An atypical aggressive Kaposi's sarcoma in a HIV-negative bisexual man

We describe a case of Kaposi's sarcoma in a previously healthy 35-year-old bisexual West Indian man of African descent who was seronegative for the human immunodeficiency virus (HIV) and human T-cell lymphotropic virus-1 (HTLV-1) and who presented with extensive mucocutaneous lesions, weight loss, visceral and generalized lymph node involvement, poor response to combination therapy with vinblastine and inter feron alfa-2a and a short survival of eight months from onset of illness. This is the first document case of Kaposi's sarcoma in Domonica. The presentation is unusal in that it is similar to the aggressive and disseminated Kaposi's sarcoma seen only in AIDS and florid variant of the endemic disease in young men in Equatorial Africa. (AU)

A novel human papillomavirus identified in epidermodysplasia verruciformis

Epidermodysplasia verruciformis (EV) is a rare inherited condition in which there is widespread infection with human papillomavirus (HPV). Patients have a high risk of developing squamous cell carcinoma and Bowen's disease on sun-exposed sites. We describe a Jamaican man with the typical clinical and histopathological features of EV.HPV 8, 24 and a subtype of HPV 38, along with a novel HPV sequence most closely related to HPV 9 have been detected in his skin lesions. Although skin tumours are rare in black patients with EV and he has lived in a temperate climate most of his life, several of the lesions showed bowenoid atypia and he is at risk of developing invasive cutaneous malignancies.(AU)

Generalized endemic Kaposi's sarcoma

Kaposi's sarcoma (KS) is a multicentric neoplasm thought to arise from both vascular and lymphatic endothelium. It is subdivided into four main categories on the basis of clinical features, course and prognosis. We report a 54 year old Afro-caribbean mle, living in the UK for the past 26 years, with classic features of generlized endemic KS. Because he has never lived on the African continent, the role of genetic rather than environmental factors is favoured in the aetiology of KS in this individual. This disorder is rarely seen in Afro-Caribbeans living in the UK, who have never actually lived in Africia.(AU)

Dermatofibrosarcoma protuberans: a 10 year clinicopathological review of an uncommon tumour

A review of dermatofibrosarcoma protuberans diagnosed at the University hospital of the West Indies over a 10-year period revealed 23 cases. The mean age of the patients was 36.3 years. There were 13 females and 10 males. The trunk was the most common site. The clinical diagnosis was commonly missed. The results of this study are compared with those from other countries (AU)

Cancer incidence and mortality in Antigua/Barbuda

An inquiry into the incidence and mortality of malignant neoplasms in Antigua/Barbuda was undertaken to document the magnitude of the disease. The top ranking cancers diagnosed in 114 males were skin (26.3 percent), prostate (22.8 percent) and upper respiratory and alimentary tract (10.5 percent). In 130 females, the 3 main cancers were breast (23.1 percent), cervix uteri (22.3 percent), and skin (15.3 percent). The main cancers causing death were stomach (22.3 percent) and prostate (17.8 percent) in 157 males; and breast (18.2 percent) and cervix uteri (14.1 percent) in 149 females. Imprecise documentation, insufficient clinico-pathological correlation and the finding of advanced cancers underscore the need for a cancer registry and cancer society in Antigua/Barbuda. (AU)

Cancer incidence and mortality in Antigua/Barbuda

An inquiry into the incidence and mortality of malignant neoplasms in Antigua/Barbuda was undertaken to document the magnitude of the disease. The top ranking cancers diagnosed in 114 males were skin (26.3 percent), prostate (22.8 percent) and upper respiratory and alimentary tract (10.5 percent). In 130 females, the 3 main cancers were breast (23.1 percent), cervix uteri (22.3 percent), and skin (15.3 percent). The main cancers causing death were stomach (22.3 percent ) and prostate (17.8 percent) in 157 males; and breast (18.2 percent) and cervix uteri (14.1 percent) in 149 females. Imprecise documentation, insufficient clinico-pathological correlation and the finding of advanced cancers underscore the need for a cancer registry and cancer society in Antigua/Barbuda. (AU)

Skin cancer on Saba - abstract

The objective of this study was to document skin tumours in Saba from 1965 to 1986 and calculate incidence rates (IR) for different types of skin cancers for the period 1977-1986. Data on skin tumours were obtained from local medical records, correspondence with doctors and from pathology laboratories in Curacao, Aruba and Puerto Rico. There were 382 skin tumours in 140 patients . Of these, 269 (70.4 per cent) in 98 patients were malignant of which 174 (65 per cent) were confirmed by histology and one was a melanoma. Basal cell carcinoma (BBC) accounted for 49 per cent, squamous cell carcinoma (SCC) 14 per cent, and kersol 36 per cent of skin cancers. The age-standardized IR for BCC was 11.29 cases/1,000 persons/year for males and 6.19 for females. Corresponding IRs for SCC were 2.53 and 2.06 and for kersol, 9.83 and 9.67 for males and females respectively. No skin cancer was found in non-Caucasians, and it was calculated that an average of 11 persons develop a non-melanoma skin cancer per year in Saba (AU)

Renal artery stenosis in a Jamaican with Von Recklinghausen's neurofibromatosis

This report of a 30-year-old male Jamaican presenting with severe refractory hypertension describes the uncommon association between renal artery stenosis and neurofibromatosis; and serves to focus attention upon this potentially treatable secondary cause of hypertension in such patients (AU)

Report on 151 childhood malignancies observed in Jamaica

During a 10-year period 1958-67, 151 tumors were noted in children under 15 years of age in Jamaica. This comprised 2.9 percent of all malignant tumors observed. Leukemia was the most common form of cancer. The incidence of retinoblastomas was high and surpassed incidences of neuroblastomas and of Wilms' tumors. Kaposi's sarcoma was not observed, and hepatocellular carcinoma was extremely rare. The tumor incidence pattern in Jamaica therefore largely resembles that in the United States and in Western Europe. It contrasts significantly with that in Uganda and in Western Nigeria. This merits attention, since over 90 percent of the Jamaican population is either pure Negro or of predominantly Negro descent as a result of importation from West Africa in former days. (Summary)

The five most frequent cancers in Jamaica

The pattern of cancer in Jamaica is in several respects remarkably different from that in Africa, yet also quite different from that in temperate zones (Fig. 6 Table 2). It is unlikely that genetic differences could account for this. A search for possible environmental aetiological factors is clearly indicated for such neoplasms as oesophageal cancer, where Jamaica shows the highest figures of 25 countries compared and where the Caribbean seems to be especially afflicted (Table 2). Carcinoma of the cervix, the highest ranking cancer in females, shows an incidence second to Cali, Columbia. Our present knowledge of the environmental aetiology of this disease, justifies the recommendation that circumcision of newborn boys should be widely offered in Jamaica. This practice would also offer virtually complete protection against penile cancer, a relatively frequent cancer in males. In any event, the knowledge that reasonable cleanliness would go a long way in preventing both cervical and penile cancers should be widely disseminated throughout the Jamaican population. Our breast cancer incidences are remarkably high and indicate that a careful epidemiological study should be dine of the practice of breast-feeding in patients with breast cancer as compared with controls. Gastric cancer, the highest ranking cancer in males, is not frequent in absolute terms when compared with other countries (AU)

Malignant melanoma in Jamaica

Data collected from thirty-nine cases of melanoma seen at the University Hospital of the West Indies form the basis of this study. The period under review is 1953 to 1965.(AU)

Skin cancer in Trinidad and Tobago

This paper reviews the various types of skin cancer diagnosed in a dermatological practice covering all of Trinidad and Tobago. Also included are precancerous skin conditions, dermatoses associated with malignancy, kerato acanthomas, as well as reticuloses involving the skin. The breakdown of these cases seen over the last five years (1962-1966) is presented: (a) malignant conditions: basal cell carcinoma - 21, squamous cell carcinoma - 2, basi-squamous carcinoma - 1, malignant melanoma - 4, Bowman's intra-epidermal cancer - 1 (b) precancerous skin conditions: solar keratosis - 8 (c) sermatomyositis complicating carcinoma of cervix - 2 (d) reticuloses: mycosis fungoides - 1, kaposi's sarcoma - 1 (e) kerato acanthomas - 3. In some measure, the type of cancer was determined by the degree of skin pigmentation. All four malignant melanomas were in Negroes or East Indians. This disagrees with the frequently quoted observation that malignant melanomas tend to occur in Caucasians rather than in pigmented races. All the melanomas occurred on the feet. Three were on the planter aspect, and on a pre-existing eczematous condition of the great toe. All patients except two with basal cell or basi-squamous carcinoma were of European ancestry. The two were of mixed race and fair complexion. This is to be expected since basal cell carcinoma is known to be a frequent complication of excessive exposure to sunlight in skin unprotected by melanin. The kerato acanthomas and the solar keratoses also fall into this category in my group, occurring only in European types. The small number of the other uncommon lesions seen does not allow for any valid conclusions (AU)

Observations on the canine transmissible venereal tumour as seen in the Bahamas

The high incidence of the canine transmissible venereal tumour among dogs in the Bahamas is recorded. The clinical syndrome associated with this tumour is described and particular mention is made of the frequent occurrence of large numbers of extragenital lesions. The literature is reviewed briefly, the aetiology is discussed and an attempt is made to explain the high number of animals showing multiple extragenital cutaneous lesions.(AU)