand‑sewn anastomoses.Keywords: Anastomoses, gastrointestinal, Nigeria, staple

Metastatic breast cancer in a Nigerian tertiary hospital

Background: Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome.Objective: To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital.Method: Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were reviewed.Results: More than half of all histologically confirmed breast cancer patients seen within the study period presented with metastatic disease. Their ages ranged between 20-81years with a mean age of 45.9 years. Only 3% (6 of 202) were males. Twothirds had more than one secondary site on initial evaluation and the commonest sites were liver (63%), lung parenchyma (51%), pleura (26%) and contralateral breast in 25%. On immunohistochemistry, basal like tumours were found in 46.1%. Mastectomy was done in 37 patients with fungating breast masses while only one third of those referred to a nearby center for radiotherapy had it done. One year survival rate was 27%.Conclusion: Metastatic disease is common in Nigeria and treatment is limited due to resource limitations. Improved awareness of the disease is advocated to reduce late presentation

Metastatic breast cancer in a Nigerian tertiary hospital

Background: Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome.Objective: To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital.Method: Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria were reviewed.Results: More than half of all histologically confirmed breast cancer patients seen within the study period presented with metastatic disease. Their ages ranged between 20-81years with a mean age of 45.9 years. Only 3% (6 of 202) were males. Twothirds had more than one secondary site on initial evaluation and the commonest sites were liver (63%), lung parenchyma (51%), pleura (26%) and contralateral breast in 25%. On immunohistochemistry, basal like tumours were found in 46.1%. Mastectomy was done in 37 patients with fungating breast masses while only one third of those referred to a nearby center for radiotherapy had it done. One year survival rate was 27%.Conclusion: Metastatic disease is common in Nigeria and treatment is limited due to resource limitations. Improved awareness of the disease is advocated to reduce late presentation