Intracranial neoplasmin Ibadan, Nigeria

Objective: To determine the pattern of histopathological variants of intracranial neoplasms, relative distribution of the variants in the age groups and also to determine the gender differences that exist in these tumours.Design: Case control study. Setting: Department of Pathology, University College Hospital, Ibadan, Nigeria.Patients: Two hundred and ten histologically confirmed cases of intracranial neoplasms seen during eleven-year period (1980 to 1990) were analysed. Interventions: Slides of tumours stained with haematoxylin and eosin, reticulin and phosphotungstic acid haematoxylin.Results: Two hundred and ten intracronial neoplasms comprising 172 primary and 48 secondary neoplasms were seen. One hundred and thirty five neoplasms occurred in adults and 75 in children. There was no gender difference, the ratio being 1:1. Gliomas accounted for the largest group of tumours followed by metastases to the brain. Of the gliomas, astrocytoma was the commonest. Craniopharyngiomas were found to becommon in children. Germ cell tumours were found to be uncommon.Conclusion: Gliomas are the commonest group of intracranial neoplasms in both adults and children. This is followed by metastatic tumours. Tumours of the sella turcica are predominantly found in children. Involvement of the brain in disseminated Burkitt’s lymphomas is predominantly found in Africans as the Burkitt’s tumour is uncommonin non Africans

Gastric malignancies and associated pre-malignant lesions in a teaching hospital in South West Nigeria

The histologic types of gastric malignancies and other associated histopathological indices in gastric biopsies received at the Department of Morbid Anatomy and Forensic Medicine, Obafemi AwolowoUniversity Teaching Hospitals Complex, Ile-Ife, Osun State, Nigeria were determined. The study was retrospective and it involved collecting all slides on all available cases of gastric biopsies over a periodof ten years and reviewing them to screen for gastric malignancies and associated pathologies of the stomach. Out of 107 cases of gastric malignancies reviewed, 102 (95.3%) were carcinomas, 3 (2.8%)were sarcomas and 2 (1.9%) cases were lymphomas. Of 102 cases of carcinomas, 36 (35.3%) were tubular adenocarcinomas, 14 (13.7%) cases were papillary adenocarcinomas, 22 (21.6%) cases weremucinous adenocarcinomas, 9 (8.8%) cases were signet carcinomas, and 21 (20.6%) were poorly differentiated adenocarcinomas. One hundred and two (95.33%) cases of gastric malignancies were inthe pyloric antrum, 3 (2.80%) were in the gastric cardia, and 1 case each (0.93%) in the corpus and fundus. Sixty-four (60%) of cases showed moderate to numerous Helicobacter pylori. Mild chronicgastritis was seen in 11 (10%) cases, moderate chronic gastritis was seen in 75 (70%) of cases, and severe chronic gastritis was seen in 16 (15%) cases. Five (5%) cases were indeterminate. Mild glandularatrophy was seen in 5 (5%) cases, 32 cases (30%) showed moderate glandular atrophy, 1 (1%) case of severe glandular atrophy was seen. Intestinal metaplasia was seen in 17 cases (16%). Peptic ulcerdisease was not seen in any of the cases

Granular Cell Tumor Of The Esophagus: An Unusual Cause Of Dysphagia And Management Dilemma

We report an uncommon case of dysphagia caused by a granular cell tumor in a 38 year old black female. Previously documented granular cell tumors are reported as being small and treated endoscopically. This is probably the largest reported in literature and possibly the fi rst documented in the West African subregion. She required excision via thoracotomy and end to end anastomosis of the residual esophagus. Some management dilemmas are also discussed.We conclude that granular cell tumor of the esophagus should be considered in any patient presenting with dysphagia associated with a large esophageal mass

Mucinous adenocarcinoma of the appendix: A case report and literature review

Primary adenocarcinoma of the appendix is a rare disease as compared with cancer of the colon. It is  common in patients in the middle age. Mucinous adenocarcinoma is one of the histological types seen. The usual presentation of patients is acute appendicitis or peri –appendicular abscess. Diagnosis is often made after the surgical specimen has been sent for histopathological review. It is important to rule out synchronous and metachronous tumour during surgery. We present a case of a 42 year old female whom an appendectomy had been attempted, the procedure was aborted and she developed an enterocutaneous fistula prior to presentation in our hospital. At exploratory laparotomy, the fistulous tract was excised and an appendectomy done. Histological report was that of mucinous adenocarcinoma. There was no synchronous or metachronous tumour in the patient and she did well after surgery. Mucinous adenocarcinoma of the appendix is a diagnosis made on histopathological assessment and is a very rare tumour. To the best knowledge of the authors, there is no known reported case of the disease in Nigeria. Thus, physicians and surgeons should entertain a diagnosis of the disease in middle aged patients such that exploration of bowel is performed with thorough surgical surveillance for synchronous and metachronous tumours

HIV vaccine acceptability in seronaive patients in a resource limited setting - a pilot study

Background: Current lifetime antiretroviral regimes are associated with clinically important toxicities, and have several limitations (eg. cost, development of resistance, complications). There is need for an alternative regime that must be acceptable, easy to administer and permanent for the eradication of HIV/AIDS. This creates a necessity for vaccine trials in human subjects. Objectives: To evaluate the response and acceptability profile of a possible coming HIV vaccine trial and usage among a study population that are not aware of their serostatus. Methods: Five hundred males and females who were seronaive regarding their HIV status were recruited into the study. An open ended questionnaire was administered before and after counselling to assess the acceptability of the proposed vaccine with and without counselling.Results: Male:female ratio was one to one. Ninety percent (450 out of 500) said they would not take part in a new HIV vaccine trial but only sixty five percent (325 out 500) reacted negatively after counselling. Sixty eight percent (340 out of 500) said they would partake in the vaccination after a successful trial has been carried out on other human subjects and after counselling, this increased to eighty five percent (425 out of 500). The general attitude to HIV vaccine was that of fear and distrust. Discussion: Coming HIV vaccine trials and usage is likely to be met with suspicion and distrust in resource limited settings. Certain barriers to acceptability of the vaccines need to be addressed to increase acceptability both to the trials and usage of the vaccine. Successful trial will lead to increased acceptability of usage.Sudanese Journal of Dermatology Vol. 3(3) 2005: 113-11

Malignant tumors of the upper aerodigestive tract as seen in a Nigerian tertiary health institution

Background: Cancers of the upper aerodigestive tract constitute a diverse heterogeneous group of malignant neoplasms with unique epidemiological, pathological, and treatment considerations. Only few studies have been conducted so far on these tumors in Nigeria. This study aims to study in greater detail, the pathological features of these cancers in Nigerian patients.Materials and Methods: The surgical specimens of patients diagnosed with malignant tumors of the upper aerodigestive tracts in the Department of Morbid Anatomy and Forensic Medicine, Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) in Ile‑Ife, Nigeria, over a 10‑year period, formed the basis of this study. Analysis was done for differences in proportion using the Chi‑square test (P is significant at < 0.05) by SPSS version 15.Results: There were a total of 62 cases. The overall mean age was 50.7 years, while the age range was from 3 years to 90 years. The male to female ratio was 3.1:1. A majority of the patients (67.7%) were older than 40 years. About 30.6, 27.4, and 16.1% of cases occurred in the larynx, nasopharynx, and nasal cavity, respectively, while 93.5% of the tumors were carcinomas. Squamous cell carcinoma was the most common histological variety. Nonepithelial tumors were not seen below the age of 20 years.Conclusion: This study shows that malignant upper aerodigestive tract tumors seen in our environment are mainly diseases of adulthood that tend to occur about seven to nine years earlier than in other populations. Squamous cell carcinoma is the predominant histological variety. Although the larynx is the most frequent anatomic site, the nasopharynx and nasal cavity are more commonly affected than the oral cavity unlike in other populations. Nonepithelial tumors are extremely rare below the age of 20 years.Key words: Malignant tumors, Nigeria, upper aerodigestive trac

Giant fibroadenoma presenting like fungating breast cancer in a Nigerian teenager

Background:Giant fibroadenoma of the breast is a rare benign breast tumour which seldom grows to a giant size, it is even rarer for this benign tumour to grow rapidly, ulcerate spontaneously and present like a fungating breast tumour in a way mimicking breast cancer. Case Presentation:This is a presentation of a 14 year old premenarchal girl with a massive ulcerating and fungating left breast mass that was initially thought to be a fungating locally advanced breast carcinoma on clinical examination. Further examination of the morphology of the resected surgical specimen and histological examination confirmed it to be giant fibroadenoma of the breast. It was successfully managed by partial mastectomy and breast reconstruction with an excellent result and a high degree of patient satisfaction was achieved. Conclusion:Though a rare clinical entity benign breast tumour can present like a fungating breast cancer and this must be bore in mind especially in young adolescent patients presenting with ulcerating breast tumour

Case Report: Hepatocelluar Carcinoma In Pregnancy And Postpartum Period: A Study Of 6 Cases In Nigerian Women.

Six Nigerians women with hepatcocelluar carcinoma (HCC) in pregnancy and the postpartum period were studied. Their ages ranged from 22 to 37 year with a mean of 28.2 years. Five (83.3%) of the women presented in the postpartum while 1 (16.7 %) presented during pregnancy.There was co – existing cirrhosis in 5 (83.3%) of them. All the 4 women tested for HBsAg were positive. Rapid tumour growth was observed in 2 women who were breastfeeding their babies while on admission. One of the 6 women had a fresh stillbirth at 32 weeks gestation but the other 5 had normal deliveries. Five out of 6 patients died on admission (after an average of 20 weeks of illness) while 1 patient discharged herself against medical advice. The major causes of death were hepatic failure and intra – peritoneal haemorrhage. This study shows that the pregnant Nigeria with women with HCC may carry her pregnancy to term and have normal delivery. Those women who do not present pregnancy may do so in the postpartum period. It is suggested that breastfeeding may ad rapid HCC growth and rupture. Key Words: Hepatocellular Carcinoma, pregnancy, postpartum period, Breastfeeding Nigerian Journal of Clinical Practice Vol.7(1) 2004: 46-4