Testicular metastases from carcinoma of the prostate

Secondary testicular tumours are uncommon and most originate from prostatic carcinoma. A retrospective study of the clinico-pathological features of prostatic carcinoma metastatic to the testes was conducted in the Department of Pathology, University of the West Indies, Jamaica, for the period June 1958 to January 1998. Metastatic prostatic carcinoma was seen in 1.4 percent of the 284 orchiectomy specimens examined. A brief review of the literature related to this entity was undertaken.(AU)

Late presentation of a vulval carcinoma in Trinidad

Carcinoma of the vulva is a disease mainly of post-menopausal women, and constitutes between 3 percent-5 percent of gynaecological malignancies. A retrospective study was undertaken of the clinical presentations, treatments and outcomes of all patients with vulval carcinoma presenting to the two major hospitals in North Trinidad between 1972-1989 (AU)

Carcinoma of the uterine cervix: a three-year study - abstract

This was retrospective hospital-based study of all cases of carcinoma of the cervix seen at the Public Hospital, Georgetown, Guyana from June, 1983 to May, 1986 to obtain data on the epidemiology of cervical cancer in Guyanese women. The Public Hospital is the principal referral centre for histopathological diagnosis and radiotherapy in Guyana. Information on age, parity, ethnicity, place of residence, histopathology and clinical staging was collected. There were 202 women with cervical cancer which was confirmed by biopsy in 193 (95.5 percent). The highest incidence (33.3 percent) occurred in the 46-55 year age group, 11 percent were below 35 years of age and 89 percent were above 35. Most cases occurred in women of East Indian descent (63 percent), and in women living in rural areas (69 percent). The incidence increased with increasing parity with a peak incidence in women with parity of 8. Squamous cell carcinoma was the commonest type (88 percent) and all patients with adenocarcinoma (6.2 percent) were over 38 years of age. These results indicate that screening programmes in Guyana should be re-directed to women aged 36-45 years living in rural areas (AU)

Genital tract malignancies in Trinidad

In Trinidad, genital tract malignancy is the leading cause of death and the commonest of all female cancers, constituting 38.9 per cent of all malignant neoplasms. This clinico-pathological study comprised 82 patients who were diagnosed as having a genital organ malignancy at the Mount Hope Women's Hospital, during a five year period between November, 1981 and October, 1986. The malignancies were categorized by site and broad-type, based on the Sixth International Classification of Diseases. Carcinoma of the cervix was the commonest malignancy (62.2) percent after the age of 25. It was 3.2 times more frequent than corpus uteri cancer, and the mean age at presentation was 54.4 years. Endometrial carcinoma was found only in post-menopausal patients presenting with bleeding at a higher mean age of 63.2 years (0.05>p>.02). Diabetes mellitus, obesity and hypertension were more commonly associated with endometrial carcinoma than with carcinoma of the cervix, but only hypertension significantly so(.01>p>.001). There was no significant difference in the incidence in both major ethnic groups in endometrial and cervical carcinoma. However, only one Muslim patient had a genital tract cancer (p<.05). Forty-four per cent of our patients with Stage I cervical carcinoma were in the reproductive age group (AU)

Solitary thyroid nodule

Palpable thyroid nodules are extremely common. The discovery of such nodules can be an alarming event for the patient and requires a rational, clinical and diagnostic approach for successful management. The article outlines a simplified diagnostic approach to this common problem, and discusses the major causes, clinical presentation, diagnosis and management (AU)

Pseudosarcoma (spindle cell variant of squamous cell carcinoma) of the larynx

Pseudosarcoma of the larynx is reported in a 50-year-old man. With the use of special stains and light microscopy, the tumour was identified as a spindle cell variant of squamous cell carcinoma. The histogenesis of the tumour is discussed (AU)

Primary carcinoma of the duodenum

Duodenal carcinoma is a rare disease associated with a poor prognosis. Six patients with primary carcinoma of the duodenum are described. There were five men and one woman. The mean age was 73 years and the mean duration of symptoms was 10 months. Vomiting, abdominal distension and pain were the most frequent presenting symptoms. Fifty per cent had jaundice and hepatomegaly. The tumour was infra-ampullary in three patients, supra-ampullary in two and peri-ampullary in one. The mean survival was 6.5 months. Increased awareness and earlier detection are needed for improved survival (AU)

Carcinoma of the thyroid gland: a case report and discussion

This report describes a 46-year-old male patient who presented with symptoms of an acute febrile upper respiratory illness with no past history of a goitre or any swelling in the neck. This was an unusual presentation of a lethal carcinoma of the thyroid gland (AU)

Gastric carcinoma - abstract

Gastric carcinoma, the commonest cause of death from malignant disease in Trinidad, accounts for about 100 deaths annually. There has been a steady decrease in incidence of this condition over the past 10 years - a trend noted in many countries including the U.S.A. and Jamaica. Although a male to female ratio of 2 - 3:1 is common, it is only 1.2: in our population, the disease being sufficiently common among females to rank third as a cause of death due to malignancy. The highest incidence is between the ages 60 - 75. As in other populations the commonest clinical features are weight loss (90 percent), anorexia (84 percent) and vomiting (76 percent). In over 80 percent of patients tumour spread at the time of diagnosis or treatment contributes to a poor prognosis. It may affect any age, sex or race but its predeliction for the negro of the lower income group (over 80 percent) suggests that genetic and environmental factors may be important. This prediposition of the negro had also been noted in the United States though gastric carcinoma is quite uncommon in Africa. Elucidation of possible aetiologic factors may assist in further decreasing the incidence while greater suspicion and easy availability of diagnostic methods should result in improved survival from this common condition (AU)

Vulval cancer following or co-existing with chronic granulomatous diseases of vulva: an analysis if its natural history, clinical manifestation and treatment

In this study a series of postgranulomatous vulval carcinoma is analysed. The epidemiological and clinical aspects are studied and guidelines for management of such tumours are given. The problem of clinical staging of this variety of tumour is discussed (AU)

Apocrine carcinoma of the male breast

Two cases of aprocrine carcinoma of the male breast have been reported. The extreme rarity of the condition is emphasized (AU)

Carcinoma of the female breast in Jamaica

The incidence of breast cancer in Jamaican women is intermediate between the low levels of African countries and the high levels of USA, UK, and other Western industrial societies. The annual incidence in Jamaica has shown an upward trend from 1958 to 1974. Compared with Uganda, breast cancer in Jamaica conforms to a "westernized" pattern with regard to the shape of the age-specific incidence curve and stage of presentation. There are no obvious histological differences between breast cancer in Uganda, USA and Jamaica. The incidence of breast cancer in Jamaica appears diaproportionately high in view of the high proportion of early pregnancies occurring in Jamaican women. (AU)

Intra-epithelial and early invasive carcinoma of the uterine cervix

Ninety-nine patients with suspicious and positive cervical cytology smears seen at the University Hospital during the period 1966-1970 have been investigated. Symptoms referrable to cervical pathology were present in only one-third of the cases, and only a small number of the cervices showed a clinical suspicion of cancer. There was good overall cytohistological correlation except for the cases with Class IIIB smears a high proportion (80 percent) of which showed malignancy in the biopsy material. Treatment regimes for the different pre-clinical lesions are discussed. A disturbing feature was that only 36 percent of patients treated by conization alone attended for cytological follow-up. (AU)

The incidence of carcinoma of the cervix in Barbados

The purpose of this study was to determine the incidence of carcinoma of the cervix in Barbadian women of different ages and to compare the results with similar figures for other parts of the world. 299 cases of carcinoma of the cervix were recorded in the Cancer Registry, Queen Elizabeth Hospital, during the period 1969-1971. Using figures from the 1970 Census of Barbados the average annual number of cases per 100,000 persons in several age groups was compared with similar data from other parts of the world. The overall average annual incidence of carcinoma of the cervix in Barbados was high, 59.1 per 100,000 female population. Compared to the developed countries, Barbados, like Jamaica and Puerto Rico showed a high incidence in the younger age groups (AU)

Population screening for cervical cancer in Jamaica: a pilot survey on a high-risk community of well women - abstract

Several reports have emphasized the very high incidence of cancer of the uterine cervix in Jamaica. It was anticipated therefore that the prevalence of pre-clinical carcinoma of the cervix in the population at risk ought to be high. The present investigation was designed, as a pilot survey, to evaluate by cytological methods the prevalence of asymptomatic cervical malignancy in a low-income community considered to be at high risk. It was hope also that this pilot study would serve as a yardstick for any similar programme which may be planned in the future. Cervical scrape smears were obtained from 652 well women aged 20 - 75 years residing in the community of Hermitage and August Town which is situated adjacent to the Mona campus of the U.W.I. The women, predominantly Negro, were asked to attend the Outpatient Clinic of the Department of Social and Preventive Medicine. They were interviewed following which, cervical smears were taken. Smears were graded using a modification of the International Classification of Papanicolaou. Since this was a pilot survey, re-screening procedures were not carried out. Treatment facilities for cases with positive smears were arranged with the Department of Obstetrics and Gynaecology. Seventy-six per cent of women examined were aged 20-50 years, and 90 percent had had previous pregnancies. The average parity was 4.3. Of the 652 women screened, 12 were found to have suspicious and positive smears (classes IIIB-V), giving a prevalence rate of 18 per 1000. Cytological evidence of cervicitis (classes II and IIIA) was found in 70 percent of women, and Trichomonas infestation occurred in 19.3 percent. All positive smears were confirmed histologically. It is of considerable interest that, despite the low socio-economic status of the women, 63.5 percent in the community participated in the programme. The prevalence of pre-clinical carcinoma of the cervix obtained in this survey is about three to six times that observed in similar programmes conducted in Cananda, U.S.A. and the United Kingdom where the rates ranged from 3.1 - 7.2 per 1000. However, the Jamaican figures compare with those obtained in similar screening programmes carried out in three other West Indian territories - Barbados, Cayman Islands and the Bahamas (AU)