Histopathologic pattern of neoplastic testicular and paratesticular lesions in university of Maiduguri Teaching Hospital: a 10-year retrospective review

Objective: The present study is undertaken to describe the spectrum of histopathological features and age distribution of neoplastic testicular and paratesticular lesions in the University of Maiduguri Teaching Hospital.Materials and Methods: A retrospective descriptive study of 14 testicular and paratesticular neoplastic lesions was conducted over a period of 10 years; between January-2005 and December-2014 in the Department of Histopathology, University of Maiduguri Teaching Hospital. Histopathological examination was done after routine processing and staining with Haematoxylin & Eosin.Results: There were 14 cases of neoplastic testicular and paratesticular tumours of which 12cases (85.7%) were malignant lesions and 2 (14.3%) were benign. There were 7 cases (50.0%) of testicular germ cell tumours, 4 cases (28.6%) of paratesticular tumoursand 3 cases (21.4%) of metastasis to the testis. The testicular germ cell tumours also accounted for 100% of all primary testicular tumours. These included 3 cases (42.9%) of seminoma and teratoma each and a case (14.3%) of endodermal sinus tumour (yolk sac tumour). The age distribution of the testicular and paratesticular tumours in this study shows that the majority of malignant lesions were present in the third and sixth decades of life (66.6%), while the only two benign lesions have also one case each in the third and sixth decades of life. The study also shows thatonly 2 cases were seen in the second decade of life; a case of seminoma in a 14-year-old boy and rhabdomyosarcoma in 15 years old, while the oldest patient was a 61-year-old male whose diagnosis was yolk sac tumour.Conclusion: This study highlights the rarity of testicular tumours in Maiduguri, Northeastern Nigeria and correlates well with the histopathological spectrum of testicular tumours in other parts of the world. The relative higher percentage of up 21.4% of cases of metastasis to the testis also emphasizes the need for thorough evaluation of testicular specimens especially in cases of advanced carcinoma of the prostate.Keywords: testicular, neoplastic lesions, histopatholog

Nasopharyngeal cancer in north-eastern Nigeria: clinical trends

Nasopharyngeal cancer is the malignancy of the posterior aspect of the nose called Nasopharynx. It is one of themost difficult diseases to diagnose at an early stage. To determine prevalence, clinical trends and histopathological types of Nasopharyngeal cancer in Maiduguri, North Eastern Nigeria. Fifteen year retrospective evaluation of patient’s case notes and cancer registry records of 40 patientswith histologically confirmed nasopharyngeal cancer between 1991-2005. Nasopharyngeal cancers constituted 35.1% of all malignancies of ear, nose, throat during the study period.TheM:Fwas 2.1-1, themean agewas 39( 16.5) years and a peak age group and its occurrence of 40-49 years. The commonest symptom at presentation were cervical lymphadenopathy (72.5%), rhinorrhoea (55%), epistaxis(45%). The commonest histological type was squamous cell carcinoma(92.5%). Patients who received chemotherapy in addition to radiotherapy and higher symptom free period. Cancer is a difficult disease to diagnose at an stage.Ameticulous ear, nose and throat examination and thorough evaluation of nasal symptoms with associated cervical lymphadenopathy may lead to an early diagnosis of nasopharyngeal cancer’s.Keywords: Nasopharyngeal cancer, clinical trend, Maiduguri, Nigeria

A clinico-pathologicalanalysis of uterine leiomyomata in Maiduguri, Nigeria

Uterine leiomyoma (UL) is the commonest benign tumour of the female genital tract in the reproductive age group. There is little or no literature on the histopathological study of the disease in Nigeria. This may be the first study to serve as a baseline data in Maiduguri. Objective: To analyse the frequency of occurrence, age and parity of the patients, clinical presentation, degenerative changes, diseases associated with uterine leiomyomata and the treatment modalities of the tumour in Maiduguri. Methods: A retrospective analysis of all cases of uterine leiomyomata histologically diagnosed in the Histopathology Department of the University of Maiduguri Teaching Hospital, Nigeria between January 1994 and December 2003 inclusive. Results: A total of 501 cases of uterine leiomyomas were examined in this study, representing 4.5% of all disease conditions histopathologically diagnosed within the study period. The mean age of patients was 36.3 (±8.3SD) and the th peak age incidence was in the 4 decade of life. The symptoms are presented in the following order of frequency: lower abdominal pain, 187 (87.8%); menstrual pain and irregularity, 164 (77.0%); urinary frequency/hesitancy/urgency, 68 (31.9%); infertility/subfertility, 42 (19.7%) and constipation 24 (11.3%). Multiparous women accounted for 64.9% of all cases. There were 121 cases of uterine leiomyoma coexisting with adenomyosis (30), ovarian cysts [Non-neoplastic (41), Neoplastic [benign (12), malignant (8)] and cervical inflammatory diseases (30). The commonest mode of treatment was myomectomy in 367 (73%) and hysterectomy in 134 (27%) cases, with mean age of 33.9 and 46.7 years respectively There were 104 cases of degenerative changes: hyaline (92), cystic (12), calcification (9) and red degeneration(6) Conclusion: Uterine leiomyoma is common, especially in the reproductive age group and is often associated with degenerative changes, and coexistent with ovarian cysts, adenomyosis and chronic cervicitis. There is need to find the aetiological relationships of the disease in order to reduce its incidence as well as the frequent exposure of women to operations that are necessitated by the disease and its associated complications

Induction of Labour

Induction of labour is one of the common obstetric interventions in the world with varied incidence rates between developed and developing countries. It is generally employed by obstetricians and physicians managing pregnant women when the risk of continuing such pregnancy is far greater than delivery at that said point. A detailed evaluation and indications for induction of labour should be done for every single woman. Methods of induction of labour could be pharmacological, mechanical or both; taking care to reduce or eliminate complications associated with this intervention. Decision for induction of labour should involve the most senior member of the team with a woman centered approach to care. Induction of labour carries multiple risks and complications compared with spontaneous onset of uterine contractions with increase tendency of operative vaginal delivery and caesarean section

Vaginal Birth After Caesarean (VBAC)

The rising rate of caesarean section has implications in the reproductive performance of a woman and increases the likelihood of complications during repeat operations, whether they are planned or performed on an emergency basis. A successful vaginal delivery after caesarean is associated with increased maternal satisfaction, reduced caesarean section rate, and appears to be cost effective. There is a need for careful selection of women that are willing to attempt vaginal birth after caesarean with a clear set of local protocols to increase overall success rate, reduce litigation and improve neonatal outcome. The benefits and risks of planned vaginal birth after caesarean and elective repeat caesarean section should be discussed in detail with the woman during antenatal care and reemphasized at admission to the labour ward. A decision to embark on VBAC should be free from coercion with full informed consent as the bedrock for such a decision. Facilities offering vaginal birth in women with prior caesarean delivery should be equipped with 24-hour standby emergency caesarean section capability. The intrapartum care should be carefully tailored to meet the woman’s need with support from the health care team. Every obstetrics unit should debrief women after delivery irrespective of the outcome and should conduct regular audits to improve the care of women with previous caesarean sections

Childhood ovarian juvenile granulosa cell tumour: a case report and review of literature

Juvenile granulosa cell tumour (JGCT) is very uncommon gynecological malignancy that occurs more commonly in under five years old of age. We describe a case of JGCT in a 4-years old girl. The malignancy is assigned to International Federation of Gynecology and Obstetric staging system (FIGO stage I). Treated with complete excision only, the patient showed no evidence of relapse one year after surgery. Findings in this case are discussed and histological examination confirmed the diagnosis. The natural history of JGCT, epidemiology, histology, treatment and prognosis are reviewed along with the case presentation.Key words: Childhood, Juvenile Granulosa Cell, Tumour, Ovar

Embryofetal effects of the methanolic root extract of Cissampelos mucronata A. Rich in rats

This study was designed to examine the effect of the methanolic extract of the root of Cissampelos mucronata on embryo-foetal development in rats. A total of 60 nulliparous female rats weighing 143-215gm approximately 13 weeks of age in the proestrous stage were cohabited (1:1) with 60 male rats to obtain 40 pregnant rats which were assigned to four dosage groups (10 rats per group, I-IV) by random stratification to nearly equalized body weight difference between groups on gestataion day zero GD 0. Group I served as the control group while rats in Groups II, III and IV were administered with 100mgkg-1, 200mgkg-1and 300mgkg-1 doses of the extract respectively from implantation (GD6) to the day prior to the expected day of parturition (GD20). On GD20, the female rats were euthanized and uterine implantation data including live and dead foetuses were counted, weighed, gender determined and observed for external malformations. The results indicate that administration of the extract from gestation day 6 to 20 had no significant effect on the number of implantation sites while resorptions sites were significantly (p<0.05-0.001) high in a dose dependent manner. There was a decrease in the foetal weight, placental weight and crown rump length of the rats indicating that administration of the extract from gestation day 6 to 20 caused resorptions in pregnancy and decrease in foetal weight, placental weight and crown rump length rats in a dose dependent manner.Key words: Embryotoxic, crown rump, resorption, viable, foetu

Phaeochromocytoma in a 4-year old girl: case report

This is a report of a 4-year old female Nigerian patient with phaeochromocytoma, a rare surgically correctable cause of hypertension, highlighting the problems in diagnosis and management in our sub region with review of the literature

A CLINICO-PATHOLOGICAL ANALYSIS OF UTERINE LEIOMYOMATA IN MAIDUGURI, NIGERIA

Background: Uterine leiomyoma (UL) is the commonest benign tumour of the female genital tract in the reproductive age group. There is little or no literature on the histopathological study of the disease in Nigeria. This may be the first study to serve as a baseline data in Maiduguri. Objective: To analyse the frequency of occurrence, age and parity of the patients, clinical presentation, degenerative changes, diseases associated with uterine leiomyomata and the treatment modalities of the tumour in Maiduguri. Methods: A retrospective analysis of all cases of uterine leiomyomata histologically diagnosed in the Histopathology Department of the University of Maiduguri Teaching Hospital, Nigeria between January 1994 and December 2003 inclusive. Results: A total of 501 cases of uterine leiomyomas were examined in this study, representing 4.5% of all disease conditions histopathologically diagnosed within the study period. The mean age of patients was 36.3 (+/-8.3SD) and the th peak age incidence was in the 4 decade of life. The symptoms are presented in the following order of frequency: lower abdominal pain, 187 (87.8%); menstrual pain and irregularity, 164 (77.0%); urinary frequency/hesitancy/urgency, 68 (31.9%); infertility/subfertility, 42 (19.7%) and constipation 24 (11.3%). Multiparous women accounted for 64.9% of all cases. There were 121 cases of uterine leiomyoma coexisting with adenomyosis (30), ovarian cysts [Non-neoplastic (41), Neoplastic [benign (12), malignant (8)] and cervical inflammatory diseases (30). The commonest mode of treatment was myomectomy in 367 (73%) and hysterectomy in 134 (27%) cases, with mean age of 33.9 and 46.7 years respectively There were 104 cases of degenerative changes: hyaline (92), cystic (12), calcification (9) and red (6). Conclusion: Uterine leiomyoma is common, especially in the reproductive age group and is often associated with degenerative changes, and coexistent with ovarian cysts, adenomyosis and chronic cervicitis. There is need to find the aetiological relationships of the disease in order to reduce its incidence as well as the frequent exposure of women to operations that are necessitated by the disease and its associated complications

Aberrant axillarybreast carcinoma: a case report andliterature review

Ectopic breast tissue (EBT) develops along the mammary line owing to incomplete embryologic regression of the mammary ridges. This includes supernumerary breasts and aberrant breast tissue, in which malignancy is rarely reported. The commonest site of ectopic breasts is at the axilla, and the subcutaneous axillary mass may pose a diagnostic challenge to theclinician. Case Report: We report the case of a 31 year old multiparous Nigerian woman who presented with a painless left axillary mass of two months' duration. The anatomical breasts were grossly and radiologically normal. A diagnosis of aberrant breast carcinoma in her left axilla was confirmed by tissue biopsy. She had wide local excision and left axillary dissection, followed by one course of cytotoxic chemotherapybeforeshe began radiotherapy. Conclusion: Malignancy of aberrant breast tissue is a rare entity. A high index of suspicion and a low threshold for biopsy of subcutaneous lesions in the periphery of the breast allows for early intervention and a better prognosis. Triple assessment with clinical, radiological and pathological assessment of lesions in the axilla or along the embryonic milk line can not be over-emphasized