Dermatofibrosarcoma protuberans: clinicopathologic presentation in Nigerians

Introduction: dermatofibrosarcoma protuberance (DFSP) is in general a rare low grade malignant sarcoma and possesses a tendency for local recurrence. It has a site predilection for the trunk. Occurrence in the facial area is extremely rare. Ample knowledge of its clinical, histological and biologic characteristics is vital for accurate and prompt recognition. Methods: over 13 years, clinicohistologic information of cases was retrieved. Histological and immunohistochemical re-evaluation were performed to re-confirm diagnosis. Data collected and analyzed with SPSS Statistics version 20 were presented as frequency tables, charts and proportions as appropriate. Results: of 191 soft tissue sarcomas, a total of 28 cases were diagnosed as DFSP (14.7%). Facial types occurred in 3 cases (1.6%). Tumour had age and site predilections for the 4th decade and trunk respectively. There was an equal gender distribution among cases. Most common clinical presentation was in form of painless protruding nodular mass. General histologic presentation revealed cellular lesions composed of spindle to oval neoplastic cells arranged in a storiform pattern. Mitotic figures were rare. All cases showed positive expressions to CD34. Conclusion: facial DFSP is rare among Nigerians. Its clinical appearance may mimic other common benign lesions of the head and neck region often resulting in misdiagnoses. A comprehensive knowledge of its clinical and histologic presentations and biologic behavior, combined with its identification with the aid of advanced histologic and radiographic techniques results in prompt confirmatory diagnosis. Appropriate treatment should include adequate surgical excision techniques combined with adjuvant radiotherapy or chemotherapy

Cancer Mortality Pattern in Lagos University Teaching Hospital, Lagos, Nigeria

Background. Cancer is a leading cause of death worldwide and about 70% of all cancer deaths occurred in low- and middle-income countries. The cancer mortality pattern is quite different in Africa compared to other parts of the world. Extensive literature research showed little or no information about the overall deaths attributable to cancer in Nigeria. Aims and Objectives. This study aims at providing data on the patterns of cancer deaths in our center using the hospital and autopsy death registers. Methodology. Demographic, clinical data of patients who died of cancer were extracted from death registers in the wards and mortuary over a period of 14 years (2000–2013). Results. A total of 1436 (4.74%) cancer deaths out of 30287 deaths recorded during the period. The male to female ratio was 1 : 2.2 and the peak age of death was between 51 and 60 years. Overall, breast cancer was responsible for most of the deaths. Conclusion. The study shows that the cancers that accounted for majority of death occurred in organs that were accessible to screening procedures and not necessary for survival. We advise regular screening for precancerous lesions in these organs so as to reduce the mortality rate and burden of cancer

The challenges of lymphoma diagnosis in a Tertiary Hospital in Lagos, Nigeria

Background: In most tertiary centers across sub-Saharan countries, hematoxylin and eosin (H and E) stained slide is the main method of diagnosing lymphomas, and this has been found to be inadequate in diagnostic hematological malignancies. Aim and Objectives: To review the diagnostic utility and limitations of H and E, tissue diagnostic modality of solid hematolymphoid malignancies. Materials and Methods: The diagnosis based on both morphology and immunohistochemistry (IHC) assessments were compared with those based solely on morphology. Results: Of all, the 116 cases of lymphomas, only 32 (27.6%) were correctly diagnosed and subtyped by morphology while 53 (46%) cases were diagnosed to be lymphomas but could not be subtyped by morphology. Nineteen (16.4%) cases were wrongly subtyped. Five cases of reactive lesions were wrongly diagnosed as malignant lymphoma. Conclusion: This study makes a case for the mandatory use of IHC in the diagnosis of suspected cases of lymphomas

Neonatal neuroblastoma with adrenal primary and metastasis to the liver: A case report and a review of literature

We report the case of a 23-day-old neonate with neuroblastoma (NBL) in the right adrenal gland and widespread metastases to the liver. This raises the possibility of foetal NBL, which was missed during periodic ultrasonography done during the mother's pregnancy. We hope that this report would increase the awareness of physicians about foetal, congenital and neonatal NBL; and of sonographers about space-occupying lesions in the foetus. The clinicopathologic features and the management of neonatal NBL are discussed