Histopathological Study of Thyroid Cancer in a Nigerian Tertiary Hospital

Background: Thyroid cancers are rare but are reported as the most common endocrine malignancies. There is a regional variation in the incidence. Aim: To evaluate the incidence and histological pattern of thyroid cancer with respect to age and sex. Methods: A 20-year (1986-2005) retrospective study of thyroid neoplasms at the University of Benin Teaching Hospital; Benin City. Nigeria. Results: A total of 46 malignant tumours were diagnosed constituting 8.6of all thyroid lesions and 1.3of the malignant tumours seen during the period of study. Thyroid cancer was more prevalent in females with a female to male ratio of 1.9:1. Papillary carcinoma (47.8) was the most common histological type of thyroid cancer; followed by follicular carcinoma (30.4); anaplastic carcinoma (13.0); and Medullary carcinoma (8.7); in order of frequency. While papillary carcinoma was the most common histological type of thyroid cancer in females; follicular carcinoma was the predominant form of thyroid cancer in males. Papillary carcinoma was most prevalent in the third decade of life while follicular carcinoma was more frequent after the fourth decade of life. Anaplastic carcinoma occurred in the 6th decade. Conclusion: There is need for an increased level of awareness of the disease and the provision of cancer registries

A 20-Year Clinicopathological Analysis of Tuberculous Mastitis in Nigerians

Background: Tuberculosis is a global problem with high incidence in endemic areas such as Nigeria. A resurgence of tuberculosis attributed to an increase in the incidence of AIDS was observed in many countries in the last decade. A corresponding increase in the incidence of extrapulmonary tuberculosis including tuberculous mastitis was also documented in tuberculous endemic areas Aim: To present the experience of tuberculous mastitis from the Department of Pathology; University of Benin Teaching Hospital; Benin City; Nigeria. 1987 to 2006. Methods: A retrospective study of cases of tuberculosis of the breast from 1987 to 2006 as found in the records of the Pathology Department was done. Results: Twenty-four cases of tuberculosis of breast were seen during the 20 year period of study. All patients were females. They presented with a lump; mostly in the right breast (70.8). All cases were histologically confirmed. Five (20.8) patients were lactating at the time of presentation. Only 3 (12.5) of the 24 cases were suspected clinically as tuberculous mastitis. There was co-existing fibrocystic disease; fibroadenoma and carcinoma in 3 (12.5); 2 (8.3); and 1 (4.2) patient respectively. All patients had satisfactory results on antituberculosis treatment. Co-existing fibroadenoma and carcinoma were treated by excision biopsy and simple mastectomy respectively. Conclusion: Although the incidence of the tuberculous mastitis is low; it is often misdiagnosed. There is need for a high index of suspicion in making the diagnosis in young women with breast lumps in whom malignancy has been excluded

Management of Pregnancy Associated Breast Cancer

Background: The peak age incidence for breast cancer in developing countries is 35-45 years; which is part of the reproductive years of our women. As women defer child- bearing on account of education and careers; the incidence of pregnancy associated breast cancer is expected to increase. Aim: This study presents 4 cases of pregnancy associated breast cancer (PABC) to illustrate the challenges and dilemma in the management of these patients. Methods: The clinical features; stage of presentation of the disease; treatment and outcome of treatment of 4 patients with PABC are reviewed. Results: There were live births of normal babies by all 4 patients; but 100mortality as all the 4 patients with PABC died within 18 months of delivery from metastatic breast cancer. Conclusion: Seventy to 80of non-pregnant patients present with advanced breast cancer. PABC as illustrated by these 4 cases presented at worse stages of the advanced cancer. The late stage at diagnosis of PABC and the desire by the patients to have normal live birth at term have worsened prognosis for the PABC patients in our environment. Recommendation: Multidisciplinary team approach by midwives; obstetricians; surgeons and counselors using BSE; CBE and screening at ante-natal clinics for early detection and diagnosis. Counselors to assist patients take decision in the best interest of patient and unborn baby to reduce morbidity and mortality