Occult cancer with cervical lymph node metastasis: histologic profile of cervical lymph node and pan-endoscopic biopsies at university college hospital, Ibadan, Nigeria

Background: Occult cervical lymph node metastasis is a relatively rare oncologic disease presenting as a neck lump without an obvious mucosal lesion. Most cases arise from the upper aerodigestive tract and affect all ages. It is often a diagnostic dilemma when there is no facility to carry out a thorough evaluation.Methods: A prospective study of all patients with neck lump with unknown primary tumor site evaluated within the periods, January 2010 to December 2012 at the ENT/Head and Neck Department of University College Hospital, Ibadan. The patients went through clinical, radiological and endoscopic assessments. Fine Needle Aspirate and Cytology (FNAC) of neck node and random pan-endoscopic specimens obtained were cytological and histological analysed.Results: The prevalence of cervical nodal metastasis with unknown primary site was 9.7%. We found no gender predilection in the study. Majority of the patients with occult cervical node metastases were in the third decade of life. The histological yield of pan-endoscopy biopsy specimen was 72%. Undifferentiated nasopharyngeal squamous (39%) cell carcinoma was the commonest diagnosis following random biopsy during pan-endoscopy.Conclusion: Despite limitations arising from lack of FDG PET, the yield from pan-endoscopy biopsy specimen was appreciable. Inadequate immunohistological stains and lack of FDG PET scan may have diminished the histological yield of the blind pan-endoscopy biopsy specimens.Keywords: Cervical nodal metastasis with unknown primary site, pan-endoscopy biopsy, occult cancerJos Journal of Medicine, Volume 7 No.

Primary osteogenic sarcoma of the breast

BACKGROUND: Primary extra-osseous osteogenic sarcomas have been reported in many tissues of the body but their occurrence in the breast is extremely rare. It can arise as a result of osseous metaplasia in a pre-existing benign or malignant neoplasm of the breast or as non-phylloides sarcoma from the soft tissue of a previously normal breast. CASE PRESENTATION: A 40 year-old Nigerian woman was clinically diagnosed to have carcinoma of the left breast. The histology report of core-needle biopsy of the mass showed a malignant neoplasm comprising islands of chondroblastic and osteoblastic stromal cells. This report changed the diagnosis from carcinoma to osteogenic sarcoma of the breast. She had a left modified radical mastectomy, however there was significant post surgery skin deficit. A latissimus dorsi musculocutaneous flap was used to cover the anterior chest wall defect. Sections from the mastectomy specimen confirmed the diagnosis of osteogenic sarcoma. She died six months after mastectomy. CONCLUSION: A diagnosis of osteogenic sarcoma of the breast was made based on histology report and after excluding an osteogenic sarcoma arising from underlying ribs and sternum. This is the second documented case of primary osteogenic sarcoma of the breast coming from Nigeri

Waist–Hip Ratio and Breast Cancer Risk in Urbanized Nigerian Women

Background: The aim of this study was to examine the relationship between waist–hip ratio and the risk of breast cancer in an urban Nigerian population. Methods: Between March 1998 and August 2000, we conducted a case–control study of hospital-based breast cancer patients (n = 234) and population-based controls (n = 273) using nurse interviewers in urban Southwestern Nigeria. Results: Multivariable logistic regression showed a significant association between the highest tertile of waist–hip ratio and the risk of breast cancer (odds ratio= 2.67, 95% confidence interval = 1.05–6.80) among postmenopausal women. No association was found in premenopausal women. Conclusion: The present study, the first in an indigenous African population, supports other studies that have shown a positive association between obesity and breast cancer risk among postmenopausal women

Amyloid angiopathy of the floor of the mouth: a case report and review of the literature

Amyloidosis is a rare disease characterised by the deposition of insoluble extracellular fibrillar proteins in various tissues of the body. The pattern of manifestation is organ dependent and also on whether the disease is localised or systemic, primary or secondary

Lymphomas in sub-Saharan Africa - what can we learn and how can we help in improving diagnosis, managing patients and fostering translational research?

Approximately 30 000 cases of non-Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing in this part of the world, very little is known about lymphomas in Africa. This review provides information regarding the current infrastructure for diagnostics in sub-Saharan Africa. The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub-Saharan Africa were based on a review undertaken by a team of lymphoma experts on 159 fine needle aspirate samples and 467 histological samples during their visit to selected sub- Saharan African centres is presented. Among children (age), BL accounted for 82% of all NHL, and among adults, diffuse large B-cell lymphoma accounted for 55% of all NHLs. Among adults, various lymphomas other than BL, including T-cell lymphomas, were encountered. The review also discusses the current strategies of the International Network of Cancer Treatment and Research on improving the diagnostic standards and management of lymphoma patients and in acquiring reliable clinical and pathology data in sub- Saharan Africa for fostering high-quality translational research

Parity and breastfeeding are protective against breast cancer in Nigerian women

As the relation between reproductive factors and breast cancer risk has not been systematically studied in indigenous women of sub-Saharan Africa, we examined this in a case–control study in Nigeria. In-person interviews were conducted using structured questionnaires to collect detailed reproductive history in 819 breast cancer cases and 569 community controls between 1998 and 2006. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI). Compared with women with menarcheal age <17 years, the adjusted OR for women with menarcheal age ⩾17 years was 0.72 (95% CI: 0.54–0.95, P=0.02). Parity was negatively associated with risk (P-trend=0.02) but age at first live birth was not significant (P=0.16). Importantly, breast cancer risk decreased by 7% for every 12 months of breastfeeding (P-trend=0.005). It is worth noting that the distribution of reproductive risk factors changed significantly from early to late birth cohorts in the direction of increasing breast cancer incidence. Our findings also highlight the heterogeneity of breast cancer aetiology across populations, and indicate the need for further studies among indigenous sub-Saharan women

Prostate cancer disparities in Black men of African descent: a comparative literature review of prostate cancer burden among Black men in the United States, Caribbean, United Kingdom, and West Africa

<p>Abstract</p> <p>Background</p> <p>African American men have the highest prostate cancer morbidity and mortality rates than any other racial or ethnic group in the US. Although the overall incidence of and mortality from prostate cancer has been declining in White men since 1991, the decline in African American men lags behind White men. Of particular concern is the growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry in the Caribbean Islands, United Kingdom and West Africa. This higher incidence of prostate cancer observed in populations of African descent may be attributed to the fact that these populations share ancestral genetic factors. To better understand the burden of prostate cancer among men of West African Ancestry, we conducted a review of the literature on prostate cancer incidence, prevalence, and mortality in the countries connected by the Transatlantic Slave Trade.</p> <p>Results</p> <p>Several published studies indicate high prostate cancer burden in Nigeria and Ghana. There was no published literature for the countries Benin, Gambia and Senegal that met our review criteria. Prostate cancer morbidity and/or mortality data from the Caribbean Islands and the United Kingdom also provided comparable or worse prostate cancer burden to that of US Blacks.</p> <p>Conclusion</p> <p>The growing literature on the disproportionate burden of prostate cancer among other Black men of West African ancestry follows the path of the Transatlantic Slave Trade. To better understand and address the global prostate cancer disparities seen in Black men of West African ancestry, future studies should explore the genetic and environmental risk factors for prostate cancer among this group.</p

Childhood malignancies in Nigeria

No Abstract. IFEMED Vol. 13 (1) 2007 pp. 79-8