Her-2/neu overexpression in breast cancers in patients of West African extraction seen in Lagos state University Teaching hospital, Nigeria.

INTRODUCTION: Her-2/neu is one of the most important molecular markers of breast cancer. Overexpression of Her-2/neu as evaluated by immunohistochemistry is necessary in the management of breast cancers. This study was performed to determine the proportion of expression of the biomarker amongst breast cancer patients who presented in our 'one-stop breast cancer unit' using automated immunohistochemistry. MATERIALS AND METHODS: Automated immunohistochemical analysis of 107 newly diagnosed breast cancer patients was done for expression of Her-2/neu, between 1st April, 2016 and 30th September, 2018. The data was analyzed using SPSS version 25 for windows and Microsoft excel, 2013. RESULTS: Her-2/neu was overexpressed in 30.1% patients, and it shows no correlation with age and histological grade of the disease. CONCLUSION: There is overexpression of Her-2/neu in our local setting, and this observation is very relevant to any therapeutic decisions and management of these patients.

Non-trauma surgical emergencies in adults: Spectrum, challenges and outcome of care.

INTRODUCTION: Significant deaths of between 21% and 38% occur from non-trauma surgical conditions in the accident and emergency room. Access to emergency surgical care is limited in many developing countries including Nigeria. We aimed to study the spectrum of non-trauma surgical emergencies, identify challenges in management and evaluate outcomes. METHODS: A one year prospective cohort study of all non-trauma emergencies in adults seen at the surgical emergency room of LASUTH from 1st October, 2011 to 30th September, 2012 was conducted. Data was analyzed using SPSS version 15.0. RESULTS: Of a total of 7536 patients seen, there were 7122 adults. Those with non-trauma conditions were 2065 representing 29% of adult emergencies. Age ranged between 15 and 97 years and male to female ratio was 1.7:1. Acute abdomen (30%), urological problems (18%) and malignancies (10%) were the most common. Among 985 patients requiring admission only 464 (47%) were admitted while the remaining 53% were referred to other centers. Emergency surgical intervention was carried out in 222 patients representing 48% of admitted patients. There were 12 (24%) non-trauma deaths in the emergency room. They were due to acute abdomen and malignancies in half of the cases. CONCLUSION: Facilities for patients needing emergency care were inadequate with more than half of those requiring admission referred. Attention should be paid to the provision of emergency surgical services to the teeming number of patients seen on yearly basis in the Teaching Hospital.

Testicular Biopsies of Azoospermic Men at The Lagos State University Teaching Hospital

Objectives: This study was conducted to evaluate the histological findings from testicular biopsies in azoospermic men seen at the Lagos State University Teaching Hospital; Ikeja - Lagos; Nigeria. Patients and Methods: A retrospective study of testicular biopsies of azoospermic men who presented to our institution from 2005 to 2006 was performed. The patient's age; type of infertility and histopathological diagnosis were evaluted. All biopsies were preserved in 10formaldehyde solution. Results: Of the 51 azoospermic men (mean age 30 years; range 25 - 46 years) 25 (49.0) had primary infertility; 11 (21.6) had secondary infertility and 15 (29.0) were not specified. Five (9.8) patients had normal spermatogenesis. Abnormal histological parameters occurred in 46 (90.2) patients: testicular atrophy in 30 (58.8); maturation arrest in 14 (27.5) and hypospermatogenesis in 2 (3.9) patients. Conclusion: The presence of normal spermatogenesis in azoospermic men; which would suggest an obstructive lesion; is not common in our practice; in contrast to previous studies from our country. This may indicate a changing pattern in the aetiology of male infertility in our environment. Identification of the possible causes of testicular damage resulting in non-obstructive azoospermia in our environment may help to prevent male infertility

Primary lymphoma of the testis in remission for more than ten years: a case report.

BACKGROUND: Primary testicular lymphoma is a unique, rare and aggressive extra nodal non-Hodgkins Lymphoma (NHL). It is the most common testicular tumour in males between 60 and 80 years old OBJECTIVE: To report a case of primary testicular lymphoma in a young man who has done very well on surgery and chemotherapy. METHODS: The patient a Nigerian male civil servant who was single and aged 31 years presented to us with a history of a progressive painful right scrotal swelling of two years duration and associated painful right groin swelling for one year. A working diagnosis of right hydrocele with differential diagnosis of lymphangioma was made. Investigations were essentially normal and patient was scheduled for hydrocelectomy but findings at operations were different. RESULTS: At surgery, there was grossly enlarged hard right testis with thickened spermatic cord. Right radical inguinal orchidectomy with excision of the right spermatic cord and a regional lymph node was carried out. Histology revealed intermediate grade nodular NHL of the right testis. He was treated with systemic combination chemotherapy and has since been in complete remission for over 10 years. CONCLUSION: Primary testicular lymphoma is a rare and unique neoplasm of the testis and is most commonly seen in men over the age of 60, but should be considered in the differential diagnosis of testicular tumours in younger age groups. It is curable in early stage with appropriate multimodalities of management.