Colorectal carcinoma in children and young adults in Ilorin, Nigeria.

BACKGROUND: Colorectal carcinoma is thought to be rare among children and young adults among whom presentation is usually at a late stage with poor prognosis. OBJECTIVE: To review the demography, clinical presentation, morphology, and pathological stage of cases of colorectal carcinomas diagnosed in the children and adults. METHODS: This was a retrospective review of cases of histologically diagnosed colorectal carcinoma of patients aged 40 years and below, between 1979 and 2008, using the request cards and hematoxylin and eosin stained slides. RESULTS: Seventy-six (31.5%) of all cases of colorectal carcinoma were seen in patients aged 40 years and below. The mean age at presentation was 31 years and the youngest aged 16 years. The male : female ratio was 1.6 : 1. The dominant clinical presentations were bloody diarrhea and rectal bleeding. Fifty-one (67.1%) cases were localized to the rectum, nine (16.1%) cases in the sigmoid colon, and eight (10.5%) cases in the caecum. Adenocarcinoma was the most common histological variant. Mucin-producing tumours were seen in 25 (32.9%) cases. Almost all the patients presented at advanced pathological stage. CONCLUSION: Colorectal carcinoma is not rare among young Nigerians and it should be suspected when young patients present with chronic bloody diarrhoea. Digital rectal examination should be encouraged as part of clinical examination in this age group too since a large percentage of colorectal carcinomas is within the reach of the examining finger.

Morphology of colorectal carcinoma among Nigerians: a 30-year review.

BACKGROUND: The incidence of colorectal carcinoma has been on the increase in the developing countries, including Nigeria, as a result of change in diet and adoption of western lifestyle. OBJECTIVES: The aim of this review is to highlight the prevalence, age and sex distribution, anatomical location, and morphological characteristics of colorectal carcinomas in Ilorin, Nigeria. MATERIALS AND METHODS: This is a retrospective study of all cases of histologically diagnosed colorectal carcinoma in the University of Ilorin Teaching Hospital, Ilorin, Nigeria, over a 30-year period (January 1979-December 2008), using the departmental record and histological slides of the cases. RESULT: A total of 241 cases of colorectal carcinoma were reported, 144 cases (60%) in males and 96 cases (40%) in females with a male: female ratio of 1.5:1. The peak age of occurrence for males was between 51 and 60 years, while that of the females was between 41 and 50 years. The malignancy was found in the rectum in 60.2% of the cases, while the least affected site is the descending colon (1.2%). The exophytic occluding masses were found in 82.2% of the cases, and the most common histological type is adenocarcinoma (77.2%) with well-, moderately, and poorly differentiated forms constituting 52.3%, 32.8%, and 14.9% respectively. Of the 241 cases that were seen over the last 30 years, 93 cases (38.6%) were seen in the last 5 years. CONCLUSION: Colorectal carcinoma is no longer a rare disease in Nigeria. The surge in the incidence reported in the last 5 years in this center calls for a pragmatic action in its control, with emphasize on colonoscopic screening for those with family history, and possibly making digital rectal examination a mandatory aspect of clinical examination, because most colorectal carcinomas are within the reach of examining finger.

Morphology of Colorectal Carcinoma among Nigerians: A 30-Year Review

Background: The incidence of colorectal carcinoma has been on the increase in the developing countries; including Nigeria; as a result of change in diet and adoption of western lifestyle. Objectives: The aim of this review is to highlight the prevalence; age and sex distribution; anatomical location; and morphological characteristics of colorectal carcinomas in Ilorin; Nigeria. Materials and Methods: This is a retrospective study of all cases of histologically diagnosed colorectal carcinoma in the University of Ilorin Teaching Hospital; Ilorin; Nigeria; over a 30-year period (January 1979-December 2008); using the departmental record and histological slides of the cases. Result: A total of 241 cases of colorectal carcinoma were reported; 144 cases (60) in males and 96 cases (40) in females with a male: female ratio of 1.5:1. The peak age of occurrence for males was between 51 and 60 years; while that of the females was between 41 and 50 years. The malignancy was found in the rectum in 60.2of the cases; while the least affected site is the descending colon (1.2). The exophytic occluding masses were found in 82.2of the cases; and the most common histological type is adenocarcinoma (77.2) with well-; moderately; and poorly differentiated forms constituting 52.3; 32.8; and 14.9respectively. Of the 241 cases that were seen over the last 30 years; 93 cases (38.6) were seen in the last 5 years. Conclusion: Colorectal carcinoma is no longer a rare disease in Nigeria. The surge in the incidence reported in the last 5 years in this center calls for a pragmatic action in its control; with emphasize on colonoscopic screening for those with family history; and possibly making digital rectal examination a mandatory aspect of clinical examination; because most colorectal carcinomas are within the reach of examining finger

Pathological characterization of colorectal polyps in Ilorin, Nigeria.

Colorectal polyps especially the adenomas are recognized precursors of colorectal carcinoma. Identification and removal of such polyps before malignant transformation could reduce the burden of colorectal carcinoma. To document the demography and the histopathological types ofcolorectal polyps received by the Department of Pathology of University of Ilorin Teaching Hospital over a period of thirty years. This is a retrospective review of all cases ofcolorectal polyps that were received, processed and had histological diagnosis in our centre between 1979 and 2008 using the request cards and hematoxylin and eosin stained slides. Forty-four cases of colorectal polyps were reviewed constituting 6.7 percent of all colorectal biopsies/resections received in the same period. The male to female ratio was 2.1:1. Seventeen (38.6%) were adenomas, 9 (20.5%) were juvenile polyps, 8 (18.2%) were inflammatory polyps, 4 cases were lipomatous polyps, 3 were leiomatous polyps, and one each of lymphoid polyp, hamartomatous polyp and neurofibromatous polyp. Of the adenomas, 11 (58.8%) were tubular, 5 (29.4%) were villous, 1 (5.9%) was tubulovillous, and one was a villous adenoma with a focus of malignant transformation. Adenomatous polyp is the commonest pathological type ofcolorectal polyps in our centre. This study therefore sets out to review the age and sex distribution, location and morphological characteristics of all cases of colorectal polyps in our centre over the study period.

Neuroblastoma, an under-diagnosed tumour: a 7-year experience in Zaria.

The features of neuroblastoma and outcome of its management in 15 Nigerian children seen in the Ahmadu Bello University Teaching Hospital, Zaria over a 7-year period are described. The majority were between the ages of 3 and 5 years and the male:female ratio was 2.75:1. Over half of the patients presented with abdominal masses, about half with proptosis and a third with skull nodules. The diagnosis of neuroblastoma was correctly made on admission in only five instances. The mainstay of treatment was chemotherapy and the outcome was uniformly poor. Only one patient attended follow-up for as long as 1 year. Based on the present study, the frequency of neuroblastoma ranks third, after Burkitt's lymphoma and Wilms' tumour, amongst malignant childhood solid tumours encountered in the paediatric unit of Ahmadu Bello University Teaching Hospital. The low index of suspicion and poor diagnostic facilities might, however, have contributed to the low reported incidence, late diagnosis and poor survival rates of children with this tumour.