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INTRODUCTION: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985. An update of the data on paediatric CNS neoplasms at our centre is presented. METHODS: A retrospective review of all histologically diagnosed CNS tumours in children (0-14 years) from January 2001 to December 2010 from the database of the Department of Pathology, University College Hospital, Ibadan, Nigeria was done. The cases were classified using the 2007 WHO Classification of Tumours of the Central Nervous System and were also based on their supratentorial and infratentorial locations. RESULTS: Seventy-seven tumours, 44 in males, were included in the study. Astrocytic tumour comprised 20 cases, embryonal tumours 15, ependymal tumours 15, germ cell tumours 6, sellar tumours (all craniopharyngiomas) 9 and other histological types- 12 cases. Thirty-seven were WHO Grade 1, eleven Grade 2, ten Grade 3 and nineteen Grade 4 neoplasms. Thirty-six cases were supratentorial and thirty-eight were infratentorial in location. The most common tumours in this series were pilocytic astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas in that order. CONCLUSION: Childhood CNS tumours are being increasingly diagnosed in our centre. This is largely explained by the recent expansion of the available neurosurgical services.
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Neoplasias do Sistema Nervoso Central/epidemiologia , Neoplasias Infratentoriais/epidemiologia , Neoplasias Supratentoriais/epidemiologia , Adolescente , Neoplasias do Sistema Nervoso Central/patologia , Criança , Pré-Escolar , Feminino , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Neoplasias Infratentoriais/patologia , Masculino , Nigéria/epidemiologia , Estudos Retrospectivos , Neoplasias Supratentoriais/patologiaRESUMO
AIM: The most recent study on the clinicopathological features of gastric carcinoma from the University College Hospital (UCH), Ibadan, was done in 2000. The aim of this study is to update the knowledge on the clinicopathological features of gastric carcinoma diagnosed in the Pathology Department of the UCH Ibadan between 2000 and 2011. MATERIALS AND METHODS: This was a 12-year retrospective review of clinical and demographic data and the histopathological features of gastric cancers diagnosed at the Pathology Department of the UCH. The chi square test, Fisher's exact test, and the t-independent test were used as applicable in the statistical analyses. RESULTS: A total of 117 cases of gastric carcinoma were histologically diagnosed at the Pathology Department of UCH, Ibadan in this period giving a relative ratio frequency of 1.38% for all cancers. It represented 18.4% of all gastrointestinal tract malignancies diagnosed in the same period. There was a male preponderance with male:female ratio of 1.72:1; the middle-aged and elderly made up about 76.1% of cases. The disease was clinically and histologically advanced in 92.8% of cases. Gastric tumours were predominantly antral/ pyloric in 80% of cases and exophytic in 62.3% of cases. The intestinal histotype constituted 47.0% cases although a rise in the diffuse histological type was observed. CONCLUSION: There is a decline in the relative ratio frequency of gastric carcinoma in Ibadan; and a fall in the rate of the intestinal type of gastric carcinoma relative to the diffuse type when compared to previous studies from our centre.
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UNLABELLED: Germ cell neoplasms which have the potentials of differentiating along somatic cell lines are regarded as teratomas. They are mature teratomas when tissues are fully differentiated and immature teratomas when primitive or immature tissue elements are present. In this retrospective study, we analyzed all the renal biopsies submitted to the Department of Pathology of the University College Hospital, Ibadan, South-West Nigeria over a thirty one year period (1981-2011). Over the period, a total of 119,986 specimens were received for histological assessment and only 1,027 (0.86%) represented kidney specimens which included all the trucut biopsies and nephrectomies. Two (0.19%) of the nephrectomy specimens from a one-year and a five-month old children were diagnosed as mature and immature cystic teratoma respectively. The sample from the one-year-old child was heavy (810 g), cystic and measured 17 x 10 x 10 cm. On microscopy, the tissues were predominantly mature neural tissue, mature skeletal muscle, cartilage and foci of normal kidney tissue while the sample from the five month old child was almost double the weight of the former (1600 g) and measured 18 x 14 x 9 cm. Cut sections revealed cystic and solid areas comprising bone, glial tissue, primitive neuroectodermal tissue, choroid plexus, immature cartilage, skeletal muscle, fat, intestinal tissue, breast structures,odontogenic and squamous epithelial tissues on microscopy. CONCLUSION: Cystic teratoma is a rare occurrence in kidneys.
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Neoplasias Renais/diagnóstico , Teratoma/diagnóstico , Biópsia , Feminino , Humanos , Lactente , Nigéria , Estudos Retrospectivos , Fatores de TempoRESUMO
Infection with genital herpes simplex virus (HSV) remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.
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CONTEXT: Langerhans cells (LCs) are a unique population of antigen processing cells in the epidermis and mucous membrane, which may play a role in the defence mechanism against epithelial tumors. AIMS: To compare the distribution of LCs in oral squamous cell carcinomas (OSCC) and normal oral epithelium; and to determine whether the population of LCs in OSCC has any correlation with histological grading of these malignancies. SETTINGS AND DESIGN: A cross-sectional immunohistochemical analysis of OSCC cases. MATERIALS AND METHODS: Forty-eight randomly selected paraffin tissue blocks of OSCC cases and 30 cases of normal oral epithelium were included. Hematoxylin and eosin-stained sections of the OSCC cases were reviewed and categorized as high-grade malignant tumors or low-grade malignant tumors. Tissue sections were analyzed for density of LCs using CD1a antibody expression. STATISTICAL ANALYSIS USED: Data are expressed as percentages compared by Chi-square statistics; mean ± standard deviation, compared by Mann-Whitney-U test and Spearman's correlation tests. RESULTS: LCs population was significantly higher in normal oral epithelium when compared with OSCC cases (P = 0.001). There was also a significant difference in the number of LCs per millimetre square area of tissue section between well-differentiated tumors and poorly-differentiated tumours (P = 0.03). There was a negative correlation between the population density of LCs and the grade of OSCC. CONCLUSIONS: These findings suggest that oral mucosal LCs are involved in immune-surveillance and immunologic impairment may characterize invasive OSCC. In addition, LCs density characterizes histological grades of OSCC, which may be of a prognostic value.
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BACKGROUND: There has been a paucity of autopsy studies on atherosclerotic lesions in Nigerians, the last one conducted at our centre being more than four decades ago. There has also been considerable epidemiological transition. The objective of the study was to determine the frequency, severity, pattern and distribution of atherosclerotic lesions in extra cranial carotid arteries (ECCA) in Nigerians at autopsy. METHODS: ECCA of 30 consecutive Nigerian patients undergoing autopsy at a University teaching hospital were examined using the American Heart Association (AHA) histological grading and classification of atherosclerosis. RESULTS: Atherosclerotic lesions of ECCA were present in 73.3% of the subjects with the right and the left carotid bifurcations (28.3%) being the most frequently affected sites. Using the AHA classification of atherosclerosis, a total of 176(73.3%) lesions were found in the 240 histological sections of blood vessels examined. Of these, 22.5% were types I, 22.5% were types II, 15.4% were type V, and 7.5% were type III. The VII to type IX lesions were rare. When these atherosclerotic lesions were grouped into mild, moderate and severe, 52.5% were mild lesions (types I-III); 18.3% were moderate lesions (types IV and V); and 2.5% were severe lesions (types VI to IX). The severe lesions were most frequently observed in the left carotid bifurcation (50%) and they first appeared in the age group 45-49 years. Age, hypertension and diabetes mellitus were strong risk factors for atherosclerosis. CONCLUSIONS: Compared with four decades ago there has been an apparent increase in severity and extent of ECCA atherosclerosis especially after the age of 45 years in autopsies from our centre. This change in the amount of atherosclerosis over time is possibly due to the epidemiologic transition. This may worsen the rise in stoke incidence within this community and as such, great effort should be made to follow-up and manage CVD risk factors within the community.
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Doenças das Artérias Carótidas/epidemiologia , Adulto , Fatores Etários , Idoso , Autopsia , Doenças das Artérias Carótidas/etiologia , Doenças das Artérias Carótidas/patologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco , Circunferência da CinturaRESUMO
INTRODUCTION: Intravascular papillary endothelial hyperplasia is a reactive proliferative lesion of endothelial cells in blood vessels. It typically presents as a painless, reddish purple lesion in the sites affected. The orbit remains an uncommon site of affectation of this relatively common disease. It is noteworthy that this is the first reported case, to the best of our knowledge, of orbital intravascular papillary endothelial hyperplasia in a Nigerian child. CASE PRESENTATION: The case reported here is an orbital intravascular papillary endothelial hyperplasia causing non-axial proptosis and loss of vision in a 14-year-old Nigerian boy. We describe the clinical and histological findings of intravascular papillary endothelial hyperplasia in the orbit of this 14-year-old boy. The key distinguishing features are discussed and relevant literature is reviewed. CONCLUSION: Although unusual in presentation, intravascular papillary endothelial proliferation should be considered in the list of differentials of proptosis due to mass lesion in young Nigerians and, possibly, Africans.
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PURPOSE: The relationship between overall obesity and breast cancer risk has been well recognized, but the role of central obesity in breast cancer development is uncertain. METHODS: Between 1998 and 2009, 1,233 invasive breast cancer cases and 1,101 community controls were recruited into the Nigerian Breast Cancer Study at Ibadan, Nigeria. Logistic regressions were used to calculate multivariate odds ratio (OR) and 95% confidence intervals (CI), adjusting for age, body mass index (BMI), and other known risk factors for breast cancer. RESULTS: The OR for the highest quartile group of waist circumference relative to the lowest was 2.39 (95% CI, 1.59-3.60; P-trend < 0.001). Comparing women with waist/hip ratio (WHR) in the lowest quartile group, the OR for women in the highest quartile category was 2.15 (95% CI, 1.61-2.85; P-trend < 0.001). An inverse association was observed between hip circumference and breast cancer, with an OR of 0.36 for the highest quartile (95% CI, 0.24-0.55; P-trend < 0.001). The effects of these three measures existed in both pre- and postmenopausal women. Of note, we found a significant interaction between WHR and BMI (P-interaction = 0.016): the OR comparing the highest to the lowest WHR quartile was 2.81 (95% CI, 1.90-4.16) for women with BMI < 25 kg/m2 and 1.70 (95% CI, 1.11-2.61) for women with BMI ≥ 25 kg/m2. CONCLUSIONS: These results suggest that central adiposity, measured by waist circumference and waist/hip ratio, was an important risk factor for breast cancer in Nigerian women, and the effect of central adiposity was strong in normal-weight women.
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Distribuição da Gordura Corporal , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Relação Cintura-Quadril , Adulto , Índice de Massa Corporal , Feminino , Humanos , Pessoa de Meia-Idade , Nigéria/epidemiologia , Obesidade/complicações , Fatores de Risco , Circunferência da CinturaRESUMO
The occurrence of cerebral pleomorphic xanthoastrocytoma (PXA) in individuals with neurofibromatosis type 1 (NF1) is very rare. We present a 10-year-old Nigerian boy with NF1 who was found to harbor a thalamic-lateral ventricular solid mass lesion whose histologic and immunohistochemical findings were in keeping with PXA. We also carried out an updated review of the PXA-NF1 literature and found only eight previous reports of this clinical disease association. These reports have been limited to only certain regions of the world, with none yet reported from Africa, South America, Australia, and Eastern Europe. As far as we know, this might be the first such report from Africa. The case we present, in addition, demonstrated some other unique clinical, radiological, and histopathologic characteristics which have been highlighted in this review.
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Astrocitoma/patologia , Neoplasias Encefálicas/patologia , Neurofibromatose 1/patologia , Astrocitoma/complicações , Astrocitoma/diagnóstico , Neoplasias Encefálicas/diagnóstico , Manchas Café com Leite/etiologia , Humanos , Masculino , Neurofibromatose 1/complicações , Nigéria , Tomografia Computadorizada por Raios XRESUMO
In Africa, epidemiological data on the effect of the HIV epidemic on the occurrence of lymphomas are scanty. The 1990s witnessed the alarming rates of HIV/AIDS in Nigeria. The prevalence of HIV/AIDS in Nigeria increased from 1.8% in 1991 to 4.4% in 2005. The aim of this study was to determine whether there have been any changes in the frequency and pattern of lymphomas in view of the HIV/AIDS epidemic in the country. This is a retrospective study of all lymphoma cases diagnosed during 1991-2005. The prevalence of lymphomas declined from 1.4% to 0.7% of surgical biopsies during 1991-2005. There was a decline in the proportion of high-grade non-Hodgkin lymphoma and Burkitt's lymphoma from 79.1% and 45.8% respectively to 21.1% and 13.6% respectively. There is a suggestion that the HIV/AIDS epidemic in the country may not have influenced the pattern of occurrence of both major histomorphological types of lymphoma in Ibadan.
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Transição Epidemiológica , Linfoma/epidemiologia , Feminino , Hospitais Universitários , Humanos , Masculino , Nigéria/epidemiologia , Estudos RetrospectivosRESUMO
Approximately 30 000 cases of non-Hodgkin lymphoma (NHL) occur in the equatorial belt of Africa each year. Apart from the fact that Burkitt lymphoma (BL) is very common among children and adolescents in Africa and that an epidemic of human immunodeficiency virus (HIV) infection is currently ongoing in this part of the world, very little is known about lymphomas in Africa. This review provides information regarding the current infrastructure for diagnostics in sub-Saharan Africa. The results on the diagnostic accuracy and on the distribution of different lymphoma subsets in sub-Saharan Africa were based on a review undertaken by a team of lymphoma experts on 159 fine needle aspirate samples and 467 histological samples during their visit to selected sub-Saharan African centres is presented. Among children (<18 years of age), BL accounted for 82% of all NHL, and among adults, diffuse large B-cell lymphoma accounted for 55% of all NHLs. Among adults, various lymphomas other than BL, including T-cell lymphomas, were encountered. The review also discusses the current strategies of the International Network of Cancer Treatment and Research on improving the diagnostic standards and management of lymphoma patients and in acquiring reliable clinical and pathology data in sub-Saharan Africa for fostering high-quality translational research.
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Linfoma/diagnóstico , Linfoma/epidemiologia , Melhoria de Qualidade , Pesquisa Translacional Biomédica/métodos , África Subsaariana/epidemiologia , Atenção à Saúde/normas , Gerenciamento Clínico , Humanos , Cooperação Internacional , Linfoma/terapiaRESUMO
INTRODUCTION: This retrospective study analysed head and neck malignancies seen over a 19-year period at the University College Hospital, Ibadan. METHODOLOGY: One thousand, one hundred and ninety two patients with head and neck malignancies were analysed according to age, gender, topography and histology. RESULTS: There was an annual hospital frequency of 62 cases per year. The overall mean age for these malignancies was 43.9 (SD ± 19.3) years. The lesions from the respiratory tract were the most frequent (43.2%) of all cases. The palate was the most frequent intra-oral site (13.8%). Epithelial malignancies constituted 73.4% of all cases with a male: female ratio of 2:1, a mean age of 48.1 (SD ± 17.5) years and were mostly located in the larynx (19.7%). Lymphomas constituted 17.5% of all head and neck cancers with a male: female ratio of 1.6:1, a mean age of 35.1 (SD ± 20.6) years and nodal involvement (39.7%) was most common. Sarcomas constituted 8.9% of all malignancies with a male: female ratio of 1.5:1, mean age of 27.1 (SD ± 16.7) years and the maxillofacial bones (42.5%) were most commonly involved. Neuroendocrine malignancies accounted for 0.2% of head and neck malignancies with a male: female ratio of 1:1, a mean age of 28.5 (SD ± 6.4) years and both cases involved the nose. CONCLUSION: This study has further confirmed that carcinomas remain the most frequent cancers of the head and neck region in south-western Nigeria.
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Neoplasias de Cabeça e Pescoço/diagnóstico , Hospitais Universitários/estatística & dados numéricos , Estadiamento de Neoplasias/métodos , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Estudos Retrospectivos , Distribuição por Sexo , Adulto JovemRESUMO
A 36-year-old male painter presented to our service in 2007 with an ulcerated solitary scalp swelling of 8 months' duration. The mass was a dormant, painless, pea-sized growth, which he had had since childhood and which he bruised in a passenger motorcycle road traffic accident 8 months prior to presentation. The accident caused it to flare up and progressively increase in size, with associated pain, contact bleeding, and ulceration. A work-up for excision biopsy was proposed, but the patient defaulted and presented 2 years later with an increased number of lesions all around the scalp and face and in an obviously deteriorating clinical status with regional lymph node involvement at this stage. An incisional biopsy was then carried out and the histological reports came out with three different diagnoses of glioblastoma multiforme, poorly differentiated angiosarcoma, and squamous cell carcinoma, constituting a major diagnostic dilemma for our service.
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This is a retrospective analysis of poorly-differentiated head and neck malignancies at University College Hospital, Ibadan. Eighty-six poorly-differentiated neoplasms were categorized as carcinomas, sarcomas, lymphomas or neuroendocrine cancers with a panel of 7 antibodies (cytokeratin AE1/AE3, vimentin, desmin, myogenin, leukocyte common antigen and neuron-specific enolase). Immunohistochemical and original hematoxylin-eosin diagnoses were contrasted.The male: female ratio was 2.5:1, with mean age of 38.9 years. Nasopharynx, nose and maxillofacial bones were the most common locations. Immunohistochemistry confirmed 54.8% of carcinomas, 70.6% of sarcomas and 80% of lymphomas.Hematoxylin-eosin was able to distinguish between sarcoma and lymphoma but differentiation between a carcinoma and neuroendocrine lesion was poor. Further studies are required to maximize the role of immunohistochemistry as an ancillary diagnostic tool in the West African sub-region.
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Carcinoma/metabolismo , Neoplasias de Cabeça e Pescoço/metabolismo , Imuno-Histoquímica/métodos , Linfoma/metabolismo , Sarcoma/metabolismo , Adulto , Carcinoma/diagnóstico , Carcinoma Neuroendócrino/diagnóstico , Carcinoma Neuroendócrino/metabolismo , Diferenciação Celular/fisiologia , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Hospitais Universitários , Humanos , Linfoma/diagnóstico , Masculino , Nigéria , Sarcoma/diagnóstico , Sensibilidade e EspecificidadeRESUMO
Previous studies have shown that weight is inversely associated with premenopausal breast cancer and positively associated with postmenopausal disease. Height has been shown to be positively correlated with breast cancer risk, but the association was not conclusive for premenopausal women. These previous studies were conducted primarily in Western countries, where height is not limited by nutritional status during childhood. The authors assessed the association between breast cancer and anthropometric measures in the Nigerian Breast Cancer Study (Ibadan, Nigeria). Between 1998 and 2009, 1,233 invasive breast cancer cases and 1,101 controls were recruited. The multivariate-adjusted odds ratio for the highest quartile group of height relative to the lowest was 2.03 (95% confidence interval (CI): 1.51, 2.72; P-trend < 0.001), with an odds ratio of 1.22 (95% CI: 1.14, 1.32) for each 5-cm increase, with no difference by menopausal status. Comparing women with a body mass index in the lowest quartile group, the adjusted odds ratio for women in the highest quartile category was 0.72 (95% CI: 0.54, 0.94; P-trend = 0.009) for premenopausal and postmenopausal women. Influence of height on breast cancer risk was quite strong in this cohort of indigenous Africans, which suggests that energy intake during childhood may be important in breast cancer development.
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Estatura , Peso Corporal , Neoplasias da Mama/epidemiologia , Pós-Menopausa , Pré-Menopausa , Adulto , Pesos e Medidas Corporais , Estudos de Casos e Controles , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Pessoa de Meia-Idade , Nigéria/epidemiologia , Fatores de Risco , Fatores SocioeconômicosRESUMO
BACKGROUND/AIMS: To retrospectively evaluate the clinicopathological features, treatment modalities and factors affecting prognosis in patients with both conjunctival intraepithelial and invasive squamous neoplasms. METHOD: Review and analysis of clinical and pathological records of all cases histologically diagnosed in the Department of Pathology, University College Hospital, Ibadan, Nigeria between January 1990 and December 2004. RESULTS: There were a total of 46 cases in 45 patients (eight intraepithelial carcinomas, 37 invasive squamous cell carcinomas (SCC) and a single case of mucoepidermoid carcinoma in a 71-year-old man). The intraepithelial neoplasms occurred in patients aged between 20 and 90 years. Seven of these patients had actinic changes on histology. For invasive SCC, patients' ages ranged from 18 to 84 years with a mean age of 53 years. Male to female ratio was 1:1. The majority presented with an orbital mass and loss of vision. Twenty-two (60%) of the patients with invasive SCC had enucleation or exenteration as the primary modality of treatment with or without radiotherapy or chemotherapy. Altogether for intraepithelial and invasive squamous neoplasms, the duration of presenting complaints ranged from 1 month to 5 years with an average of 2 years. Human immunodeficiency virus (HIV) infection and smoking were not significantly associated with these cases but a significant number had outdoor occupation. Low socioeconomic status and inability to afford treatment was common among our patients. CONCLUSION: Patients with invasive SCC in Nigeria present late and have significant delay before having any form of treatment. This contributes to the poor outcome. Human papilloma virus (HPV) and actinic aetiology are possible strong causative agents in Nigerians.
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Carcinoma in Situ/patologia , Carcinoma in Situ/fisiopatologia , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/fisiopatologia , Neoplasias da Túnica Conjuntiva/patologia , Neoplasias da Túnica Conjuntiva/fisiopatologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma in Situ/complicações , Carcinoma in Situ/terapia , Carcinoma Mucoepidermoide/complicações , Carcinoma Mucoepidermoide/patologia , Carcinoma Mucoepidermoide/fisiopatologia , Carcinoma Mucoepidermoide/terapia , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/terapia , Neoplasias da Túnica Conjuntiva/complicações , Neoplasias da Túnica Conjuntiva/terapia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Nigéria/epidemiologia , Estudos Retrospectivos , Distribuição por Sexo , Transtornos da Visão/etiologia , Adulto JovemRESUMO
Head and neck cancers display diverse patterns of biological behavior and considerable variation in geographical distribution. This study presents an analysis of head and neck cancer in a Nigerian tertiary healthcare center. It comprises cases diagnosed at the University College Hospital, Ibadan, Nigeria, 1991-2005. Out of 1,750 head and neck tumors, 972 (55.5%) were malignant and 778 (44.5%) were benign. Cancers displayed male predominance, with a gender ratio of 1.8:1. The mean age of cancer patients was 43.8 +/- 19.6 years. Carcinomas constituted 71.7% of head and neck cancers, with 2.4% occurring in children and overall mean age of 48.2 years. Squamous cell carcinoma comprised 66.7% of carcinomas and 47.8% of all head and neck cancers. Hematopoietic malignancies constituted 20.4% of head and neck cancers, and comprised mainly lymphomas, which accounted for 19.3% of all head and neck cancers. The mean age of patients with hematopoietic malignancies was 34.9 years. The most common childhood malignancy was Burkitt's lymphoma, which comprised 28.2% of pediatric head and neck cancers. Connective tissue tumors constituted 7.9% of all cancers, the most common being rhabdomyosarcoma, accounting for 44.2% of sarcomas. The mean age of patients with sarcomas was 26.5 years. There is a need for uniformity in the definition of head and neck cancer so as to permit comparison of international studies. In addition, prospective population-based studies are required to determine the national incidence and to identify risk factors for head and neck cancer in the Nigerian population.
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Neoplasias de Cabeça e Pescoço/epidemiologia , Adulto , Distribuição por Idade , Carcinoma de Células Escamosas/epidemiologia , Distribuição de Qui-Quadrado , Criança , Feminino , Hospitais Universitários/estatística & dados numéricos , Humanos , Incidência , Linfoma/epidemiologia , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Fatores de Risco , Distribuição por SexoRESUMO
OBJECTIVE: Previous studies suggest that the majority of breast cancer in Africans are hormone receptor negative and thus differ from breast cancer in other populations. We decided to evaluate the hormone receptor status of patients seen in our practice to see if they indeed differ from that of other populations. METHODS: We prospectively collected and analyzed tumors from consecutive patients presenting to our clinic over an 18 months period from July 2004. During the period, we saw 192 patients without previous histological diagnosis and conducted routine histological and immunohistochemical analysis of their tumors for hormone receptor status. RESULTS: Most, 65.1% of tumors were ER+, 54.7% were PR+ and 79.7% were HER2 negative. Majority of the tumors, 77.6% were luminal type A, 2.6% were luminal type B, 15.8% were basal type and the remaining 4.0% (6/152) were HER2+/ER- subtype. We found an association between hormone receptor status and tumor grade but not with stage at presentation. CONCLUSION: We conclude that there is no difference in the pattern of hormone receptors in breast cancer patients of African origin compared to other populations and urge more use of hormone manipulation for management of breast cancer in this population.
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Neoplasias da Mama/química , Receptor ErbB-2/análise , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/classificação , Neoplasias da Mama/patologia , Feminino , Humanos , Imuno-Histoquímica , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos ProspectivosRESUMO
The UDP-glucuronosylatransferase 1A1 (UGT1A1) gene is involved in the metabolism of estrogen and detoxification of potential carcinogens. The number of TA repeats in the promoter region of UGT1A1 has been linked to breast cancer risk, but results varied by race. We performed a comprehensive assessment of genetic polymorphisms in the UGT1A1 gene, and examined these polymorphisms and TA repeats in relation to breast cancer risk in a case-control study in Nigeria. 512 breast cancer cases and 226 community controls were genotyped for UGT1A1. Compared with high-activity TA repeat genotypes, the odds ratios (OR) for low-activity and moderate-activity genotypes were 0.47 (95% confidence interval CI, 0.26-0.83) and 0.64 (95% CI, 0.39-1.06), respectively, in premenopausal women (P = 0.009 for trend), but no association was observed in postmenopausal women (P = 0.24). The effect of TA repeats was also differentiated by age: the OR was 0.39 (95% CI 0.21-0.71) for low-activity genotypes and 0.58 (95% CI 0.33-1.00) for moderate-activity genotypes in women <45 years old (P = 0.002 for trend), but no association was observed in women >or=45 years old (P = 0.15). Haplotype analysis showed that UGT1A1 haplotypes were highly diverse with blocked structures. We found a specific haplotype in block 2 that was significantly associated with a 2.1-fold elevated risk (95% CI 1.05-4.39; P = 0.04). In contrast with previous studies, we found low-activity TA repeat alleles were protective against breast cancer among premenopausal indigenous Africans, suggesting that the role of UGT1A1 in breast cancer development may vary by population, presumably due to different environmental and genetic modifier effects.
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Neoplasias da Mama/etnologia , Neoplasias da Mama/genética , Predisposição Genética para Doença , Glucuronosiltransferase/genética , Adulto , África , Alelos , Éxons , Feminino , Genótipo , Haplótipos , Humanos , Íntrons , Pessoa de Meia-Idade , Polimorfismo Genético , RiscoRESUMO
Amyloidosis is a rare disease characterised by the deposition of insoluble extracellular fibrillar proteins in various tissues of the body. The pattern of manifestation is organ dependent and also on whether the disease is localised or systemic, primary or secondary.Though the disease is usually fatal with a 5-year survival rate of 20%, there is still paucity of literature on this disease entity worldwide. Diagnosis has remained mostly at autopsy.A case of amyloid angiopathy involving the submandibular gland and floor of the mouth with an associated fatal bleed is reported. The purpose of this case report is to reiterate the importance of a high index of suspicion in the approach to the management of head and neck swellings.