Yolk-sac carcinoma mimicking sacrococcygeal teratoma in an infant.

Extragonadal germ cell tumors (GCTs) are rare, accounting for 1% to 5% of all GCTs, with malignant sacrococcygeal yolk sac tumors (SCYSTs) being part of this uncommon subset. These tumors primarily occur in children and young adults and are known for their aggressive behavior, necessitating early diagnosis and prompt treatment. In this case report, we present the case of an 8-month-old female who presented with mild abdominal distension and a 3-week history of difficulty passing urine. Imaging revealed a pelvic mass originating from the coccyx, compressing the urinary bladder. The mass was surgically excised, and histopathological analysis confirmed a malignant yolk sac tumor with positive margins. The patient received adjuvant chemotherapy postsurgery. Despite treatment, follow-up scans showed residual tumor tissue, leading to a second tumor resection. Surveillance was continued using Alpha Fetoprotein (AFP) levels as a marker, which revealed a relapse of the tumor. Subsequent imaging confirmed a growing tumor, and the patient was scheduled for second-line chemotherapy. Management of SCYSTs is complex and requires a multidisciplinary approach, including surgeons, oncologists, radiologists, and pathologists. While relapse is rare, it poses a significant challenge for treatment, underscoring the need for clear and updated guidelines for managing relapsed cases.

Lifestyle score is associated with cellular immune profiles in healthy Tanzanian adults.

Immune system and vaccine responses vary across geographical locations worldwide, not only between high and low-middle income countries (LMICs), but also between rural and urban populations within the same country. Lifestyle factors such as housing conditions, exposure to microorganisms and parasites and diet are associated with rural-and urban-living. However, the relationships between these lifestyle factors and immune profiles have not been mapped in detail. Here, we profiled the immune system of 100 healthy Tanzanians living across four rural/urban areas using mass cytometry. We developed a lifestyle score based on an individual's household assets, housing condition and recent dietary history and studied the association with cellular immune profiles. Seventeen out of 80 immune cell clusters were associated with living location or lifestyle score, with eight identifiable only using lifestyle score. Individuals with low lifestyle score, most of whom live in rural settings, showed higher frequencies of NK cells, plasmablasts, atypical memory B cells, T helper 2 cells, regulatory T cells and activated CD4+ T effector memory cells expressing CD38, HLA-DR and CTLA-4. In contrast, those with high lifestyle score, most of whom live in urban areas, showed a less activated state of the immune system illustrated by higher frequencies of naïve CD8+ T cells. Using an elastic net machine learning model, we identified cellular immune signatures most associated with lifestyle score. Assuming a link between these immune profiles and vaccine responses, these signatures may inform us on the cellular mechanisms underlying poor responses to vaccines, but also reduced autoimmunity and allergies in low- and middle-income countries.

Surgical management of basal cell adenoma of the parotid gland: A case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Basal cell adenoma (BCA) is a rare, benign tumor of the salivary gland. It has distinct histologic features that are different from mixed tumors of the salivary gland. Often times, it occurs in the parotid gland. Usually it appears as a hard, slowly growing, asymptomatic lump that may exist for years prior to treatment. Pathologically, BCA tumors demonstrate a monomorphic basaloid cell population devoid of myxochondroid components. This rather uncommon tumor's clinical appearance, pathological characteristics, differential diagnosis, and available treatments have been briefly described. CASE PRESENTATION: A 52-year-old female patient presented with a longstanding, gradual facial asymmetry that resulted from a mass of parotid region. She had no other symptoms. Radiology and cytology test results were suggestive of a benign salivary gland tumor of the parotid gland. A superficial parotidectomy was successfully done with a preservation of the facial nerve. Histopathology reported concluded the diagnosis of BCA trabecular subtype. During the 12-month follow-up period, the tumor did not recur, and there was no postoperative impairment of the facial nerve. CLINICAL DISCUSSION: Imaging studies, including CT scans and MRI, are helpful in determining the tumor's size, location, and relationship to adjacent structures. The definitive diagnosis is achieved through histopathology. This clinically asymptomatic mass requires early recognition, a prompt therapeutic intervention and long-term follow-up. CONCLUSION: As clinicians, it is critical that we have a thorough understanding of clinicopathology in terms of clinical presentation, pathology, diagnosis, treatment, and prognosis of this rare tumor.

Uterine leiomyoma in a 16-year-old young adolescent from Northen Tanzania: A rare case report and review of current literature.

INTRODUCTION AND IMPORTANCE: Uterine leiomyomas, or fibroids, are benign mesenchymal tumors, which represent the most common tumors of the female genital tract. Their occurrence in pediatric and adolescent populations is uncommon, and relatively few cases have been documented in the literature, particularly in lower-resourced settings. This case highlights the importance of recognizing that although uncommon, fibroids can occur in much younger populations. Also highlights the need for healthcare practitioners in resource-limited environments to be vigilant in considering leiomyoma in differential diagnoses, even in younger patients, and to adapt their treatment approach given the constraints of local healthcare systems. CASE PRESENTATION: Here we present an uncommon case of uterine leiomyoma in a 16-year-old female from Northern Tanzania. She presented with lower abdominal pain associated with abdominal distension, prolonged menses, headache, and anemia. Transvaginal US and pelvic MRI were performed and revealed an enlarged uterus with a heterogeneous mass in the posterolateral uterine wall. Myomectomy was performed, and post-operative recovery was uneventful. The final histopathological report confirmed the diagnosis of intramural uterine leiomyoma. CLINICAL DISCUSSION: In this report, we discuss the rarity of this condition, the literature surrounding similar reports, and the many challenges that arise in the management of leiomyoma in a young adolescent population. CONCLUSION: Uterine leiomyomas should be considered as a differential diagnosis in pediatric and adolescent females presenting with a pelvic mass and abdominal pain. Though there are no specific guidelines for treatment, management of leiomyomas in this age group, should be conservative and based on symptom severity with the goal of preserving fertility.This case underscores the need for more research and awareness of uterine leiomyomas in adolescents to improve understanding and management of this rare condition in this age group, particularly in regions like Northern Tanzania where access to healthcare may be limited.

Giant mucinous borderline tumor of the ovary in a postmenopausal woman: A rare case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Mucinous cystadenoma is a benign cystic ovarian tumor arising from the surface epithelium of the ovary that usually presents with vague, unspecified abdominal symptoms. If not detected early, this tumor has the potential to grow to a substantial size and can present with huge abdominal distention leading to various compression symptoms. The reported incidence of giant ovarian cystadenoma in postmenopausal women is relatively unknown due to the widespread use of ultrasound and other radiological imaging modalities. CASE PRESENTATION: Here, we present a rare case of giant borderline mucinous cystadenoma in a 67-year-old female 10 years postmenopausal from Northern Tanzania with multiple comorbidities including hypertension and type 2 diabetes mellitus. She presented with abdominal distention which was of gradual onset for 1 year. Abdominal CT scan with contrast revealed a huge septated cystic mass occupying the entirety of the abdominal and pelvic cavities causing a mass effect on adjacent intra-abdominal structures. An intact 23-kg left ovarian cyst was removed, and a total abdominal hysterectomy (TAH) along with bilateral salpingo-oophorectomy (BSO) was performed. Post-operative recovery was excellent and the patient was discharged. The final histopathological report showed a borderline ovarian mucinous cystadenoma and the patient was managed conservatively after surgery. CLINICAL DISCUSSION: In this case report, we discuss the condition's rarity especially in postmenopausal women, related reports in the literature, and the numerous difficulties clinicians face when encountering a patient with borderline mucinous cystadenoma. The rarity of borderline mucinous cystadenomas in postmenopausal women makes these cases clinically unusual, challenging diagnostic and therapeutic expectations. CONCLUSION: This case report highlights the importance of thoroughly evaluating women with vague abdominal symptoms. While this condition is rare in postmenopausal women, its massive form can be dangerous if not diagnosed and managed promptly, with the potential to progress to malignancy. Greater awareness of this condition could lead to earlier detection and reporting of more cases.

Symptomatic leiomyoma in a patient with a bicornuate uterus: A rare case report.

INTRODUCTION AND IMPORTANCE: Uterine anomalies are congenital malformations caused by fusion or resorption defects during embryogenesis. A bicornuate uterus is a rare condition that results from abnormal development of the paramesonephric ducts. It results from an incomplete fundus-level fusion of uterovaginal horns. CASE PRESENTATION: A 30-year-old female presented with a longstanding abdominal distension. An abdomino-pelvis CT scan result was suggestive of a huge right ovarian mass (25.8 × 25.9 × 14.3 cm). Intraoperatively, a bicornuate uterus with normal left cornua was encountered. The right cornua was not extending to the vagina vault and had a huge cystic mass arising from the fundus. The right cornua excision along with the mass was performed, preserving the left normal cornua and its adnexa. Histopathology confirmed the diagnosis of leiomyoma. The patient was kept in follow-up. To date, six months have passed; she has resumed her menstrual cycles and is free from symptoms. DISCUSSION: Symptomatic fibroids in patients with a birconuate uterus are rare. Thus, diagnostic challenges can be encountered, as was seen in this case. A huge size of the fibroid in one horn of the bicornuate uterus projecting into the pelvic cavity can contribute to recurrent pregnancy loss. An MRI of the pelvis is recommended for assessment of the internal and external contours of the uterus. CONCLUSION: A bicornuate uterus with lieomyomas is an uncommon but difficult condition. An appropriate pre-operative assessment of the mullerian anomaly type, quantity, location, and size of lieomyomas, as well as urinary tract mapping, are essential for effective management.

Management challenges of a cervical carcinosarcoma in a premenopausal woman in northern Tanzania: A rare case report and review of current literature.

INTRODUCTION AND IMPORTANCE: Cervical carcinosarcomas (CCS) are uncommon aggressive gynecological malignancies that typically occur in postmenopausal females. Data on CCS, incidence, clinical presentation, magnitude and management strategies remain scarce especially in Sub-Saharan countries like Tanzania. In this report, we report the rarity of this particular condition in premenopausal woman, the literature surrounding similar reports, and the many challenges that arise in the management of CCS. CASE PRESENTATION: We present a redudancy case of a 35-year-old female from Northern Tanzania who presented with vaginal bleeding, foul smelling discharge, and severe abdominal pain intermittently for a year. The Speculum exam revealed a fungating mass on the cervix, and CT confirmed the irregular mass centered in the uterine cervix expanding in the fornices infiltrating the uterine neck. A cervical biopsy revealed carcinosarcoma of the cervix stage IIA. Due to the patient's instability, she was admitted and started on chemotherapy and later on recommended for radiation without surgical intervention. CLINICAL DISCUSSION: In this case report, we discuss the condition's rarity and multiple barriers we encountered during management of this complicated patient with CCS. Choosing an optimal treatment approach was challenging due to the lack of guidelines and available literature as well as the patient's instability. CONCLUSION: his case is notable due to the rarity of this cervical neoplasm especially in premenopausal women and the challenging management of the condition due to a notable lack of treatment recommendations.

Novel CTR9 germline pathogenic splice site variant in siblings with Wilms tumor from Tanzania.

Wilms tumor is the most common childhood renal malignancy. Though mostly non-genetic, it can be syndromic with the involvement of many Wilms tumor predisposing genes and non-syndromic with the involvement of four genes: WT1, REST, TRIM28, and CTR9. Familial and bilateral Wilms tumors do occur, but these are rare. So far, four Wilms tumor families with pathogenic variants in the CTR9 gene have been described, all (presumably) inherited from unaffected fathers, and three leading to deletion of exon 9. We are reporting female siblings, of whom one has a bilateral Wilms tumor, with a novel pathogenic splice site variant in the CTR9 gene, leading to deletion of exon 9, and inherited from their asymptomatic father. The loss of heterozygosity in the tumor was confirmed. In conclusion, CTR9 pathogenic variants are a very rare cause of Wilms tumors and typically result in familial Wilms tumors.

Meaningful engagement of people living with cancer: Leveraging breast cancer survivors in a stigma reduction intervention in Tanzania.

INTRODUCTION: Cancer-related stigma is a key driver of advanced breast cancer stage in Sub-Saharan Africa (SSA). We developed and tested the impact of a breast cancer survivor-led Stigma reduction intervention (SRI) on stigma and treatment adherence of newly diagnosed patients with breast cancer in Tanzania. METHODS: Breast cancer survivors were trained on breast cancer knowledge and motivational interviewing. A total of 4 trained survivors delivered a SRI (standardized flipchart breast education talk, personal testimony, and motivational interviewing) to 30 newly diagnosed patients with breast cancer before treatment. Pre- and post-intervention knowledge surveys and stigma scale surveys were analyzed via Fisher's exact test and Wilcoxon rank-sum tests. A discussion was held with a group of survivors after the intervention period to elicit feedback on their intervention experience. RESULTS: Among the 30 patients, breast cancer knowledge (median overall percent correct) increased from 28% (IQR: 18%-45%) to 85% (IQR: 79%-88%) (p < 0.001) and stigma (median score) decreased from 75 (IQR: 57-81) to 53 (IQR: 44-66) (p < 0.01) following the intervention. All participants were willing to pursue hospital-based treatment after undergoing the intervention. Eighty-seven percent (n = 26) initiated treatment at 8-week follow-up after the intervention. All survivors endorsed feeling empowered and valued in their role in this intervention. CONCLUSIONS: Breast cancer survivors are a powerful group to combat the lack of knowledge and stigma in community and healthcare settings. Expanding the scope and scale of this intervention holds promise for improving treatment-seeking behavior and ultimately breast cancer outcomes in SSA.

Primary Breast Lymphoma: A Case Report of a Common Tumor in an Uncommon Location.

Primary breast lymphoma (PBL) is a rare malignant lymphoid neoplasm limited to the breast, accounting for about 0.15% of all malignant breast tumors and 1.7% to 2.2% of extra-nodal lymphomas. PBL must be distinguished from conventional breast carcinomas due to different therapeutic approaches. A 25-year-old female presented with a left breast mass. Histopathology and immunohistochemical tests confirmed the diagnosis of diffuse large B-cell lymphoma (DLBCL). She had no similar lesions elsewhere in the body. She received 1 cycle of R-CHOP chemotherapy but absconded from the treatment and succumbed afterward while at home. Recent developments in DLBCL treatment have greatly improved patient outcomes by incorporating targeted medicines like rituximab, increased chemotherapy regimens, new drugs, and individualized treatment techniques. PBL appears to have a worse prognosis; thus, delay or abscondment from treatment is of serious concern when it comes to improving the prognosis of patients with PBL.

Management of a large uterine fibroid arising from the cervical stump following subtotal hysterectomy causing massive abdominal distension. A rare case report and review of the current literature.

INTRODUCTION AND IMPORTANCE: A cervical stump fibroid is a rare type of leiomyoma (fibroid) that occurs in the remaining cervical tissue following a subtotal hysterectomy. In this procedure the uterus is removed but the cervix is left intact. Cervical stump fibroids are quite rare, with studies indicating that they occur in less than 1 % of women who have undergone subtotal hysterectomy. The present report describes a rare case of uterine fibroid arising from the cervical stump 7 years after subtotal hysterectomy. The aim is to strengthen the existing literature and aid clinicians in the management of similar cases. CASE PRESENTATION: A 45-year-old female presented with a history of abdominal distension, abdominal pain, and bilateral lower limb swelling for 1 year. An abdominal Computed Tomography (CT) scan with contrast and Magnetic Resonance Imaging (MRI) revealed a large multilobulated mass in the pelvis measuring 14.3 × 7.4 × 21.1 cm. The mass displaces and compresses the urinary bladder anteriorly and the rectosigmoid colon posteriorly. Additionally, there is compression of the distal ureters bilaterally with resultant bilateral hydroureteronephrosis. The patient underwent explorative laparotomy and post-operative recovery was uneventful. The final histopathological report showed the diagnosis of uterine fibroid. CLINICAL DISCUSSION: In this case report, we discuss the condition's rarity, related reports in the literature, and the numerous difficulties clinicians face when encountering a patient with cervical leiomyomas. CONCLUSION: This case highlights the importance of long-term follow-up for patients post-supracervical hysterectomy, adds to the existing literature, and provides insight to healthcare providers in handling similar cases. Patients who are affected should receive appropriate counseling on postoperative care, recurrence after treatment, and the value of early and regular follow-up visits.

Assessment of Breast Pathology Reporting Needs and Development of Tumor Synoptic Templates in Sub-Saharan Africa.

CONTEXT.­: Breast pathology reports include many important details to guide clinical management. Reports with missing critical data elements are commonly seen in non-subspecialized pathology practices. The use of synoptic templates has been shown to improve pathology reports. Although synoptic templates are readily available by professional societies, many are not tailored to low-resource settings. OBJECTIVE.­: To perform an assessment of current breast pathology reporting at 3 referral hospitals in sub-Saharan Africa and design a locally adapted breast cancer synoptic template. DESIGN.­: We conducted semi-structured interviews with key stakeholders involved in breast cancer care including pathologists, radiologists, oncologists, and surgeons from Nigeria, Tanzania, and Mozambique. Moreover, each stakeholder reviewed a preliminary synoptic template that was compiled by using templates from the College of American Pathologists, Royal College of Pathologists, and International Collaboration on Cancer Reporting, and was asked to score each data element as essential, optional, or exclude. A locally adapted synoptic template was then designed from the needs assessment. Using the adapted templates, a retrospective review of breast cancer pathology reports from 2020 to 2022 was conducted to determine the completeness of reports at the 3 institutions. RESULTS.­: A total of 17 physicians were interviewed. Review of pathology reports revealed that none of the reports across all 3 sites contained all data elements considered essential by local physicians. CONCLUSIONS.­: There is an urgent need to improve breast pathology reporting in sub-Saharan Africa. Development and implementation of synoptic templates in collaboration with key stakeholders has the potential to improve pathology reporting practices in low-resource settings.

Surgical management of mandibular ameloblastoma and immediate reconstruction with iliac crest and costochondrial bone grafts: A case report.

INTRODUCTION AND IMPORTANCE: Ameloblastoma is a benign but locally aggressive odontogenic tumor mostly occurring in the jaws. Ameloblastoma can be difficult to diagnose because it mimics other benign lesions. Its diagnosis requires a combination of imaging data, histopathological analysis, and molecular tests. Its treatment modality diverges from simple enucleation with bone curettage up to wide surgical resections. CASE PRESENTATION: A 25-year-old female presented with a right-sided mandibular mass for five years. Histopathology and radiology tests confirmed it to be an ameloblastoma. A hemimandibulectomy was done, followed by immediate reconstruction using an autogenously inserted iliac crest bone and a costochondral graft as an interposition graft for the lost part. The patient had a satisfactory clinical outcome, and no sign of recurrence after a follow-up of six months. CLINICAL DISCUSSION: The ideal management of ameloblastoma should minimize recurrence, restore function and appearance, and present minimal donor site morbidity. While the removal of a wide part of the bone and soft tissue leads to defects that may cause functional and aesthetic concerns, conservative management is associated with minimal downtime but high recurrence rates. Reconstructive surgery is of paramount importance for the recovery of the lost parts in these patients. CONCLUSION: Radical surgery is the treatment of choice for large tumors to minimize recurrence, and immediate reconstruction utilizing grafting techniques is essential to restoring function and appearance. The autologous bone graft technique is satisfactory for immediate mandibular reconstruction as it represents a simple, easy, less costly, and reliable method for restoring mandibular continuity defects.

Prenatal detection and management challenges of a huge cystic hygroma of the neck in a resource-constraint setting: A case report.

INTRODUCTION AND IMPORTANCE: Cystic hygroma is a benign congenital malformation of lymphatic and blood vessels, with an incidence of 1 in 6000 live births. Most cases are associated with genetic syndromes and can compromise fetal viability. Due to its rarity, comprehensive data is limited, mainly relying on case reports. CASE PRESENTATION: A 21-year-old pregnant woman at 27 weeks' gestation presented to triage with abdominal pain. Abdominal ultrasound revealed a single living female fetus with an estimated fetal weight of 734 g and a complex cystic mass causing hyper-extension of the neck. The pregnancy was terminated given the poor prognosis. Histopathology of the mass confirmed it to be a cystic hygroma. CLINICAL DISCUSSION: In limited-resource settings, management of huge cystic hygromas often necessitates termination of pregnancy due to a lack of sufficient resources for complex interdisciplinary interventions for the mother and infant after birth. In such cases, focus should be shifted toward promoting shared decision-making and sensitive patient counseling. CONCLUSION: Cystic hygromas that are diagnosed prenatally generally have a poorer prognosis than those diagnosed after birth. The management of cystic hygramas, particularly those diagnosed prenatally, represents a persistent challenge in low-resourced settings. Counseling and treatment recommendations must be tailored based on tumor characteristics, the expected prognosis, and the feasibility of medical or surgical intervention in a given clinical environment.

A case report on rare co-occurrence of invasive ovarian mucinous adenocarcinoma, unilateral renal agenesis, and bicornuate uterus: is it a new triad?

BACKGROUND: Concomitant invasive ovarian mucinous adenocarcinoma, unilateral renal agenesis and bicornuate uterus is a rare combination. Unilateral renal agenesis has been associated with genital anomalies, such as unicornuate and bicornuate uterus. Furthermore, a wealth of studies has reported the association between unicornuate uterus and ovarian anomalies, such as the absence of an ovary or ectopic ovaries, but rarely has there been a combination of the three to the best of our knowledge. The present case report is the first case presentation with a combination of the three syndromes: ovarian mucinous tumor, unilateral renal agenesis, and bicornuate uterus. CASE PRESENTATION: We report the case of a 17-year-old who presented with abdominal distension. On examination, a CT scan revealed a large multicystic abdominal mass on the right side, with an absence of the right kidney while the left kidney was normal in size, appearance, and position. Intraoperatively, massive blood-stained ascitic fluid was evacuated. Additionally, a large whitish polycystic intra-abdominal mass with mucus-like materials and solid areas was attached to the midpoint of the colon and the right ovary, with visible metastasis to the omentum. The uterus was bicornuate. The mass and omentum were taken for histopathology and a diagnosis of invasive ovarian mucinous cystadenocarcinoma with metastasis to the colon and omentum was made after a pathological report. CONCLUSIONS: The presence of these conditions in the same individual could potentially complicate medical management and fertility considerations. Thus, a need for a multidisciplinary medical team, including gynecologists, urologists, and oncologists, to address their unique needs and provide appropriate treatment and guidance. Further research and case studies are needed to better understand the possible association and implications of these rare co-occurring conditions.

Surgical management of a huge oral verrucous carcinoma: A case report and review of the literature.

Verrucous carcinoma is a well-recognized low-grade variant of squamous cell carcinoma. Cutaneous, oral, and anogenital forms exist. Exposure to persistent chronic irritation, inflammation, and repeated injury, as well as carcinogenic agents such as human papillomavirus infection, smoking, and alcohol use, are established risk factors. These neoplasms occur mostly in the oral cavity. The usual extraoral sites include the larynx, esophagus, genitals, and perineum. It is an extremely uncommon site of occurrence for the extraoral chin region. This unusual location makes the index case unique. Other uncommon sites reported include finger and foot. Case studies of verrucous carcinoma with huge tumor sizes are rare. Although it can be destructive locally, verrucous carcinoma typically does not spread to distant sites. Wide surgical excision with free margins is the most common treatment approach with a favorable prognosis. These tumors are likely to recur if they are incompletely excised, and recurred lesions tend to be more aggressive clinically as compared to their original counterparts. Herein, the authors describe a case of a huge oral verrucous carcinoma localized on the chin of a 43-year-old female patient. The clinical course, diagnostics, and proposed treatment have been discussed with the existing available literature.

The role of clinical breast examination and fine needle aspiration cytology in early detection of breast cancer: A cross-sectional study nested in a cohort in a low-resource setting.

BACKGROUND: Breast cancer is prevalent worldwide, with disparities in screening, diagnosis, treatment outcomes, and survival. In Africa, the majority of women are diagnosed at advanced stages, affecting treatment outcomes. Screening is one of the best strategies to reduce mortality rates caused by this cancer. Yet in a resource-constrained setting, there is limited access to screening and early detection services, which are available only at a few referral hospitals. OBJECTIVES: We aimed to evaluate the prevalence and screening results of breast cancer using clinical breast examination coupled with fine needle aspiration cytology in a resource-constraint setting. DESIGN: A combined cross-sectional and cohort study. METHODS: Women at risk of developing breast cancer in the Kilimanjaro region of Tanzania were invited, through public announcements, to their primary healthcare facilities. A questionnaire was used to assess the participants' characteristics. The women received a clinical breast examination, and detectable lesions were subjected to a confirmatory fine needle aspiration cytology or an excisional biopsy. Preliminary data from this ongoing breast cancer control program were extracted and analyzed for this study. RESULTS: A total of 3577 women were screened for breast cancer; their mean age was 47 ± 7.53 years. About a third of them (1145, 32%) were practicing self-breast examination at least once a month. Of 200 (5.6%) with abnormal clinical breast examination, 18 (9%) were confirmed to be breast cancer, making the prevalence to be 0.5%. The vast majority of participants with breast cancer (13, 72.2%) had early disease stages, and infiltrating ductal carcinoma, no special type, was the most common (15, 83.3%) histopathology subtype. Hormonal receptor status determination results indicated that 11 (61.1%), 7 (38.9%), and 5 (27.8%) of the tumors overexpressed estrogen receptor, progesterone receptor, and human epidermal receptor-2, respectively. CONCLUSION: Our study demonstrates 5.6% of Tanzanian women have abnormal clinical breast examination findings, with 9% having breast cancer. Nearly three-quarters (72.2%) of breast cancer screened for early disease were detected in the early disease stages. This finding suggests that organized screening with clinical breast examination coupled with fine needle aspiration cytology, which is a simple and cost-effective screening method, has the potential to improve early detection and outcomes for breast cancer patients in a resource-constraint setting.

Giant intravesical prostatic protrusion mimicking bladder carcinoma: Navigating diagnostic and management challenges.

INTRODUCTION AND IMPORTANCE: Benign prostate hyperplasia is common condition among elderly men, but giant intravesical prostatic protrusion is rare and may be confused with bladder carcinoma. CASE PRESENTATION: We report an unusual case of giant intravesical prostatic protrusion mimicking bladder carcinoma. A diagnosis of giant intravesical prostatic protrusion was confirmed with the assistance of cystoscopy and patient was managed by transvesical simple open prostatectomy where he had uneventfully recovery. CLINICAL DISCUSSION: Both bladder carcinoma and benign prostate hyperplasia are more prevalent in elderly men and they all present with lower urinary tract symptoms. Ultrasound and computer tomography may all suggest bladder carcinoma. The two conditions are treated differently, and therefore having correct diagnosis is mandatory. Cystoscopy is an important investigation that can act as a tiebreaker in differentiating giant intravesical prostatic protrusion from bladder carcinoma. Transvesical simple open prostatectomy is the preferred surgical approach with good postoperative outcome. CONCLUSION: This case report reminds urology surgeons on the possibility of having giant intravesical prostate mimicking bladder carcinoma and the importance of cystoscopy in differentiating the two. Transvesical simple open prostatectomy has promising result.

Prostate cancer knowledge and barriers to screening among men at risk in northern Tanzania: A community-based study.

BACKGROUND: Although prostate cancer (Pca) screening plays important role in early diagnosis and reduction of mortality, Tanzanian men are relatively unscreened. We aimed to investigate Pca knowledge level and barriers to screening among at-risk men in northern Tanzania. METHODS: This community-based survey was conducted in northern Tanzania from May to September 2022, involving men age ≥40 years. Participants were invited by announcing in local churches, mosques, brochures, and social media groups. Participants attended a nearby health facility where survey questionnaires were administered. Knowledge level was measured on the Likert scale and scored as poor (<50 %) or good (≥50 %). RESULTS: A total of 6205 men with a mean age of 60.23 ± 10.98 years were enrolled in the study. Of these, 586 (9.5 %) had ever been screened for Pca. Overall, 1263 men (20.4 %) had good knowledge of Pca. Having health insurance, knowing at least 1 risk factor or symptoms of Pca, and hospital as the source of Pca information were significantly associated with ever being screened. The most common reasons for not being screened were a belief that they are healthy (n = 2983; 53.1 %), that Pca is not a serious disease (n = 3908; 69.6 %), and that digital rectal examination (DRE) as an embarrassing (n = 3634; 64.7 %) or harmful (n = 3047; 54.3 %) procedure. CONCLUSION: Having Pca knowledge, health insurance and hospital source of information were correlated with increased screening. False beliefs about DRE and the seriousness of Pca had negative effects on screening. Increasing community knowledge and universal health coverage would improve uptake of Pca screening.

Management of ossifying fibroma of the bone of the maxilla: a case report and review of the literature.

Ossifying fibroma (OF) is a slow-growing benign fibro-osseous neoplasm. It is mostly odontogenic in origin, and it arises in the jaws, particularly the mandible. OF is characterized by the production of bone and cementum-like calcifications in a fibrous stroma. OF reports of the bone of the maxilla are uncommon. Diagnosing OF can be challenging due to the considerable overlap of clinico-pathological characteristics with those of other neoplasms. Herein, the authors describe a case report OF in a 26-year-old male who presented with a huge fibro-osseous tumor of the maxilla. Histopathology established the diagnosis of maxillary OF. The tumor was surgically removed via a Weber-erguson approach with satisfactory functional and cosmetic results. No recurrence has been found after one year of follow-up. Clinical, radiological, and pathological characteristics, as well as surgical treatment approaches, are further discussed. This is one of a few documented cases of maxillary OF in our setting.