African Rigorous Innovative Stroke Epidemiological Surveillance: Protocol for a Community-Based Mobile-Health Study.

Despite projections of stroke being a leading cause of mortality in Africa, reliable estimates of stroke burden on the continent using rigorous methods are not available. We aimed to implement a mobile-Health community-based interactive Stroke Information and Surveillance System to sustainably measure stroke burden and improve stroke health literacy and outcomes in urban and rural sites in Nigeria. African Rigorous Innovative Stroke Epidemiological Surveillance (ARISES) is an observational cohort study, which will be conducted in urban (Ibadan North LGA Ward 3) and rural (Ibarapa Central LGA) sites with a combined base population of over 80,000 people. The study will use a consultative approach to establish an mHealth-based Stroke Information and Surveillance System comprising a Stroke Alert System and a Stroke Finding System. These systems will enable the community to report stroke events and the research team/health workers find stroke cases using phone calls, short message service, and Voice Over Internet Protocols (VoIP). We will update community household data and geo-locate all households. Over the 5 years of the study, the system will collect information on stroke events and educate the community about this disease. Reported stroke cases will be clinically adjudicated at home and in prespecified health facilities. Baseline and endline community surveys will be conducted to assess stroke occurrence and other important study variables. The proportion of strokes alerted and found will be determined over the study period. Focus group discussions and key informant interviews will be conducted to understand community stroke literacy and perspectives. The study will also assess any impact of these efforts on time from stroke onset to referral, community uptake of orthodox health services for stroke patients. ARISES is anticipated to establish proof of concept about using mHealth for stroke surveillance in Africa. The potential impact of the SISS on improving patient outcomes will also be determined.

The importance of the autopsy in ascertaining the cause of death and as an audit tool at the university college hospital, Ibadan.

BACKGROUND: Different reasons for autopsies include medico-legal causes, medical education and deducing the cause of death. An additional benefit is auditing with regards to patient care in the diagnosis and treatment of diseases. The main objective of this study was to determine the concordance between ante-mortem clinical diagnoses and post-mortem causes of death. MATERIALS AND METHODS: From January 2009 to December 2015, Autopsy records at the Department of Pathology, University College Hospital, Ibadan were reviewed. Discrepancies between the clinical diagnoses and postmortem findings were categorised using Goldman criteria into major and minor classes. Goldman's criteria can be sub-categorised into five classes: Class I, Class II, Class III, Class IV and Class V. Classification of the cause of death categories was by the International Classification of Diseases, Version 10. The study was carried out with respect to the world medical association's Declaration of Helsinki (2013). Data analysis was carried out with the use of the Statistical Package for the Social Sciences (SPSS version 22). RESULTS: Five hundred and thirty-three cases were involved with a male-female ratio of 1.6. The most common postmortem causes of death were traumatic Injuries (20.6%), Circulatory system-related deaths (19.7%), infections (16.9%) and malignant neoplasms (9.4%). Only 298 (55.9%) of the cases showed a concordance between the post-mortem causes of death and the clinical diagnosis. CONCLUSION: The post-mortem autopsy is useful in the audit of current medical practice in our environment.

Cyclic lipopeptide-producing Pseudomonas koreensis group strains dominate the cocoyam rhizosphere of a Pythium root rot suppressive soil contrasting with P. putida prominence in conducive soils.

Pseudomonas isolates from tropical environments have been underexplored and may form an untapped reservoir of interesting secondary metabolites. In this study, we compared Pseudomonas and cyclic lipopeptide (CLP) diversity in the rhizosphere of a cocoyam root rot disease (CRRD) suppressive soil in Boteva, Cameroon with those from four conducive soils in Cameroon and Nigeria. Compared with other soils, Boteva andosols were characterized by high silt, organic matter, nitrogen and calcium. Besides, the cocoyam rhizosphere at Boteva was characterized by strains belonging mainly to the P. koreensis and P. putida (sub)groups, with representations in the P. fluorescens, P. chlororaphis, P. jessenii and P. asplenii (sub)groups. In contrast, P. putida isolates were prominent in conducive soils. Regarding CLP diversity, Boteva was characterized by strains producing 11 different CLP types with cocoyamide A producers, belonging to the P. koreensis group, being the most abundant. However, putisolvin III-V producers were the most dominant in the rhizosphere of conducive soils in both Cameroon and Nigeria. Furthermore, we elucidated the chemical structure of putisolvin derivatives-putisolvin III-V, and described its biosynthetic gene cluster. We show that high Pseudomonas and metabolic diversity may be driven by microbial competition, which likely contributes to soil suppressiveness to CRRD.

P57kip2 immunohistochemical marker as a diagnostic tool for cases of hydatidiform moles in a tertiary health facility in Southwestern Nigeria.

BACKGROUND: Hydatidiform mole (HM) is the most common gestational trophoblastic disease. P57kip2 has been reported to be helpful in differentiating between partial and complete HMs. OBJECTIVES: The study aims to evaluate the P57kip2 immunohistochemical (IHC) marker as a useful ancillary investigation to differentiate complete hydatidiform mole (CHM) from partial hydatidiform mole (PHM). MATERIALS AND METHODS: A retrospective study of all histologically diagnosed HM cases over a 20 year period was undertaken. Clinicopathological parameters were extracted from the surgical day book and medical record archives. Archival haematoxylin- and eosin-stained slides and formalin-fixed paraffin-embedded tissue blocks of all cases of HM diagnosed within the study period were retrieved and reviewed. Cases of HM were reclassified using the P57kip2 IHC marker. The data obtained were analysed using the SPSS version 23. RESULTS: One hundred cases of HMs were studied. CHM accounted for 68%, while PHM accounted for the remaining 32%. The incidence of HM was 2.98 cases per 1000 deliveries. The ratio of CHM to PHM was found to be 2.1:1. Seventy-two per cent of the cases were diagnosed in the first trimester, while the remaining 28% were diagnosed in the second trimester of pregnancy. Based on the P57kip2 IHC staining pattern, HM cases were finally reclassified into 68 cases of CHM and 32 cases of PHM. The age range for all the HM cases was 18-50 years with the majority of the cases seen in the third and fourth decades of life. CONCLUSION: P57kip2 could be useful as an ancillary investigation in confirming the diagnosis of CHM and differentiating it from PHM, particularly in difficult and challenging cases.

Gender differential in inclination to donate brain for research among Nigerians: the IBADAN Brain Bank Project.

BACKGROUND: Laboratory-based studies of neurological disease patterns and mechanisms are sparse in sub-Saharan Africa. However, availability of human brain tissue resource depends on willingness towards brain donation. This study evaluated the level of willingness among outpatient clinic attendees in a Nigerian teaching hospital. METHODS: Under the auspices of the IBADAN Brain Bank Project, a 43-item semi-structured interviewer-administered questionnaire was designed to evaluate knowledge, attitude, and beliefs of individuals attending Neurology, Psychiatry and Geriatrics Outpatient clinics regarding willingness to donate brain for research. Association between participants characteristics and willingness towards brain donation was investigated using logistic regression models. Analysis was conducted using Stata SE version 12.0. RESULTS: A total of 412 participants were interviewed. Their mean age was 46.3 (16.1) years. 229 (55.6%) were females and 92.5% had at least 6 years of formal education. Overall, 109 (26.7%) were willing to donate brains for research. In analyses adjusting for educational status, religion, ethnicity, marital status and family setting, male sex showed independent association with willingness towards brain donation OR (95% CI) 1.7 (1.08-2.69), p = 0.023. Participants suggested public engagement and education through mass media (including social media) and involvement of religious and community leaders as important interventions to improve awareness and willingness towards brain donation. CONCLUSION: The survey revealed low willingness among outpatient clinic attendees to donate brain for research, although men were more inclined to donate. It is imperative to institute public engagement and educational interventions in order to improve consent for brain donation for research.

Assessment of Serological Markers of Genital Chlamydia trachomatis Infection Among the Gynaecology Patients attending Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria.

Genital Chlamydia trachomatis infection causes significant morbidity and mortality in women. A number of epidemiologic studies have suggested that Polymerase Chain Reaction (PCR) is more accurate as a diagnostic tool for Chlamydia trachomatis. However, the use of serological markers may be cost effective and practical in diagnosing and estimating the burden of the disease in resource limited countries.This study was aimed at determining the serological markers (IgG, IgM and IgA) of Chlamydia trachomatis, evaluate the association between Chlamydia trachomatis infection and the sociodemographic characteristics and clinical diagnosis of the participants. This was a cross sectional hospital-based study in which blood samples from 145 consenting participants were tested for IgG, IgM and IgA antibodies against Chlamydia trachomatis using enzyme linked immunosorbent assay and their clinical diagnosis, retrieved from their case notes. The cumulative prevalence of seropositivity for Chlamydia trachomatis (IgG, IgM, IgA) was 112 (77.2%) while 33 (22.8%) were seronegative. The overall predominant seromarker was IgG 91(62.8%) while IgM and IgA accounted for 85(58.6%) and 54(37.2%) respectively. A statistically significant association was found between Chlamydia trachomatis infection and PID (p value = 0.031), primary infertility (p value 0.011) and level of income (p value= (0,045).

Clinicopathological pattern of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 over-expression of epithelial ovarian carcinomas in Nigeria.

Background: Ovarian cancer is the leading cause of death from all gynaecological malignancies. Only few biomarkers of epithelial ovarian cancer (EOC) prognosis have been studied so far among Nigerian patients. Objective: To determine the pattern of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) expression in patients with EOC seen in Nigeria. Materials and Methods: This was a retrospective multicentre study of 102 cases of epithelial ovarian cancers. Relevant clinical information was obtained from hospital-based records in the 3 participating centres. Tissue microarrays were constructed using representative tumour tissue and the ER, PR and HER2 immunohistochemical staining was carried out at the University of Chicago, United States of America. Results: Serous carcinomas predominated (71% of cases). ER positivity was observed in 31.4%, PR positivity in 21.5% and HER2/neu in 16.7% of tumours. Fifty-two percent of tumours were triple negative. Serous tumours were significantly associated with ER positivity (p=0.001). Mean patient age for EOC was 52.6 ± 13.1 years. There were no statistically significant associations between hormone receptor status and histological grade, FIGO staging or survival. Conclusion: Serous tumours were significantly associated with ER expression while non-serous tumours tended to be triple negative.

Spinal meningioma: clinical profile and outcome of surgical management.

Spinal meningiomas are relatively rare tumours with often favourable surgical outcomes. There is paucity of data on spinal meningiomas in the Nigerian literature. This study was designed to evaluate the incidence, the anatomical distribution and outcome of surgical treatment of spinal meningiomas in our center. This was a retrospective study of patients who had surgery for spinal meningioma at our center during the study period. We obtain data from case note, operation and pathology registers. Univariate analysis was performed using SPSS version 15 (SPSS Science Inc; Chicago, IL, USA). There were 11 patients in the study all of whom were females with age range of 26-65 years. All the patients had motor deficit at presentation. Four patients (36.4%) presented within 6 months of onset of symptoms while the duration of symptoms was more than a year in 5 patients (45.5%). The preoperative functional grading was Frankel A in 2 patients (18.2%), Frankel D in 1 patient (9.1%), Frankel B and C each in 4 patients (36.4%). The tumours were located in the thoracic region in six patients (54.5%), cervical region in 2 patients (18.2%) while the tumours were cervicothoracic in the other 3 patients (27.3%). All the patients had gross total tumour resection. Post-operative neurological improvement occurred in 7 patients (63.6%) while 4 patients (36.4%) remained neurologically the same. All the patients in this study were women. Gross total tumour resection was achieved in all the cases with satisfactory functional outcome.

Hormonal Receptor Expression in Endometrial Carcinoma: A Retrospective Immunohistochemical Study in a Nigerian Tertiary Hospital.

Background: Endometrial carcinoma is the commonest genital tract malignancy in most developed nations, but it lags behind cervical carcinoma and ovarian cancers in most developing nations including Nigeria. Estrogen has been described as a promoter of endometrial carcinogenesis. Objectives: The aim of this study was to demonstrate the frequency of estrogen receptor (ER) and progesterone receptor (PR) expressions of endometrial carcinoma and to correlate it with tumour grade. Materials and Methods: Cases of endometrial carcinoma diagnosed in the Department of Pathology over a 10-year period were reviewed retrospectively. The paraffin-embedded blocks were retrieved, and immunohistochemistry for ER and PR was performed on them. Haematoxylin and eosin (H&E) slides were reviewed, and tumours were graded by three independent pathologists. Data were analysed using SPSS version 22. The level of significance was set at P ≤ 0.05. Results: There were 44 cases of endometrial carcinoma. ER and PR were positive in 29.5% and 18.2% of endometrial carcinoma, respectively. There was no significant association between ER (P = 0.361) and PR (P = 0.204) expressions and histological grade of the tumour. The most common histological grade was grade 3 with 70% of cases (36 cases), whereas 13 cases (26%) were grade 2 and only 2 cases (4%) were grade 1. Conclusion: The positive expressions of ER and PR in endometrial carcinoma suggest that steroid receptor studies may be of potential benefit in the management of some patients with endometrial carcinoma. Future studies employing larger sample size are therefore recommended.

Histopathological profile of childhood thyroid carcinoma in Ibadan, Southwestern Nigeria.

Background: Thyroid carcinoma is a common endocrine malignancy. It is however rare in childhood and often occurs as a result of radiation exposure or inherited genetic mutations. Most childhood thyroid carcinomas are well differentiated. There are very few epidemiological studies of this disease in Nigeria and our study aimed to determine the frequency in a subset of our population. The study aimed to determine the prevalence and histopathological characteristics of childhood thyroid carcinoma in our environment. Methods: This was a retrospective review of histopathologically diagnosed thyroid carcinoma in children less than 18 years of age in the Department of Pathology, University College Hospital, Ibadan over a 40-year period. Histopathological diagnosis, age, sex and other relevant clinical information were extracted from the hospital records and surgical pathology records of the department. All cases of patients under18 years old had their slides re-examined and reclassified by two pathologists according to the World Health Organization histopathological classification of thyroid tumours. Results: There were 25 cases of thyroid carcinomas seen in children within the study period. Papillary thyroid carcinoma was the most common, accounting for 80% of the cases. Follicular carcinoma accounted for 12%, and medullary and anaplastic carcinoma accounted for 4% each. The mean age at presentation was 13 years. There was a female preponderance with females accounting for 60% of cases. Tumours with distant metastasis made up 20% of the cases. Conclusion: Childhood thyroid carcinomas are rare in our environment, with a minority of cases presenting with metastases.

Inflammatory Pseudotumor: A 20-Year Single Institutional Experience.

BACKGROUND: Inflammatory pseudotumor (IPT) is a relatively rare benign disease. The aim of the study was to demonstrate the demographic distribution, clinical presentation, and histomorphological characteristics of IPT while highlighting its associated diagnostic challenges. MATERIALS AND METHODS: A retrospective cross-sectional review of all the IPT diagnosed in our institution between January 1999 and December 2018 was conducted. The samples were received from within and outside the hospital facility. The demographic data, clinical history, and histologic reports were reviewed. RESULTS: A total of 25 cases of histologically confirmed IPT were seen. Patients' age ranges from 7 to 74 years with a mean age of 38.96 years and standard deviation ± 17.94 years. There was a bimodal peak occurrence in the third and fifth decades. Most of the patients were adults (23, 92%), whereas only 2 (8%) were children. There was a female preponderance with a male-to-female ratio of 1:2.6. The head and neck had the highest number of cases (44%), followed by the gastrointestinal tract (GIT) (40%). Eight (73%) of head and neck cases occurred in the orbit. The presenting complaints depended on the site of the lesion with pain and swelling being the commonest symptoms irrespective of the site of the lesions. Two cases of bilateral IPT were observed. Immunohistochemistry was used in a certain condition of diagnostic dilemma. CONCLUSION: This study showed a female preponderance of IPT with the head and neck and GIT being the most common location. It is important to rule out other differentials in the diagnosis of IPT.

Biosynthesis and Antimicrobial Activity of Pseudodesmin and Viscosinamide Cyclic Lipopeptides Produced by Pseudomonads Associated with the Cocoyam Rhizosphere.

Pseudomonas cyclic lipopeptides (CLPs) are encoded non-ribosomally by biosynthetic gene clusters (BGCs) and possess diverse biological activities. In this study, we conducted chemical structure and BGC analyses with antimicrobial activity assays for two CLPs produced by Pseudomonas strains isolated from the cocoyam rhizosphere in Cameroon and Nigeria. LC-MS and NMR analyses showed that the Pseudomonas sp. COR52 and A2W4.9 produce pseudodesmin and viscosinamide, respectively. These CLPs belong to the Viscosin group characterized by a nonapeptidic moiety with a 7-membered macrocycle. Similar to other Viscosin-group CLPs, the initiatory non-ribosomal peptide synthetase (NRPS) gene of the viscosinamide BGC is situated remotely from the other two NRPS genes. In contrast, the pseudodesmin genes are all clustered in a single genomic locus. Nano- to micromolar levels of pseudodesmin and viscosinamide led to the hyphal distortion and/or disintegration of Rhizoctonia solani AG2-2 and Pythium myriotylum CMR1, whereas similar levels of White Line-Inducing Principle (WLIP), another member of the Viscosin group, resulted in complete lysis of both soil-borne phytopathogens. In addition to the identification of the biosynthetic genes of these two CLPs and the demonstration of their interaction with soil-borne pathogens, this study provides further insights regarding evolutionary divergence within the Viscosin group.

Pediatric Meningiomas in Southwestern Nigeria: A Single-Institutional Experience.

BACKGROUND: Meningiomas are the second commonest intracranial tumors in many places worldwide. They are rare in the pediatric age group, however, and most studies have been able to document only a few patients. Meningiomas in pediatric patients have also been shown to behave differently from those in the adult population. This study was done to examine histologic types of meningiomas seen in pediatric patients from a predominantly African population using the 2016 World Health Organization (WHO) grading system for intracranial tumors. METHODS: Data from the operating logs of patients and histology reports of the samples sent to the pathology department during the study period were extracted. The data obtained were the age, sex, location of the intracranial tumor, histologic diagnosis, WHO grade, and tumor recurrence. RESULTS: Nine pediatric age patients were found among the 166 surgically excised meningiomas received at the pathology department in our institution over a 19-year period. The age range was from 8 months to 17 years. There was a male-to-female ratio of 1:2 with a female predominance. Six tumors were basally located. All tumors were WHO grade I with transitional meningiomas being the commonest followed by meningothelial. There was no history of recurrence in any of the tumors after complete surgical excisions. CONCLUSIONS: Our study showed the rarity of meningiomas in the study population, and there was a predominance of basally located tumors.

Brain banking in low and middle-income countries: Raison D'être for the Ibadan Brain Ageing, Dementia And Neurodegeneration (IBADAN) Brain Bank Project.

Brain banks are biorepositories of central nervous system (CNS) tissue including fixed and frozen whole brains, brain biopsies and spinal cord, as well as body fluids comprising the cerebrospinal fluid (CSF) and blood stored for research purposes. Though several independent brain banks exist in high income countries, only five low- and middle - income countries (LMIC) have brain banks. The African continent is yet to establish a formalized brain bank despite its huge human genomic diversity, ageing of her populations with concomitant increases in ageing - associated brain disorders and differential phenotypic expression and outcomes of brain disorders. Cellular and molecular clinicopathological studies are vital to shaping our understanding of the interaction between racial (genetic) and geographical (environmental) factors in the natural history and mechanisms of disease, and unravelling frameworks of diagnostic biomarkers, and new therapeutic and preventative interventions. The Ibadan Brain Ageing, Dementia And Neurodegeneration (IBADAN) Brain Bank, the first organized brain tissue biorepository in sub - Saharan Africa, is set up to accrue, process and store unique brain tissues for future research into a broad spectrum of neurological and psychiatric disorders. The potential unique discoveries and research breakthroughs will benefit people of African ancestry and other ancestral populations.

Cerebellar Vermian Epidermoid Tumor: A Report of 2 Cases.

BACKGROUND: Epidermoid tumors are rare, benign slow-growing congenital tumors, most frequently located in the cerebellopontine angle of the intracranial cavity. They usually grow to a large size before patients become symptomatic. Although these tumors are amenable to surgery, their adherence to neurovascular structures poses a surgical challenge that results in subtotal resection, thus increasing the risk of recurrence. CASE DESCRIPTION: We report 2 adult patients whose imaging studies revealed epidermoid tumors located in the cerebellar vermis, an uncommon site for such tumors. The patients presented with variable symptomatology. We highlight the imaging features and challenges of surgery. Both patients had good outcomes, with resolution of symptoms and neurologic deficits. CONCLUSIONS: A safe complete excision of epidermoid tumor and its capsule is possible with a good understanding of their clinical and radiologic features and a high index of suspicion. To the best of our knowledge, this is the first report of cerebellar vermian epidermoid tumors from sub-Saharan Africa.

Malignant ameloblastoma: a challenging diagnosis.

Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.

Hormone-receptor expression status of epithelial ovarian cancer in Ibadan, South-western Nigeria.

INTRODUCTION: Epidemiological evidence strongly suggests that steroid hormones are implicated in the pathogenesis of ovarian cancer. Estrogen receptor (ER) and Progesterone receptor (PR) are prognostic indicators for a number of epithelial tumors and may play the same role in ovarian cancers. This study aims to evaluate the expression of ER and PR in epithelial ovarian cancer (EOC) in an African population and compare it with other prognostic factors such as age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype. METHODS: Ninety cases of histologically confirmed EOC were reviewed. Immunohistochemistry was used to assess their ER and PR expression status and was then compared with other demographic variables using statistical methods, with level of significance set at p < 0.05. RESULTS: 30.2% and 8.3% of serous and mucinous carcinomas respectively were ER positive while 41.2% and 22.5% of both tumour types were PR positive. One of the two endometrioid carcinomas showed PR expression but neither were positive for ER. The only case of Brenner tumour in the series was ER positive but negative for PR. There was a significant association between ER and the histological subtypes (p = 0.042) while no significant association was found between PR expression and histological subtypes (p = 0.650). No significant association was found between hormone receptor status, age and stage of the EOC. CONCLUSION: The study showed a lower ER expression in serous carcinoma compared to large cohorts from developed countries. Future translational studies could be used to determine response of EOC to endocrine therapy.

Pattern of triple negative epithelial ovarian cancer in indigenous African women.

Background: Triple negative epithelial ovarian cancer (TNEOC)  refers to ovarian carcinomas that do not express estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor- type 2 (HER-2/neu).  The aim of this study is to determine the pattern of triple negative epithelial ovarian cancer in indigenous African women. Methods: We performed a retrospective review of ER, PR and HER-2/neu expression in 90 Nigerian patients with histologically diagnosed epithelial ovarian cancer. Lack of expression of ER, PR and HER2/neu antigens was used to determine carcinomas that are among the TNEOC. We also compared the clinicopathological parameters (age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype) in patients with TNEOC and non- TNEOC . Results: Thirty-eight (42.2%) of the 90 tumours diagnosed as EOC were negative for ER, PR and HER2/neu expression. There was no significant association between TNEOC with other parameters such as age, FIGO stage and histological grade. Sixteen (66.7%) of the 24 mucinous carcinomas were triple negative, while only 21 (33.3%) of the 63 serous carcinomas were triple-negative and one (50%) of the two endometrioid carcinomas was triple negative. There was a significant association between triple-negative tumours and histological subtypes of EOC (p = 0.034). Conclusions: A subtype of epithelial ovarian cancer that is negative for ER, PR and HER-2/neu has been discovered in indigenous African women. TNEOC expression is high and is comparable to the triple negative breast cancer subtype seen in people of African ancestry. Future study of TNEOC in a large sample size should be considered.

Childhood ovarian neoplasms in Ibadan, South-western Nigeria.

BACKGROUND: Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in children <15 years over a 22½ years period. MATERIALS AND METHODS: This was a retrospective study. Twenty-four cases of childhood ovarian neoplasms were seen in patients <15 years of age. These cases were classified using the current World Health Organization histological classification of ovarian tumors. RESULTS: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. CONCLUSION: Mature cystic teratoma remains the single most common childhood ovarian neoplasms, and Burkitt's lymphoma is the most malignant childhood ovarian tumor in Ibadan, South-western Nigeria.

Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study.

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.