Autosomal dominant polycystic kidney disease with ectopic unilateral multicystic kidney: a case report.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary renal disorder and the fourth cause of death of end-stage renal disease. The disease has a prevalence of 1:400-1:1000 accounting for 10% of patients on dialysis. In most ADPKD patients, bilateral kidneys are similarly affected, with numerous fluid-filled cysts arising from different nephron segments. Only a few cases of ADPKD with ectopic unilateral multicystic kidney have been reported. It has been observed that the deterioration of their kidney function seemed to be quicker than their age- and sex-matched controls and siblings especially when the ectopic kidney is dysplastic. CASE PRESENTATION: We report a case of a 46-year-old Ghanaian male patient who presented with left flank pain and hematuria with high BP and deranged renal function. Abdominal ultrasonography showed both kidneys to be larger than normal and had multiple cysts of varying sizes with the right kidney located in the right iliac fossa. Follow up Abdominopelvic computer tomographic scan (CT-Scan) without contrast showed enlarged kidneys with the renal parenchyma replaced by innumerable cyst of varying sizes. The right kidney was ectopically located in the right aspect of the pelvis. A diagnosis of ADPKD with right pelvic ectopic multicystic kidney was made. He was put on antihypertensives, analgesia for the left flank pain and to have follow up at the urology and nephrology departments. CONCLUSION: In most ADPKD patients, bilateral kidneys are similarly affected. Only a few cases of ADPKD with ectopic unilateral multicystic kidney have been reported. It has been observed that the deterioration of their kidney function seemed to be quicker than their age- and sex-matched controls and siblings especially when the ectopic kidney is dysplastic.

Determinants of Mortality among Patients Managed for Prostate Cancer: Experience from Korle Bu Teaching Hospital in Ghana.

Background: Over the past two decades, diagnosis and treatment approaches for men with prostate cancer have changed dramatically, with improvements in established prostate cancer treatments and new treatment strategies. However, In sub-Saharan African countries, there is a paucity of data on the characteristics and treatment of men who eventually die from Prostate Cancer (PCa). We used the clinical records of patients who died from PCa to describe the natural history and treatment PCa patients in Ghana. Methods: From 2013 to 2022, the medical records of 234 men who died of PCa at a tertiary hospital in Ghana were prospectively collected and retrospectively analysed. Results: The mean age at death was 71.6 years, and the median was 72.5 years. 51.3% died within 24 months of diagnosis, 23.0% between 2 and 5 years after diagnosis, and a quarter survived for more than 5 years. Over 80% presented with advanced disease, characterised by high prostate-specific antigen (PSA) levels, a high T stage on DRE, and evidence of metastasis. 43.6% presented with haemoglobin levels below 10ng/dl at diagnosis. These patients had the worst outcome, with 73% dying less than 2 years after diagnosis. The 5-yr survival rate of patients who presented with metastatic disease was 21.2 %. Over 80% were treated with bilateral total orchidectomy, with less than 10% receiving treatment intensification with the newer generation antiandrogens or chemotherapy. Conclusion: Our analysis shows that patients who die from PCa have aggressive disease, are diagnosed at an advanced stage, and are relatively younger than in Western countries. There is also a slow uptake of newer treatment strategies for metastatic prostate cancer. These results confirm literature suggesting that blacks have poorer outcomes due to the disease's aggressive nature. Further research is needed to understand the mechanisms and also define appropriate management for metastatic PCa in sub-Saharan Africa.

Penile carcinoma: a report of two cases treated by partial penectomy, its effects on quality of life and review of literature.

Penile cancer is a rare malignancy worldwide except in parts of Africa, Asia and Latin America where higher incidences have been reported. The disease leads to serious physical disfigurement of the male genitalia which can have debilitating consequences, thus it may alter micturition patterns and impair penetrative sexual intercourse. The lack of cancer registries and epidemiological surveillance programs in Ghana makes estimation of the prevalence in Ghana difficult hence to advance the course of knowledge, awareness and prevention of penile cancers, it is imperative that such cases are brought to the fore and discussed. We report two cases of penile cancer that had partial penectomy and inguinal lymphadenectomy at the Korle Bu Teaching Hospital. Clinical findings and intervention of these reported cases highlight the management process and it further assessed the psychological impact of intervention. The two patients presented to our outpatient department with penile lesions which were confirmed to be penile cancer. The first patient presented with a 30 year history with recurrent ulceration while the other presented with just 1 (one) year history of penile lesion. Both patients required partial penectomy and inguinal lymphadenopathy in the treatment of their condition. The major risk factors as reported in this case study, include uncircumcision, previous treatment for sexually transmitted infections, multiple sexual partners and smoking. Treatment is associated with reduction in sexual function although quality of life may remain satisfactory. Strong family and psychological support are key cornerstones for good treatment outcomes.