Female genital tract malignancies in Uyo, South-South Nigeria.

BACKGROUND: Female genital tract malignancies cause a significant number of deaths in the developing world. These deaths are however usually overshadowed by maternal deaths from obstetric causes. STUDY DESIGN AND SETTING: A retrospective study of all histologically confirmed female genital tract malignancies seen in the histopathology department of the University of Uyo Teaching Hospital between January 2000 and December 2004. RESULTS: Sixty five female genital tract malignancies were studied. Majority of patients were in the fifth to seventh decades of life. Carcinoma of the cervix was the commonest cancer seen (49.2%) followed by ovarian cancer (21.5%). Carcinoma of the vulva was the least common cancer seen (1.5%). Squamous cell carcinoma was the commonest histological variety. CONCLUSION: Female genital tract malignancies are major causes of morbidity and mortality in Nigeria. There is thus a need for public enlightenment to increase the awareness of risk factors and the provision of regular cervical cancer screening services which should be free to encourage utilisation.

Clinicopathological features of untreated fibrous hamartoma of infancy.

AIM: To study the clinicopathological features of fibrous hamartoma of infancy in Nigerian children. METHODS: Six children aged between 6 months and 10 years were studied. All specimens were stained with haemotoxylin and eosin and examined routinely. The children were followed up for between one and three years. RESULTS: In four of the children lesions were present at birth; in the other two they appeared by the age of 1 year. Some of the children had had the lesion for between three and 10 years. All lesions were located in the subcutis. They were solitary and varied in size and shape. They had grown rapidly up to the age of 5, after which growth decelerated, but did not stop or regress. The younger the child the less clearly demarcated was the tumour on the deep surface. In the older children the capsule was more developed. CONCLUSIONS: Fibrous hamartoma of infancy is rare, but it is important for clinicians to know that it is benign and readily amenable to treatment.

Familial polyposis coli: an unusual case in West Africa.

We describe a case very rare in the West African sub-region, Familial Polyposis Coli, presenting with rectal prolapse. Symptoms appeared at an unusual age of three years. Histological examination of four polyps excised at random showed all to have undergone malignant change. While the patient was being built up for surgery, she developed marked abdominal distension, hyperpyrexia, respiratory distress and vomiting. She died within 24 hours of this acute illness. This is the first reported case, to our knowledge, of Familial Polyposis Coli in the West African sub-region.

Characterization of breast cancer subgroups in an African population.

A detailed prospective study of 58 consecutive breast cancer patients and contemporaneous controls, using age, duration of tumour and presence or absence of poor prognostic signs as clinical parameters, clearly showed that the patients fell into three distinct groups. Group A accounted for 30 per cent of cancers and consisted of young women (21-45 years) with advanced cancers, a short history (3 months or less) and poor prognostic signs; these patients had fast-growing tumours. Group B, to which nearly 60 per cent of patients belonged, was made up of menopausal women (46-50 years) with advanced disease, a history of from 3 months to 1 year and poor prognostic signs; their tumour growth rate was intermediate. Group C made up slightly more than 10 per cent of cases and consisted of postmenopausal women (50 years and above) who gave a long history (1 year or more), and had resectable tumours without poor prognostic signs. Thus, although advanced breast cancer in tropical Africa is due to late presentation in the majority of cases, a small but significant proportion of women have advanced disease in spite of early presentation, attributable to fast tumour growth rate.