How confounding are breast pain confounders?

Nine thousand four hundred evaluable patients with breast complaints were consecutively studied from 1984 to 1994. Their ages ranged between 15-65 years with a median of 33 years. Five thousand, six hundred and seventy-five of these presented on account of pain and a mass was the cause of pain in 74%. Gross fibrocystic disease of the breast was the commonest tumour encountered in this group. Seven hundred and thirty eight patients were found to have 'referred' pain, and splenomegaly was the commonest cause of this 'referred' pain. At present, a simple breast biopsy remains the cheapest and most effective method of investigating this organ in most developing countries.

Mondor's disease: analysis of 30 cases.

Thrombophlebitis of the superficial veins of the breast is a well known disease entity, the aetiology of which remains obscure. It affects mostly middle-aged women with large pendulous breasts. The present study suggests that the causative agent may not be a single factor but rather a combination of factors. Thirty cases (28 women, two men) are presented and analysed. A larger multicentre study is recommended.

Gall stone disease in African patients with sickle cell anaemia: a preliminary report from Yaounde, Cameroon.

Cholecystosonography was undertaken in 90 patients with sickle cell disease aged 15 years and over. Gall stones were found in 26 (28.9%) patients. There was no sex difference, but the incidence increased with age from 13.2% at under 20 years to 75% at 30 years and over. The mean serum cholesterol and total and unconjugated bilirubin concentrations were not significantly different between patients with and without gall stones. As most (80.8%) stones were radiolucent they were probably of pigment type, containing little or no calcium, and further investigation into how they are produced is needed. Sickle cell patients with acute abdominal crisis should have gall bladder disease excluded before a diagnosis of vascular crisis is made.

Fournier's gangrene.

Twenty-five cases of gangrene of the scrotum and penis have been analysed. The anterior scrotum or the whole scrotum were the areas most frequently involved. The results of seminal analyses showed marked oligozoospermia during the infective period. Haemolytic streptococcus was the most common organism. The aetiology of the disease is reviewed and "infective gangrene of the scrotum and penis" is considered to be a more suitable diagnostic label than Fournier's gangrene.

Sincipital nasofrontal encephalomeningocele.

A case of a 7-year-old male child with sincipital nasofrontal encephalomeningocele is reported. The anomaly was associated with a mild degree of atrial septal defect. This is the first case reported in the Cameroons.

Hematocolpos with imperforate hymen.

A case of hematocolpos with imperforate hymen in a 16-year-old, well-developed African girl is reported. Diagnosis was established by the presence of an abdominopelvic doughy mass, a boggy mass filling the vagina and an imperforate, bulging hymen, and cryptomenorrhea despite the presence of characteristics of pubescence.