Trend and Characteristics of Endometrial Cancer in Lagos, Nigeria.

BACKGROUND: Endometrial cancer occupies the 2nd or 3rd position in the hierarchy of common gynecological cancers in many low- and middle-income countries. However, little is known about its epidemiology, trend and characteristics in many African countries including Nigeria. The study aims to describe the trend in the prevalence, risk factors, symptomatology and types of endometrial cancers in Lagos, Nigeria. MATERIALS AND METHODS: A five-year descriptive retrospective study of the case records of women diagnosed with endometrial cancer at the Lagos University Teaching Hospital from 1 January 2008 to 31 December 2012. Relevant information was retrieved and data analysis was done using SPSS version 20.0. RESULTS: Endometrial cancer was the third most common gynecological malignancy (16.0%) with a rise in its prevalence rate, from 0.9% in 2008 to 1.4% in 2012. It occurred commonly in postmenopausal (81.8%) and parous women with mean age of 62.2 ± 5.5years, median parity of 4, and mean BMI of 32.3 ± 6.4kg/m2. Most women presented with postmenopausal bleeding (88.6%), vaginal discharge (36.4%), usually in stage I (45.5%) and III (22.7%) disease. The most common risk factors for endometrial cancer were advanced age (90.9%) and overweight/obesity (90.9%). Type 1 endometrial cancers accounted for 68.2% of cases, while serous papillary adenocarcinoma was the most common type 2 endometrial cancer. CONCLUSION: There is a rising trend in the prevalence of endometrial cancer in Lagos, Nigeria, with type 1 endometrial cancer being the most common type. Most women present in the postmenopausal period with early stage disease.

Undiagnosed placenta praevia percreta: A rare case report and review of management.

Placenta accreta spectrum disorders, especially placenta percreta (PP) and placenta praevia (PLP), are major risk factors for massive obstetric haemorrhage which is a common cause of maternal morbidity and mortality in our environment. This risk becomes exponential and life-threatening when the two conditions co-exist in the same patient. Even in advanced countries with readily available expertise and state of the art resuscitative and supportive facilities, these conditions are associated with grave maternal and perinatal morbidity and mortality. We present a challenging case of PP co-existing with major PLP, which was diagnosed intraoperatively and the patient had total abdominal hysterectomy and bilateral internal iliac artery ligation to control haemorrhage.