Hydatid cyst of the orbit in a young Nigerian female: a case report

Objective: To report an unusual case of orbital hydatid cyst successfully managed by surgical excision.Case report: A 33-year-old female presented with gradual protrusion of the left eye associated with poor vision, cosmetic embarrassment and watering. She had excision biopsy of an encapsulated cystic lesion with cheesy tissue and serous content. Orbital hydatid cyst due to echinococcosis was confirmed at histopathological examination of the excised tissue. She subsequently became pregnant hence, could not undergo post-operative antihelminthic treatment, but was managed conservatively with no recurrence after five years of regular follow-up.Conclusion: Orbital hydatid cyst should be considered as a differential in a young patient presenting with unilateral proptosisFunding: NoneKeywords: Echinococcosis, Hydatid cyst, Orbit, Nigerian, Proptosi

The spectrum of non- neoplastic skin lesions in Ibadan, Nigeria: a histopathologic study

Introduction: Non-neoplastic skin lesions constitute the majority of skin diseases. There is a paucity of histopathology studies of non-neoplastic skin diseases in Nigeria and the West Africa sub-region in general. This is because the dermato-pathology sub-specialty is poorly developed. Therefore, the main aim of this study is to determine the spectrum of histologically diagnosed non-neoplastic skin lesions in Ibadan, Nigeria. Methods: This is a retrospective study. All non-neoplastic skin lesions diagnosed in the Department of Pathology, University College Hospital, Ibadan over a five year period. (January 2006 to December 2010) was reviewed. The lesions were classified into eight groups according to the International Classification of Diseases (ICD)-10 of skin and subcutaneous disorders. The main classes include Dermatitis/Eczema, Papulosquamous disorders, Infectious disorders, Connective tissue diseases, Bullous disorders, Naevi/Developmental lesions, Granulomatous lesions, keratinizing disorders and other categories/Miscellaneous group. Results: A total of 209 non-neoplastic skin lesions comprised 1.3% of all surgical pathology specimen received within the study period. The modal age group was 20-29. The Dermatitis/Eczema group has the highest frequency of 87 cases representing 41.6% of cases, papulosquamous disorders 39 (18.7%), infectious disorders 37 (17.7%), bullous disorders 11 (5.3%) and connective tissue disorder 9 (4.3%). Chronic non-specific dermatitis was the commonest specific diagnosis comprising 60 cases (28.7%) of all the skin diseases. The other common specific skin lesions were lichen planus/lichenoid dermatitis 27(12.9% of 209 cases), verruca vulgaris 25 (12% of 209 cases). Conclusion: The number of histologically diagnosed non-neoplastic skin lesions is relatively small. There is a very wide spectrum of non-neoplastic skin lesions diagnosed within this period. There is a need for a specific diagnosis considering the high frequency of chronic non-specific dermatitis.Pan African Medical Journal 2016; 2

Autopsy findings and pattern of mortality in Nigerian sickle cell disease patients

Introduction: Sickle Cell Disease (SCD) has a high mortality rate in the environment where we  practice. There is lack of contemporal autopsy studies describing causes of death among SCD patients at our centre. Methods: This is a retrospective study of SCD patients who died between January 1991 and December 2008 and that had autopsy examination to confirm the cause of death in a Nigerian teaching hospital. The clinical data, including the age, gender, Hb genotype, and the major autopsy findings and cause of death were obtained for each patient from the complete autopsy reports that included  histopathological examination. Multiple causes of death were entertained. Results: A total of 52 autopsies were performed. The mean age at death was 21.3 years (range, 1-47 years) and a male/female ratio of 1.3:1. HbS+C patients lived longer than HbS patients (21.0 years Vs 24.0 years) and peak mortality was in the 2nd and 3rd decades of life. The commonest causes of death as a single entity or in combination included infections in 78% of cases, fatal thrombotic/embolic events (37%) making acute chest syndrome a leading cause of death. This was followed closely by anemia alone or in combination with acute sequestration crises in 31% of patients.Conclusion: Infections are the commonest causes of death in Nigerian SCD patients, efforts to reduce infection especially early in life through prophylaxis or vaccination will impact on the overall survival of these patientsKey words: Sickle cell disease, cause of death, mortality, autops

Congenital orbital teratoma: a case report and challenges of its management in a resource limited setting

We report a case of congenital immature teratoma of the orbit in a female neonate who presented on the second day of life. She was successfully managed by modified exenteration. The patient was lost to follow-up intermittently over a 24-month period without recurrence of the tumour. However the patient could not be traced again after 24 months of follow up. This happened despite concerted efforts to educate the parents. The possible implications of this and other social factors, in a challenging and resource limited setting, on the prognosis of the disease and cosmetic outcome are considered.Pan African Medical Journal 2012; 12:

Pheochromocytoma in an accessory adrenal gland: a case report

Very few cases of pheochromocytoma in functional accessory adrenal glands have been documented in literature. We present a twenty-four year old Nigerian female who presented with pheochromocytoma. Investigations revealed a suprarenal mass, which was diagnosed as an accessory gland adrenal tumour at surgery. This shows that accessory adrenal glands can be a basis for development of pheochromocytoma

Proliferaton index in pituitary adenomas from a black African population

Background: The WHO has recognized a variant of pituitary adenomas with potential aggressive behaviour which have been termed atypical pituitary adenomas. This group of tumours are recognized by their mitotic rate of more than >3%, p53 expression and invasion of surrounding structures. There has however been no study of the occurrence of these tumours in a black African population. This study is a preliminary attempt to examine this group of tumours in blacks.Methods: This study retrospectively reviewed fifty-seven histologically diagnosed and immunohistochemically characterized pituitary adenomas received in our department over a twenty-one year period. Specimens were stained with ki67, a nuclear marker of cell proliferation which has been identified as the single best predictor of atypical pituitary adenoma.Results: Twelve of the tumours showed atypical features with eight (67%) of these tumours being prolactinomas. Two of the tumours were gonadotrophs and two were null cell adenomas. There was no correlation with age or gender. Two of the tumours required neurosurgical re-exploration with one of these showing a higher mitotic index in the second biopsy.Conclusion: The study suggests similarity in the rate of occurrence of pituitary adenomas with atypical features in a black African population with what is seen in Caucasians. Prolactinomas constitute a significant percentage of the tumours with this feature.Keywords: Pituitary adenoma, Immunohistochemistry, Atypical, Ki6

Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study

Introduction: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985. An update of the data on paediatric CNS neoplasms at our centre is presented. Methods: A retrospective review of all histologically diagnosed CNS tumours in children (0-14 years) from January 2001 to December 2010 from the database of the Department of Pathology, University College Hospital, Ibadan, Nigeria was done. The cases were classified using the 2007 WHO Classification of Tumours of the Central Nervous System and were also based on their supratentorial and infratentorial locations. Results: Seventy-seven tumours, 44 in males, were included in the study. Astrocytic tumour comprised 20 cases, embryonal tumours 15, ependymal tumours 15, germ cell tumours 6, sellar tumours (all craniopharyngiomas) 9 and other histological types- 12 cases. Thirty-seven were WHO Grade 1, eleven Grade 2, ten Grade 3 and nineteen Grade 4 neoplasms. Thirty-six cases were supratentorial and thirty-eight were infratentorial in location. The most common tumours in this series were pilocytic astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas in that order. Conclusion: Childhood CNS tumours are being increasingly diagnosed in our centre. This is largely explained by the recent expansion of the available neurosurgical services.Pan African Medical Journal 2016; 2

Giant deep orbital dermoid cyst presenting early in infancy in a Nigerian child: a case report and review of the literature

Abstract Introduction Dermoid cysts are the most common orbital cystic lesions seen in children. While superficial orbital dermoid cysts present early in life, deep dermoid cysts remain clinically occult until adolescence or adulthood. We here present a case of a deep orbital dermoid cyst in a Nigerian child that became symptomatic early in infancy. Case presentation A female Nigerian infant of Yoruba ethnicity presented at three months of age with left non-axial proptosis and a hazy cornea. A superotemporal cystic orbital mass was seen on ultrasonography, and her parents were counseled for simple tumor excision. They however defaulted, only for their child to re-present two years later with gradually progressive proptosis, an enlarged orbit and keratinized ocular surface, necessitating orbital exenteration. Conclusion Deep orbital dermoid cysts may be symptomatic from birth. Late presentation may result in an irreversible loss of vision, as demonstrated in our case. The need for public enlightenment on early presentation and prompt management of such benign lesions is emphasized.</p