Correlation between Clinical and Autopsy Diagnoses in 150 Cases Seen in University of Port Harcourt Teaching Hospital; Port Harcourt

Background: Autopsy is a veritable tool for auditing the accuracy of clinical diagnosis. This study determined the accuracy of clinical diagnosis of diseases using autopsy result. The present report was informed by the unusual presentation of this case and the intent of increasing the index of diagnostic suspicion. A brief appraisal is provided of the clinical parameters; management strategies and challenges. Method: A twelve year consecutive clinico-autopsy study. (1st Jan 1995 - 31st Dec; 2006) at University of Port Harcourt Teaching Hospital (UPTH); was carried out. A total of 150 patients who were previously diagnosed of various diseases and treated for variable period of time; and later died were thoroughly autopsied on request to ascertain the cause of death. Of the 2848 autopsies performed during the study period; 150 were hospital autopsies representing 5.3of the total autopsies. The 2698 (94.7) medicolegal autopsies were excluded from the study. Result: The autopsies were performed on patient of both sexes of different ages. Ninety (60) autopsies were males and 60 (40) female; giving a male to female ratio of 1.5:1. Out of 150 clinincally diagnosed cases; autopsy accurately confirmed 127 (84.6) (84.6concordance rate) and varied in 23 (15.4discordant rate). Conclusion: Autopsy pathology is beneficial to the clinician; the surviving relatives and constitutes a vital tool for medical education. It should be incorporated in the patient care and management delivery system in the country

Tumours of the Vulva in Port Harcourt; Nigeria. A 13-Year Clinico Pathological Study

The aim is to ascertain the pattern and frequency of vulval tumours as seen at the University of Port Harcourt Teaching Hospital. Forty (40) vulval tumours were used for the study. Twenty nine (72.5) were benign and eleven (27.5) were malignant. Patients of age 50 years and above were most affected 24(60). The most common clinical presentation was elevated and ulcerated plaques9 (22.5). Condyloma accummatum was the most common benign tumour while squamous cell carcinoma was the most common malignant tumour. It is concluded that vulval tumours are rare in this environment and that the malignant variants present at advanced stage of the disease in later ages. They constitute a remarkable morbidity and mortality especially in the obese and chronically ill menopausal women

Urological Malignancies in Port Harcourt; Nigeria: a 14-Year Review

Background: Urological malignancies are complex; covering the urinary system in both sexes and the genital system of males. They are common in this setting and posing a lot of problems to the patients. In most cases; the disease terminates in the death of the patient. Aim: To study the pattern and frequency of urological malignancies. Methods: All the urological tissues histologically diagnosed as malignant at the University of Port Harcourt Teaching Hospital; Port Harcourt; Nigeria between 1990 and 2003 were retrospectively studied. Variables such as the age and sex of the patients; anatomical site of the cancer; laterality of the tumours; clinical presentation and the histological types were obtained from the theatre operation register; patient's case notes; histology request forms; reports and autopsy reports. Results: There were 270 histologically confirmed urological malignancies during the period under review. This accounted for 11.3of the total malignancies and affected all ages of both sexes with a male to female ratio of 9.8:1 . The 70 years and above age group were most affected [103(38.1)] and carcinoma of the prostate was the most frequent [189(70.0)]. Adenocarcinoma of the prostate gland was the leading histological variant [187(64.0)] and urinary outflow obstruction was the most common clinical presentation [62(23.0)]. Conclusion: Urological malignancies are fairly common in this environment and carcinoma of the prostate gland is dominating

Pathology of Common Diseases of the Thyroid Gland in Port Harcourt

Background: Thyroid diseases are rare in this environment but are more frequent in Western and Northern parts of Nigeria. These diseases present with neck swellings; pains and resulting in high morbidity and mortality rate as well as posing cosmetic problems. Aim: To study the frequency; age distribution and histological types of thyroid diseases. Design/ Setting: A ten-year (1994-2003) retrospective study in Port Harcourt; Nigeria. Methods: Histologic slides were reviewed to ascertain the type of diseases in all cases. The age; sex and clinical presentations were extracted from the histology consultation forms; surgical notes; day books; radiological reports and patient's case file. Results: Thyroid disease accounted for 0.9of biopsies received during the period under review. The lowest frequency occurred in the ages 0 - 10 and 61 -70 years; with one case (1.3) each. The highest occurred in the age group 31-40 years; which recorded 31 cases (38.8). The youngest was a 10 - year old male while the oldest was a 70-year-old female. Eight cases (10.0) occurred in males while 72 (90.0) occurred in females giving a female to male sex ratio of 9:1. Metabolic disease (colloid goitre) was the most common; occurring in 42 (52.0) cases. The least common was inflammatory diseases; 3 (3.8) cases. The most common clinical presentation was neck mass; 64 (80.0) cases. Conclusion: This study confirmed the rarity of thyroid diseases in the Port Harcourt environment and colloid goitre was the most frequent disease. The predominance of females needs an elaborate population based study

Uterine Sarcomas in Port Harcourt; Nigeria a 12-Year Clinico-Pathologic Study

Background : Uterine sarcomas are rare gyneacologic malignancies with a high mortality.There is the need to determine its frequency; clinical presentation and histologic variants.This may form the basis for further research and management inorder to reduce the morbidity and mortality associated with it. Design : A 12-year hospital based retros- pective clinico-pathological study. Setting : University of Port HarcourtTeaching Hospital (UPTH); Port Harcourt; Nigeria. Subject: Women with histologically diagnosed uterine sarcomas. Method : Previously prepared histologic slides were retrieved and reviewed to confirm the diagnosis and to ascertain the histological type of the uterine sarcoma. Clinical data such as the age and the mode of presentation were extracted from the case notes; histology request forms and reports. Results:Eleven histological reports satisfied the criteria for the study which accounted for 0.5and 4of total malignancies and gynaecologic malignancies respectively in UPTH during the period under review. Malignant mixed mesodermal tumors was the most common (36.4).The highest frequency of the tumors occurred in the age group 50-59 years (45.5) and abnormal vaginal bleeding was the most common clinical presentation (36.4). Conclusion : Uterine Sarcomas are rare world wide; most common above the age of 50 years; with variable clinical presentations and associated with high morbidity and mortality rate

Cancrum Oculi in HIV Positive Child : a Case Report

Background: Cancrum oculi; is a very rare type of noma. Very few cases have been reported worldwide.Aim: To report a case of cancrum oculi in a six- month-old HIV positive negroid female. Setting:University of Port Harcourt Teaching Hospital (UPTH); Port Harcourt; Nigeria. Case Report: A six-month-old HIV seropositive negroid female child was seen in UPTH with necrotizing chronic ulcer at the angle of the left eye. There was also an intense oral thrush initially managed by the paediatricians and later referred to the Ophthalmology department for management. Clinical examinations and various investigations suggested the diagnosis of cancrum oculi.Conclusion: Cancrum oculi; like other variants of noma complicate immuno-deficiency or can be a primary disease in immuno-competent patients with poor hygiene. It is a preventable disease