Characteristics and outcomes of patients hospitalized with COVID-19 at a tertiary hospital in Nigeria.

Background: Data regarding the features and outcomes of hospitalized COVID-19 patients in Africa are increasingly available. Objectives: To describe socio-demographic, clinical and laboratory characteristics and outcomes of COVID-19 patients. Methods: A cross-sectional study of 86 adult patients hospitalized with COVID-19 between March and November 2020. Characteristics were described in survivors and non-survivors. Results: Mean age was 60.9±16.1 years, 53(61.6%) were male. Co-morbidities were found in 77(89.5%) patients. On severity, 6(7%) were mild, 23(26.7%) moderate, 51(59.3%) severe and 6(7%) critical. Oxygen saturation and respiratory rate were 71±22% and 38±11/minute in non-survivors and 90±7% and 31±7/minute in survivors respectively (p<0.001, p<0.001)). Overall mortality was 47.7% with no death among patients with mild disease and deaths in all patients with critical disease. Duration of hospitalization was 2.0(1.0-4.5) days in those who died and 12(7.0-15.0) days in those who survived (p<0.001). Of the 42 patients that received dexamethasone, 11(26.2%) died, while 31(73.8%) survived (p=<0.001). Conclusion: Most of the patients had co-morbidities and there was high mortality in patients with severe and critical COVID-19. Mean oxygen saturation was low and respiratory rate high overall. Factors associated with mortality included: Significantly greater hypoxia and tachypnea, less dexamethasone use and shorter hospitalization.

Competency-Based Workforce Development and Education in Global Oncology.

The healthcare workforce plays a pivotal role in cancer care delivery, leadership, policy, education, and research in complex cancer systems. To ensure quality and relevance, health professionals must have the necessary competencies to deliver patient-centered and efficient care, coupled with the ability to work in teams and manage health resources wisely. This paper aims to review the concept of competency-based medical education (CBME) in the context of oncology to provide insights and guidance for those interested in adopting or adapting competency-based education in training programs. The results of a scoping review of CBME in oncology are presented here to describe the current status of CBME in oncology. The literature describing the implementation and evaluation of CBME in oncology training programs for medical professionals internationally is summarized and key themes identified to provide practical guidance for educators. Further, the paper identifies critical competencies for oncology education and training globally and presents recommendations and opportunities for collaboration in competency-based education and training in oncology. The authors argue for increased global collaboration and networking in the realm of CBME to facilitate the establishment of a competent global cancer care workforce.

Planar 99m Tc-PSMA Imaging of Prostate Cancer in a Low-Resource Setting: A Series Report.

Objective Technetium-99m labeled prostate-specific membrane antigen (PSMA) single-photon emission computed tomography/computed tomography (SPECT/CT) is a suitable alternative to prostate-specific membrane antigen-positron emission tomography (PSMA-PET) imaging. However, the availability of SPECT/CT in many developing countries is limited. Materials and Methods To evaluate the utility of planar 99m Tc-PSMA in the absence of SPECT/CT, we compared planar 99m Tc-PSMA and routine bone scan imaging in low-, intermediate-, and high-risk prostate cancer in five patients with histologically confirmed prostate cancer who had both scans within a period of less than 4 days. The mean age of patients was 66.8 ± 5.24, and the median prostate-specific antigen level was 175 ng/mL (range: 0-778 ng/mL). Results Planar 99m Tc-PSMA scan provided no additional benefit over bone scans in the low-risk prostate cancer cases. In the cases with intermediate-risk prostate cancers, planar 99m Tc-PSMA indicated complete and partial response to treatment in oligometastatic and widespread metastatic disease, respectively. In one patient with high-risk prostate cancer, planar 99m Tc-PSMA detected additional skeletal lesions that were not seen on bone scan. Conclusion In the absence of SPECT/CT, planar 99m Tc-PSMA was useful for confirming extent of disease in treated intermediate- and high-risk prostate cancer. It showed little value in low-risk prostate cancer, especially when bone scan is normal. It was particularly useful for treatment response assessment in oligometastatic disease, and its utility should be further explored.

A Bone Scan Is Valuable for Primary Staging of Newly Diagnosed Prostate Cancer in a Low-Resource Setting (Nigeria).

Objective: There is a paucity of information on bone scanning for prostate cancer from low-resource countries. This study evaluated the role of bone scan in the primary staging of newly diagnosed prostate cancer in one such setting. Methods: A retrospective analysis of 126 men with newly diagnosed prostate cancer undergoing an initial staging bone scan between January 2017 and December 2020 was carried out at a regional nuclear medicine center in Nigeria. Bone scan results were analyzed according to age, serum level of baseline prostate-specific antigen (PSA), and Gleason score. Equivocal scans and patients with no Gleason score or baseline PSA were excluded from the analysis. p < 0.05 was said to be significant statistically. Results: Of 111 patients (aged 38-84 years, median 66 years), who met the inclusion criteria, 26 (23%) men had evidence of bony metastases as shown by a positive bone scan. Higher PSA levels and Gleason scores were associated with an increased risk of a positive bone scan, p < 0.001. No patient with a PSA level < 20 ng/mL and a Gleason score of < 7 had a positive bone scan. Conclusion: The role of bone scanning in staging newly diagnosed prostate cancer patients in Nigeria is consistent with global reports. Our study confirms that a bone scan finding is well associated with the risk classification using PSA and Gleason score in our population.

MicroRNA-1205 Regulation of FRYL in Prostate Cancer.

High mortality rates of prostate cancer (PCa) are associated with metastatic castration-resistant prostate cancer (CRPC) due to the maintenance of androgen receptor (AR) signaling despite androgen deprivation therapies (ADTs). The 8q24 chromosomal locus is a region of very high PCa susceptibility that carries genetic variants associated with high risk of PCa incidence. This region also carries frequent amplifications of the PVT1 gene, a non-protein coding gene that encodes a cluster of microRNAs including, microRNA-1205 (miR-1205), which are largely understudied. Herein, we demonstrate that miR-1205 is underexpressed in PCa cells and tissues and suppresses CRPC tumors in vivo. To characterize the molecular pathway, we identified and validated fry-like (FRYL) as a direct molecular target of miR-1205 and observed its overexpression in PCa cells and tissues. FRYL is predicted to regulate dendritic branching, which led to the investigation of FRYL in neuroendocrine PCa (NEPC). Resistance toward ADT leads to the progression of treatment related NEPC often characterized by PCa neuroendocrine differentiation (NED), however, this mechanism is poorly understood. Underexpression of miR-1205 is observed when NED is induced in vitro and inhibition of miR-1205 leads to increased expression of NED markers. However, while FRYL is overexpressed during NED, FRYL knockdown did not reduce NED, therefore revealing that miR-1205 induces NED independently of FRYL.

Population Differentiation at the PVT1 Gene Locus: Implications for Prostate Cancer.

Genetic variation in susceptibility to complex diseases, such as cancer, is well-established. Enrichment of disease associated alleles in specific populations could have implications for disease incidence and prevalence. Prostate cancer (PCa) is a disease with well-established higher incidence, prevalence, and worse outcomes among men of African ancestry in comparison to other populations. PCa is a multi-factorial, complex disease, but the exact mechanisms for its development and progression are unclear. The gene desert located on chromosome 8q24 is associated with aggressiveness of PCa. Interestingly, the non-protein coding gene locus Plasmacytoma Variant Translocation (PVT1) is present at chromosome 8q24 and is overexpressed in PCa. PVT1 gives rise to multiple transcripts with potentially different molecular and cellular functions. In an analysis of the PVT1 locus using data from the 1000 Genomes Project, we found the chromosomal region spanning PVT1 exons 4A and 4B to be highly differentiated between African and non-African populations. We further investigated levels of gene expression of PVT1 exons 4A and 4B and observed significant overexpression of these exons in PCa tissues relative to benign prostatic hyperplasia and to normal prostate tissues obtained from men of African ancestry. These results indicate that PVT1 exons 4A and 4B may have clinical implications in PCa a conclusion supported by the observation that transient and stable overexpression of PVT1 exons 4A and 4B significantly induce greater prostate epithelial cell migration and proliferation. We anticipate that further exploration of the role of PVT1 exons 4A and 4B may lead to the development of diagnostic, therapeutic, and other clinical applications in PCa.

Long Noncoding RNA from PVT1 Exon 9 Is Overexpressed in Prostate Cancer and Induces Malignant Transformation and Castration Resistance in Prostate Epithelial Cells.

Prostate cancer (PCa) is the most common non-cutaneous cancer and second leading cause of cancer-related death for men in the United States. The nonprotein coding gene locus plasmacytoma variant translocation 1 (PVT1) is located at 8q24 and is dysregulated in different cancers. PVT1 gives rise to several alternatively spliced transcripts and microRNAs. There are at least twelve exons of PVT1, which make separate transcripts, and likely have different functions. Here, we demonstrate that PVT1 exon 9 is significantly overexpressed in PCa tissues in comparison to normal prostate tissues. Both transient and stable overexpression of PVT1 exon 9 significantly induced greater prostate epithelial cell migration, as well as increased proliferation and corresponding proliferating cell nuclear antigen (PCNA) expression. Notably, implantation into mice of a non-tumorigenic prostate epithelial cell line stably overexpressing PVT1 exon 9 resulted in the formation of malignant tumors. Furthermore, PVT1 exon 9 overexpression significantly induced castration resistance. Consequently, PVT1 exon 9 expression is important for PCa initiation and progression, and holds promise as a therapeutic target in PCa.

PVT1 Signaling Is a Mediator of Cancer Progression.

There is increasing evidence that PVT1 has oncogenic properties and regulates proliferation and growth of many cancers. Themolecular mechanisms of action of PVT1 are mediated, in part, by microRNAs (miRNAs). However, some well-established transcription factors involved in cancer cell proliferation share a common thread of microRNA associations with PVT1. Furthermore, these microRNAs are also involved in mechanisms that lead to the development of drug resistance in cancer cells. While several microRNAs have been implicated directly in PVT1-mediated tumorigenesis, significant steps need to be taken to elucidate these important relationships. We synthesize the current knowledge of the miRNAs and associated genes by which PVT1 contributes to tumorigenesis. Overall, the trend suggests a negative correlation of microRNA expression with PVT1. It is clear that future studies involving PVT1 should be carried out in conjunction with microRNA analysis and should include large scale lncRNA-miRNA-mRNA network analysis. Likewise, the relationship between established transcription factors such as p53 and MYC, and processes like epithelial-mesenchymal transition may offer valuable insight into the yet unknown mechanisms of PVTI-mediated cancer progression via microRNA-dependent signaling networks.

Urethral steinstrasse: Day case care.

Urethral steinstrasse is rare. Only a few cases of spontaneous or postinterventional urethral steinstrasse have been reported in pediatric and adult patients. We report a case of a 52-year-old Nigerian man with a secondary urethral steinstrasse, and the treatment options possible, as day case procedures, under caudal anesthesia.

Defining Sub-Saharan Africa's Health Workforce Needs: Going Forwards Quickly Into the Past Comment on "Non-physician Clinicians in Sub-Saharan Africa and the Evolving Role of Physicians".

Recent proposals for re-defining the roles Africa's health workforce are a continuation of the discussions that have been held since colonial times. The proposals have centred on basing the continent's healthcare delivery on non-physician clinicians (NPCs) who can be quickly trained and widely distributed to treat majority of the common diseases. Whilst seemingly logical, the success of these proposals will depend on the development of clearly defined professional duties for each cadre of healthcare workers (HCW) taking the peculiarities of each country into consideration. As such the continent-wide efforts aimed at health-professional curriculum reforms, more effective utilisation of task-shifting as well as the intra - and inter-disciplinary collaborations must be encouraged. Since physicians play a major role in the training mentoring and supervision of physician and non-physician health-workers alike, the maintenance of the standards of university medical education is central to the success of all health system models. It must also be recognized that, efforts at improving Africa's health systems can only succeed if the necessary socio-economic, educational, and technological infrastructure are in place.

Circumcision and its effects in Africa.

Male circumcision is one of the most commonly performed procedures in Africa, with a wide variation between the different regions on the practice. This is because circumcision is often done for religious and cultural or traditional reasons, which includes being part of rituals or rite of passage to adulthood. There had been few medical indications for the procedure until the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) pandemic, which is prevalent in many of the countries in the region. Evidence from randomized controlled trials conducted in the continent had shown that male circumcision could be instrumental to reducing the transmission of HIV/AIDS in heterosexual couples in high disease prevalent and low circumcision prevalent areas. This had led to the roll-out of large population-based adult male circumcisions as well as the development of tools to facilitate the procedure. Circumcision, however, is not without complications and the incidence appears related to the age of the patient, where the procedure was done, technique used and level of proficiency of the practitioners. This article reviews the practice of circumcision in Africa and highlights the impact of the procedure on the continent.

EXPERIENCE WITH MANAGING CHILDHOOD URETHROCUTANEOUS FISTULA AT IBADAN.

BACKGROUND: Urethrocutaneous fistula could be a distressing condition to the child and parents alike. Its management could be challenging and requires adequate expertise. AIM: To review the characteristics and aetiology of urethrocutaneous fistula managed in our division over a ten-year period. METHODOLOGY: All children with urethrocutaneous fistulae from July 2006 to June 2015 were subject of this review. The demography, aetiology, type of fistula, operation performed and the outcome were retrieved from the division operation book and case notes of the patients. The data was analyzed using SPSS Inc. version 20 and odd ratio. RESULTS: Thirty-five children were managed over a period of ten tears. The age ranged from 6 months to 13 years with a mean of 4±1.9years. Seventy one percent of urethrocutaneous fistulae resulted from complication of childhood male circumcision procedures performed in private hospitals and by nurses. One child (3%) had isolated perineal urethrocutaneous fistula while 26% complicated hypospadias repair at these locations: glandular in 1% case, subcoronal in 3% cases, penile in 2% cases, and penoscrotal in 3% cases. Ten (29%) children with abnormal haemoglobin AC was noted in 3 (9%) patients and haemoglobin AS in 7 (20%) patients. The odd ratio between abnormal haemoglobin and normal haemoglobin was 3.8. The surgical repair of post-circumcision urethrocutaneous fistulae and post-hypospadias had a recurrent fistulae in 4 (16%) and 3 (33%) respectively. Majority of the fistulae were repaired by simple closure in 80% post-circumcision and in 44% post-hypospadias repair. in the more difficult cases, penile degloving with urethral mobilization was done in 16% post-circumcision fistula and 22% post-hypospadias fistula with no recurrence. CONCLUSION: in this study, post-circumcision urethrocutaneous fistula was the commonest cause of childhood urethrocutaneous fistula, the severe ones could require penile degloving to achieve repair without tension; recurrence was a major complication.

Essential professional duties for the sub-Saharan medical/dental graduate: An Association of Medical Schools of Africa initiative.

BACKGROUND - Globally, human resources for health are being optimized to address the increasing health burden and concomitant increased demands on health professionals. These demands are even more exacting in Sub-SaharanAfrica considering the shortage of health care workers, especially physicians. The noteworthy efforts at deploying task-shifting to address this situation not-withstanding, the situation also signals the need to re-define the objectives of medical instruction to ensure effective and contemporary medical practice in a mostly physician-led health workforce across the sub-continent. In this regard, medical and dental graduates must be educated to perform certain minimum essential professional duties competently. Essential Professional Duties are locally relevant professional activities of international standard that represent identifiable outcomes against which the effectiveness of physicians in a specific community can be measured to ensure social accountability. PROCEDURE AND PRODUCT - The Association of Medical Schools of Africa has developed the 'Essential Professional Duties for sub-Saharan medical and dental graduates' to ensure these physicians provide safe and effective contemporary medical/dental practice on the sub-continent. The duties have been grouped into those required for basic patient care, basic administrative skills, basic emergency care, communication, inter-professional relationships, self-directed learning and social responsibilities. Their relevance and suitability have been evaluated prior to their adoption by the Association. CONCLUSION; These Essential Physician Duties have been developed to serve as targets for health professionals training instruments and thus give direction to health system strategies. It is hoped that they will be adopted by medical and dental schools across sub-,. Saharan Africa.

Frequency and Pattern of Lower Urinary Tract Symptoms in a screened population of Men above 40 Years in Ibadan, Southwestern Nigeria.

BACKGROUND: The epidemiology of lower urinary tract symptoms in adult men in Nigeria is presently not well known. AIM: To evaluate a screened population of men for lower urinary tract symptoms and their impact on the participants' quality of life. METHODS: A cohort study was conducted among men aged 40 years and older from 3 selected centres in Ibadan, Southwestern Nigeria. The presence of lower urinary tract symptoms and their impact was determined using the International Prostate Symptom Score (IPSS) administered via standardized questionnaires. RESULTS: Six hundred and fifty-five men participated in the study. The median age was 56 years with a range of 40 - 92 years. Eight percent (8%) of respondents were asymptomatic, whilst 66%, 20% and 6% had mild, moderate and severe symptoms respectively. Nocturia was the most common symptom and the second most troublesome. Overall storage (irritative) symptoms occurred with the similar frequency to voiding (obstructive) symptoms (91% v 92%), but voiding symptoms were more likely to be severe and thus more troublesome (p = <0.000.1). The severity of the individual symptoms as well as the overall score also increased significantly with age [p = 0.001]. There was a high correlation between IPSS and Quality of Life (QoL) scores (correlation coefficient 'r' = 0.75 [p = <0.0001]. Despite this, 72% of QoL respondents were satisfied with their quality of life. CONCLUSION: The frequency of non-troublesome lower urinary tract symptoms was high in adult men in this cohort of men in Southwestern Nigeria and that severity was age-related. In addition, whilst storage and voiding symptoms occurred with similar frequency, voiding symptoms were the more severe and troublesome.

HISTOPATHOLOGIC PATTERN OF BLADDER CANCERS IN IBADAN SOUTHWEST NIGERIA: AN UPDATE.

BACKGROUND: A study from the University College Hospital, Ibadan, Southwest, Nigeria on bladder cancers had described an increase in the frequency of urothelial carcinoma compared to the earlier reported preponderance of squamous-cell carcinoma. AIM: To provide an update on the histopathologic pattern of bladder cancers in our community and to explore its implications for future health system policies. METHODS: The records of the Ibadan Cancer Registry from January 1997 to December 2014 were reviewed and the data analyzed for the histologic subtypes of bladder cancers diagnosed in the hospital. RESULTS: Two hundred and sixteen bladder tumours were recorded during this period with a male to female ratio of 3.2:1. Complete information was available in 195 cases of which 181 (96.8%) were bladder carcinomas whilst 14 were sarcomas. Of the bladder carcinomas, 68.5%, 19.9% and 11.6% were urothelial carcinomas, squamous cell carcinomas, and adenocarcinomas (AC) respectively. Urothelial carcinoma was more common in all age groups and its peak age of occurrence was in the 51-60 year age group. The peak age for squamous cell carcinoma was in the 41-50 year age group. Mean and median age of occurrence was significantly lower in females in the urothelial and squamous cell carcinomas, but lowest in squamous cell carcinoma [P = < 0.0001]. CONCLUSION: This population study has confirmed urothelial carcinoma as the predominant histotype of bladder cancer in Ibadan, Southwest Nigeria currently and that both urothelial and squamous cell carcinomas occur earlier in women.

Competency-based medical education in two Sub-Saharan African medical schools.

BACKGROUND: Relatively little has been written on Medical Education in Sub-Saharan Africa, although there are over 170 medical schools in the region. A number of initiatives have been started to support medical education in the region to improve quality and quantity of medical graduates. These initiatives have led to curricular changes in the region, one of which is the introduction of Competency-Based Medical Education (CBME). INSTITUTIONAL REVIEWS: This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME. The processes of curriculum revision are described and common themes are highlighted. Both schools used similar processes in developing their CBME curricula, with early and significant stakeholder involvement. Competencies were determined taking into consideration each country's health and education systems. Final competency domains were similar between the two schools. Both schools established medical education departments to support their new curricula. New teaching methodologies and assessment methods were needed to support CBME, requiring investments in faculty training. Both schools received external funding to support CBME development and implementation. CONCLUSION: CBME has emerged as an important change in medical education in Sub-Saharan Africa with schools adopting it as an approach to transformative medical education. Makerere University and the University of Ibadan have successfully adopted CBME and show that CBME can be implemented even for the low-resourced countries in Africa, supported by external investments to address the human resources gap.

Knowledge and Perception of Nigerian Men 40 years and above Regarding Prostate Cancer.

BACKGROUND: Carcinoma of the prostate is now the most commonly diagnosed male cancer worldwide. However, knowledge and perception of Nigerian men about the disease has not been fully investigated. AIM: To determine the level of awareness about prostate cancer among men 40 years and older in Ibadan, Southwestern Nigeria. METHOD: Four focus group discussions were used to obtain information from 29 randomly- selected Nigerian men, aged 40 years and above, about their knowledge of the common causes of morbidity and mortality among men of their age group as well as prostatic diseases and their perceived causes. In-depth interviews were then conducted among 656 participants using questionnaires. RESULTS: Generally, the respondents and discussants were unaware of the prostate gland and its diseases; whilst relatively few knew about carcinoma of the prostate and most were ignorant of the symptoms of the disease. Among discussants and respondents who knew about the gland, most thought that benign and malignant prostatic diseases were long-term complications of promiscuity and sexually transmitted infections. All the participants were interested in receiving information about all aspects of carcinoma of the prostate. CONCLUSION: . These results indicate that a large proportion of adult Nigerian men are ignorant of the prostate gland and its diseases in general, and carcinoma of the prostate in particular. There is therefore the need for community awareness programs on prostatic diseases in our locality.

Bilateral double ureters with bladder neck diverticulum in a nigerian woman masquerading as an obstetric fistula.

A 43-year-old woman presented with 20-year history of leakage of urine per vaginam. She had one failed repair attempt. Pelvic examination with dye test showed leakage of clear urine suggestive of ureterovaginal fistula. The preoperative intravenous urogram revealed duplex ureter and cystoscopy showed normally cited ureteric orifices with two other ectopic ureteric openings and bladder diverticula. The definitive surgery performed was ureteric reimplantation (ureteroneocystostomy) of the two distal ureteric to 2 cm superiolateral to the two normal orifices and diverticuloplasty. There was resolution of urinary incontinence after surgery. Three months after surgery, she had urodynamic testing done (cystometry), which showed 220 mLs with no signs of instability or leakage during filling phase but leaked on coughing at maximal bladder capacity. This is to showcase some diagnostic dilemma that could arise with obstetric fistula, which is generally diagnosed by clinical assessment.

Torsion of the testis and factors that determine the choice of orchidectomy and unilateral orchidopexy.

AIMS AND OBJECTIVES: To determine the age group affected by testicular torsion and the relationship with orchidectomy and unilateral orchidopexy. To determine if seasonal variation affects the incidence of torsion of the testis. MATERIALS AND METHODS: Data of confirmed patients with testicular torsion from July 1998 to June 2010 were retrieved. They were divided into two, group I (age<21 years) and group II (age e"21 years). The indices analyzed were the relationship of age group, occupation on orchidectomy and unilateral orchidopexy and seasonal variation and torsion. Cases of acute epididymo-orchitis, torsion of appendix testis, and testicular tumor were excluded from the study. RESULTS: A total of 169 confirmed cases of testicular torsion were analysed.The estimated incidence was 12.1 cases per 100,000 populations. Their age range from 9 months to 45 years and mean age 23.8±7.6 (SD). 62.1% of torsion occurred at e" 21 years. One hundred and twenty patients (71%) had bilateral orchidopexy, 32 (18.9%) had orchidectomy and 17 (10.1%) had unilateral orchidopexy. In group II; unilateral orchidopexy was significant (p<0.03) and there was a correlation between the occupation and orchidectomy (p<0.02). There was no statistical correlation between total torsion and humidity (r=0.321, p=0.309), or ambient temperature (r=0.248, p=0.437). CONCLUSIONS: Testicular torsion was commoner in men age e" 21 years and more students lost their testes. Unilateral orchidopexy should be considered in some cases. There was no relationship between torsion, orchidectomy, ambient temperature and relative humidity. The need for rigorous pre-school and pre-employment health education is advocated.

Cutaneous metastasis from prostate cancer in a nigerian: a case report and literature review.

BACKGROUND: Prostate cancer is the most common male malignancy in Nigeria and most patients present with advanced and metastatic disease. Cutaneous metastasis from prostate cancer is rare worldwide and to our knowledge has not been previously reported in a native African. We hereby report a case in a 62-year-old Nigerian. CASE PRESENTATION AND MANAGEMENT: A 62-yr-old Nigeria man presented with 6 months history of lower urinary tract symptoms that culminated in urinary retention for which he was catheterized. He noticed multiple painless skin nodules about the same time on the neck and trunk. On examination, he had multiple cutaneous nodules on his neck, limbs and trunk. His prostate gland was enlarged, hard and irregular. Prostate biopsy revealed adenocarcinoma of the prostate. He had bilateral orchidectomy with progressive regression of the skin nodules. He had successful trial of voiding without a catheter 3 weeks after bilateral total orchidectomy. CONCLUSION: Cutaneous metastasis from prostate cancer is rare in native Africans despite the high incidence of the disease in this population. To our knowledge, this index case is the first report in a native African in the English literature.