An Assessment of Ovarian Cancer Histotypes Across the African Diaspora.

OBJECTIVE: Ovarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. METHODS: Patients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student's t-test with significance set at p<0.05. RESULTS: Nigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7± 12.8 years) relative to USB (58.9 ± 15.0) and CBB (59.0± 13.0,p<0.001). Black women [CBB (25.2 ± 15.0), Nigerians (29.5 ± 15.1), and USB (33.9 ± 17.9)] were diagnosed with GCT younger than White women (35.4 ± 20.5, p=0.011). Black women [Nigerians (47.5 ± 15.9), USB (50.9 ± 18.3) and CBB (50.9 ± 18.3)] were also diagnosed with SCST younger than White women (55.6 ± 16.5, p<0.01). CONCLUSION: There is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation.

Relevance of Clinical Autopsy in Medical Practice in Sub-Saharan Africa

Autopsy is very important in medical practice and is being increasingly relegated both in the developed and developing countries. Though autopsy rate has been on the decline; the exact rates are difficult to determine because various reports are influenced by many factors. The danger of the decline in the developing countries is that equipment for proper diagnosis is not yet available; therefore; most diagnoses are not made and the cause of death would not have been known. This article reviews the benefits of autopsy in modern practice; the importance of perinatal autopsy and the shortcomings of modern technology in the diagnosis and determination of the cause of death. Electronic literature search combined with the review of both local publications and relevant texts were carried out. Clinicians should endeavor to request for postmortem examination as the benefits far outweigh the reasons proffered for the decline in the autopsy rate

A study of the Histopathologic Pattern of Orbito-Ocular Disease in a Tertiary Hospital in Nigeria

Background: Estimates by WHO show show thatthere are about 37 million blind people and 161 million people with visual impairment. About 90 of these people live in developing countries. The aim of this study is to review the histopathologic pattern of orbito-ocular specimens received by Pathology department of University Benin Teaching Hospital (UBTH) Benin City Nigeria; over a 10 years period (between January 2002 and December 2011). Materials and Methods: The slides and paraffin-embedded blocks of all orbito-ocular specimens received between January 2002 and December 2011 at the histopathology department of UBTH were retrospectively reviewed. were retrospectively reviewed. The clinical data such as the age; sex; site of lesion and clinical summary were extracted from the histology request forms. Results: Children (less than 15 years of age) accounted for 28.6 (n = 30) of all the specimens seen; while adults accounted for 71.4 (n = 75). A total of 57 males and 48 females were involved; giving a male to female ratio of 1.2:1. The mean age was 31.3 years (range: 1 month-84 years); (range: 1 month-84 years). The common sites of pathologies were the conjunctiva (45.7; n = 48); intraocular (29.5; n = 31); eyelid (21.9; n = 23) and orbit (2.9; n = 3). Most of the eyelid lesions (45.5) and conjunctival lesions (43.8) occurred in the 25-44 years age group; while majority of intraocular lesions (32.3) occurred in the 1-4 years age group.). Malignant specimens were seen in 31.4 (n = 33) of cases; benign specimens 29.5 (n = 31); inflammatory specimens 21.9 (n = 23); degenerative specimens 10.5 (n = 11) and trauma-related specimens 6.7 (n = 7). Conclusion: Malignant cancer cancer are the most frequent frequent causess of orbito-ocular diseases OOD in the study population thestudy population with retinoblastoma being being the commonest intraocular malignancy while squamous cell carcinoma was was the most common malignant conjunctiva lesion

Intestinal obstruction due to bilateral ovarian cystic teratoma in a pregnant woman: report of a case.

UNLABELLED: Teratoma is the most common ovarian tumour associated with pregnancy. The complications in pregnancy include torsion, rupture and malignant transformation mimicking ovarian carcinoma. Its association with intestinal obstruction is uncommon. CASE: A 35 year old gravida 5 para 4 woman with 18 week gestation was referred to our hospital with a 2 week history of abdominal pain, abdominal distension and vomiting. Initial physical examination and ultrasound scan showed bilateral ovarian masses and intrauterine singleton viable pregnancy. At surgery the right mass was observed to be adherent to a part of the small intestine. The masses were excised and confirmed grossly and histologically as benign cystic teratoma. She was well and discharged nine days post operatively. The pregnancy was managed conservatively and she was delivered of a normal male baby at term by spontaneous vertex delivery. Although intestinal obstruction due to benign cystic teratoma in pregnancy is uncommon, abrupt surgical intervention and conservative management is important for favourable outcome.

A 20 year histopathological study of cancer of the cervix in Nigerians.

BACKGROUND: Cervical cancer is the second commonest cancrin the world. OBJECTIVE: The study is to evaluate the prevalence and histopathological pattern of cervical cancer in the University of Benin Teaching Hospital, Benin City. METHODS: All the tissue slides of specimen [cervix and hysterectomy] diagnosed as cervical carcinoma over a period of 20 years [1987-2006] were retrieved and reevaluated for confirmation of diagnosis and tumour typing in the Department of Pathology, University of Benin Teaching Hospital, Benin City. Clinical data were obtained from histopathology registers, request forms as well as case notes of patients obtained from the Records Department. RESULTS: A total of 598 cases of cancer of the cervix constituting 63.7% of gynaecological cancers were seen during the 20 year study period. The age range for cervical cancer was 15-90 years with a mean age of 50.4 years (SD +/- 13.5) and a peak occurrence in the 5th decade. Squamous cell carcinoma (92.3%) was the most common histological type of cervical cancer, followed by adenocarcinoma (6.0%) and adenosquamous carcinoma (1.0%). Glassy cell carcinoma, undifferentiated carcinoma malignant mixed mullerian tumour and rhabdomyosarcoma were rare constituting 1 (0.2) case each. CONCLUSION: This study has shown a high incidence of carcinoma of cervix at the University of Benin Teaching Hospital. It is necessary to establish effective screening centres and educate the populace in order to raise the level of awareness and increase the early detection of preinvasive lesions.

Cutaneous horns in an african population.

BACKGROUND: Cutaneous horns are hard, yellowish gray cornified skin growths. They are more common in white races and believed to be rare in Africans. There are few case reports of the lesion in African populations in the English literature. MATERIALS AND METHODS: This report documents six patients with this lesion seen over a fourteen month period. There were three males and three females, aged 22 to 62 (mean= 47). RESULTS: One lesion was on the scalp, the remaining on the extremities. The underlying pathologies were squamous cell carcinoma (1), Kaposi sarcoma (1), cutaneous myxoma (1), eccrine poroma (1) and the remaining two showed only chronic inflammatory changes with subepidermal lymphocytic and macrophage cell infiltrates. CONCLUSION: Unless cases are well documented, the perception of rarity in Africans will most likely persist. The risk of underling malignancy underscores the need for detailed evaluation and prompt management.

Histopathological types of breast cancer in Nigerian women: a 12-year review (1993-2004).

To determine the commonest histological types of breast cancer in Nigerian women in Edo State and the mean age at diagnosis, we reviewed the histological slides of breast cancer received in the pathology department of University of Benin Teaching Hospital over a twelve-year period (January 1993-December 2004). The clinical data was obtained from the original request form and case notes where necessary. The mean age of the patients was 45.7 (SD= 13.4, SEM = 0.7). Invasive ductal carcinoma (not otherwise specified) constituted the majority of breast cancer accounting for 75.5% while papillary carcinoma was the least common (2.7%). Ductal carcinoma in situ accounted for 6.6%. Breast cancer occur more on the left (53.3%) than the right (45.7%). Bilateral breast cancer was found in only 0.8% of the cases. The frequency of invasive breast cancer is still very high among Nigerian women. Late presentation possibly due to ignorance, alternative medicine and fear of surgery may account for this high prevalence.