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.

Factors Associated with Modern Contraceptive Use Among Out of School Adolescent Girls in Majengo and Njoro Wards of Moshi Municipality, Tanzania.

Background: Low uptake of modern contraceptives among adolescents remains a serious public health concern with over 20 million adolescents in need of modern contraceptives are not using any. In Tanzania where the adolescent fertility rate is 112 per 1000, only 15.2% of adolescents are using modern contraceptives. Contraceptive use stands out to be one of the key interventions to reduce the burden of adolescent pregnancy which is high in the country at 22%. There is little information on factors associated with modern contraceptive use among out of school adolescents, who are at an increased risk of adolescent pregnancies. Objective: To determine the prevalence and factors associated with modern contraceptive use among out of school adolescent girls in Moshi municipality, Kilimanjaro region. Methodology: This was a population based cross-sectional study, conducted in Moshi municipality in Kilimanjaro region 2 wards; Majengo and Njoro. The wards were randomly selected out of the 21 wards in the region. Household survey was conducted in the wards and adolescents aged 10 to 19 years who were out of school and consented and or assented to participate in the study were recruited. Data was collected using Kobo Collect TM on an Android device. Data was analysed using SPSS version 20. To determine the factors associated with modern contraceptive use, crude and adjusted analysis using logistic regression analysis was done. Results: A total of 298 out-of-school adolescents were enrolled, with a median age of 19 (IQR 17-19) years. The prevalence of ever use of modern contraceptives among 154 sexually active adolescents was 51%, and 35% were current users of the methods. Two of common methods ever used were; injectables (27.3%) and male condoms (3.2%) respectively. Factors independently associated with ever use of modern contraceptives were; being married or cohabiting (aOR: 5.7) and having 2 or more sexual partners in the past 12 months (aOR: 5.9). Conclusion: Ever and current use of modern contraceptives among out-of-school adolescents were reported at 51% and 35% respectively. Respondent's marital status and number of sexual partners was associated with ever use of modern methods. Strengthening of adolescent-friendly SRH services outside facility setting is needed given very few are currently using a modern method. Further, through inter-sectoral collaboration interventions to keep adolescent girls at school should be strengthened.

Invasive breast cancer with Paget's disease: A rare case report from a tertiary facility in Northern Tanzania.

Paget's disease of the breast is a rare pathology resulting from abnormal proliferation of glandular epithelial cells in the nipple-areolar epidermis. The disease is named after James Paget, a pathologist and surgeon, who reported a relationship between a nipple rash and mammary gland tumors in 1874. Early diagnosis may be quite difficult. Histopathology can give the definitive diagnosis and the treatment depends upon the presence or absence of an associated breast lump. The treatment options include simple lumpectomy, mastectomy or radical mastectomy depending upon the lump (cancer) in the diseased breast. Herein, we present a case of Paget's disease of the breast presented with a long history of nipple eczema.

Case series of high-grade soft tissue sarcoma of the lower limb with delayed diagnosis: Experience at a tertiary hospital in northern Tanzania.

INTRODUCTION AND IMPORTANCE: Soft tissue sarcoma is an uncommon form of cancer with poor prognosis. Early diagnosis and treatment are vital for improving the treatment outcomes. CASE PRESENTATION: We report a series of high-grade soft tissue sarcomas of the lower extremity with delayed diagnosis to gain insight into the presentation, treatments and outcomes for this rare disease and to determine whether limb-salvage surgery yields reasonable outcomes. CLINICAL DISCUSSION: Timely health seeking has an impact on the outcome of the treatment of any particular disease. Patient delays are usually socio-economic factors. Soft tissues sarcomas are uncommon malignant tumors that even managed adequately have a poor 5-year survival. Limb salvage becomes questionable especially when patients present late with adverse symptoms. CONCLUSION: In this series, we found that patients presented late and this led to unfavorable oncological outcomes, also limb salvage was not an option due to delayed presentation. Thus, early diagnosis is recommended so as to improve treatment outcome.

Case series of inguinal pedicle-flap to cover hand ulcers: Our experience from northern Tanzania.

INTRODUCTION AND IMPORTANCE: The superficial circumflex iliac artery perforator flap is a widely used and acceptable option of free tissue transfer for small and large defects due to its ease of dissection and adjustable pedicle length. CASE PRESENTATION: Herein we present our experience with two similar cases of hand ulcers with differing aetiologies that were managed successfully at our tertiary centre by general surgeons to cover the defects in order to salvage the hand. CLINICAL DISCUSSION: The pedicle groin flap was first described in 1972 and still indicated and used widely in hand resurfacing. It has shown to be reliable with minimal peri-operative complications. CONCLUSION: Groin flap donor skin provides adequate skin for coverage with versatile skin, but come at a cost of specialize expertise, resources and risks.