Sebaceous carcinoma in a 54-year-old Black African man after cancer chemotherapy: a case report.

BACKGROUND: Sebaceous carcinoma is a very rare malignant skin adnexal tumor that is occasionally aggressive. We have not seen a case of sebaceous carcinoma in our center in the last 10 years. It is extremely rare in Black Africans. CASE PRESENTATION: We described the case of a 55-year-old man African man who presented to our ophthalmologist with complaints of growth on the right upper eyelid for 8 months. He had surgery and chemotherapy for rectal carcinoma 6 years prior to presentation and received his last dose of chemotherapy 5 years before seeing our ophthalmologist. There was a history of spontaneous unprovoked bleeding from the lesion. He subsequently underwent surgical excision under general anesthesia. Histology of the mass showed an effaced architecture due to proliferating malignant epithelial cells disposed as trabecules, solid nests, and tongues. The microscopic features of widespread multivacuolated cytoplasm of the neoplastic cells led us to conclude that the tumor was a sebaceous carcinoma. The patient is alive and well. CONCLUSION: Sebaceous carcinoma is a rare malignant skin adnexal tumor in Black Africans. It can present as an eyelid mass with spontaneous bleeding. It can follow cancer chemotherapy either because of its association with other tumors in Muir-Torre syndrome or because of mutagenic effects of chemotherapeutic agents.

Ophthalmology residency training in Nigeria: The trainers' perspective.

Introduction: Periodic evaluations are an indispensable part of any training programme. This study assessed ophthalmology residency training in Nigeria from the perspective of ophthalmology trainers. Materials and Methods: This was a nationwide web-based survey of ophthalmology trainers at the 30 institutions accredited by the National Postgraduate Medical College of Nigeria from April 2021 to June 2021. Trainers were invited to complete a Google form via E-mail and WhatsApp. Data were collected on the characteristics of trainers and the training programme. Results: One hundred and fifty-eight (71.2%) out of 222 trainers responded to the survey comprising 67 (42.4%) males and 91 (57.6%) females, amongst whom were 97 (61.4%) subspecialists. The mean age (±standard deviation) was 51.47 ± 8.61 years (range, 38-75 years). Most respondents rated human resources (trainers and support staff) as 'much more' than adequate (n = 30, 19%), the volume of surgery as 'less or much less' than adequate (n = 82, 51.9%), the conduct of examinations as 'good' or better than good (n = 120, 75.9%) and impact of emigration of ophthalmologists on training as 'very negative' (n = 36, 22.8%). Overall, 94 (59.4%) respondents rated the quality of training as 'good' or better than good. Respondents recommended improving funding and training resources, revising the current conduct of examinations, increasing the use of appropriate technology and improving remunerations and national security. Conclusions: The majority of ophthalmology trainers rated ophthalmology residency training in Nigeria as 'good' but rated 'volume of surgery' as inadequate for training. Recommendations were made to improve the quality of training, revise examination practices and reduce the negative impact of emigration.

Salvage Intra-arterial Chemotherapy for Recurrent or Persistent Intraocular Retinoblastoma: A Study of 24 Eyes.

OBJECTIVE: To analyze the outcomes of salvage intra-arterial chemotherapy (IAC) for recurrent or persistent intraocular retinoblastoma after failure with other treatment modalities. DESIGN: Retrospective study. SUBJECTS: Twenty-four eyes of 23 patients. INTERVENTION: Intra-arterial chemotherapy. MAIN OUTCOME MEASURES: Globe salvage, metastasis, and death. RESULTS: The mean age at the time of salvage IAC was 41 months (median, 36 months; range, 14-86 months). All patients (n = 23) received IV chemotherapy (IVC) as the primary treatment. The mean number of IVC cycles before salvage IAC was 10 (median, 12; range, 6-18). The indications for salvage IAC were tumor recurrence (n = 17; 71%) or persistent tumor (n = 7; 29%) post-IVC. The mean number of salvage IAC cycles was 3 (median, 3; range, 1-6). Of 24 eyes, 17 eyes (71%) achieved tumor regression with salvage IAC, whereas 7 (29%) eyes displayed poor response. Of these 17 eyes with initial tumor regression, 9 (38%) eyes sustained good response, whereas 8 (33%) eyes displayed tumor recurrence over a mean follow-up period of 21 months (median, 21 months; range, 6-44 months). The mean interval between IAC and tumor recurrence (n = 8) was 4 months (median, 3 months; range, 1-14 months). Of these 8 eyes, globe salvage was achieved in 5 (21%) eyes with additional alternate treatment. Of the 7 eyes with poor response to IAC, globe salvage was achieved in 1 (4%) eye with additional alternate treatment. Overall, globe salvage was achieved in 15 (63%) eyes. CONCLUSIONS: Salvage IAC is an effective treatment for recurrent and persistent retinoblastoma, enabling globe salvage in 63% cases. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any materials discussed in this article.

Intraocular pressure variation after conventional extracapsular cataract extraction, manual small incision cataract surgery and phacoemulsification in an indigenous black population.

INTRODUCTION: intraocular pressure changes have been reported following the various cataract surgical technique. This study aims to compare the intra-ocular pressure (IOP) variation following conventional extra-capsular cataract extraction (ECCE), manual small incision cataract surgery (MSICS) and phacoemulsification in an indigenous black population. METHODS: a comparative cross-sectional study of adult patients aged 40 years and above who had pressure was measured with Goldman's applanation tonometer pre-operatively and 1st day, 1st week, 1st month as well as 3rd month post-operative periods and recorded. Data was analyzed using SPSS version 21. Mean IOP changes between study groups were compared using ANOVA. P-value of < 0.05 was taken as statistically significant. RESULTS: total of 82 patients consisting of 20(24.4%) ECCE, 32(39%) MSICS and 30(36.6%) phacoemulsification with mean preoperative 13.4mmHg, 13.5mmHg and 14.1 mmHg (p = 0.657) respectively was studied. Mean IOP increased from baseline at 1st day post-operative period in the ECCE and MSICS groups (13.4 ± 3.0mmHg to 13.7 ± 4.5mmHg (p = 0.84) and 13.5 ± 3.1mmHg to 15.3 ± 5.1mmHg (P = 0.48) respectively), and decrease in the phacoemulsification group (14.1 ± 2.6mmHg to 13.9 ± 3.5mmHg (p = 0.378). There was a decline in IOP in all the 3 study groups by one week post-operative period; the difference was significant only in the ECCE group (p = 0.032). By 3rd month postoperatively, there was a reduction in mean IOP when compared with pre-operative IOP the difference being greatest in the ECCE group. CONCLUSION: ECCE, MSICS, and Phacoemulsification cause a decline in IOP below preoperative levels at 3rd month postoperatively in the MSICS group.