Biomedical subjects
Publications and source records attributed to H A Nggada.
Appendicovesical fistulae are rare. Only 112 cases in all ages have been reported previously in the world literature. Our case is that of a 1-year-old boy who presented during the neonatal period with missed appendiceal perforation associated with a long segment Hirschsprung's disease. The case is discussed.
We retrospectively studied 27 histologically diagnosed cases of schistosomiasis of the appendix at the University of Maiduguri Teaching Hospital between January 1994 and December 2003. Of 1183 cases of appendices histologically examined, schistosomiasis was seen in 27 (2.3%).
Tumoral calcinosis is a rare, benign disease that commonly affects the African blacks. We report on a 20-year-old Nigerian presenting with recurrent multiple subcutaneous masses around the scapular, elbow, hip and gluteal regions. The X-rays, fine needle aspiration cytology and tissue biopsy confirmed the diagnosis and the patient had a successful excision with good healing.
INTRODUCTION: Kaposi's sarcoma is an acquired immunodeficiency syndrome (AIDS)-defining illness, and with the size of the human immunodeficiency virus (HIV)/AIDS pandemic in sub-Saharan Africa, AIDS-related Kaposi's sarcoma (KS) are now being diagnosed more frequently, although the true incidence of HIV-associated KS is not known. The clinical presentations of AIDS-related KS varied markedly across the African continent. This article reports a series of unusual clinical presentations of the tumour in Northeastern Nigeria. METHODS: This is a prospective study carried out from September 2003 to August 2005, at the University of Maiduguri Teaching Hospital, Borno State, Northeastern Nigeria. RESULTS: 20 cases of histologically-confirmed KS were prospectively studied. There were 17 (85 percent) men and three (15 percent) women, giving a male to female ratio of 5.7:1. Their ages ranged from 21-45 (median 37) years. 18 (90 percent) of the patients were anaemic. Mean haematocrit value, CD4+ cell count and duration of symptoms for all the patients were 29.5 +/- 7.5 percent, 119.0 +/- 91.4 cells per microlitre and 3.5 +/-1.7 months, respectively. Multiple lesions were a common presentation affecting sites such as lower limbs, trunk, conjunctiva, upper limbs and rectum as well as penis, lymph node, scrotum and oropharynx. CONCLUSION: Contrary to other reports that KS is not associated with HIV infection, our study has demonstrated otherwise. This study also showed that both sexes are affected but with a male preponderance. KS is also a late presentation of the HIV/AIDS disease spectrum in our environment and has varied clinical manifestations. There is an urgent need to develop health education programmes to enhance the understanding of this disease and how it spreads, particularly among the young generation.
A 53-year-old male Nigerian with a rare cutaneous metastasis and a late manifestation of hepatocellular carcinoma is presented. The skin nodules were umbilicated, painless. firm and spread on the chest, abdomen and back. Ultrasonography showed a huge mass in the right lobe of the liver. Fine needle aspiration cytology of the liver revealed hepatocellular carcinoma and the skin nodule, metastatic carcinoma of hepatic origin. The immunological marker HBsAg was positive while Anti-HCV Ab and alpha-feto-protein were negative. Patient died and consent for post-mortem examination was refused.
Although sacrococcygeal teratomas are rare, there have been several reports from various parts of Nigeria, outside the Northeast region. This report reviews the experience with this tumour from the northeastern part of Nigeria. A retrospective study of 21 children with histologically confirmed sacrococcygeal teratoma managed in 18 years. Over the 18-year-period, 21 histologically confirmed cases of sacrococcygeal teratoma were seen-80% were girls. Thirteen (60.9%) presented during the neonatal period. Eighteen patients presented with benign sacrococcygeal teratoma while three patients and a recurrence from an initial benign tumour had malignant sacrococcygeal teratoma. All malignant tumours had a significant presacral component. There were associated congenital malformations in 3 (14.3%) of the patients. All the benign tumours were resectable. Using the American Academy of Pediatrics (Altman's) classification, 13 patients were type I, 5 patients type II, 3 patients type Ill and none was for type IV. The commonest post-operative complication was wound infection in six patients. Others were wound dehiscence in three and post-operative diarrhoea in two patients. Three deaths were recorded in this series. The size of mass greater than 5 cm did not correlate with the incidence of post-operative complications (P=0.367). The post-operative follow-up was very poor; but there was a recurrence in a girl, two-years after the initial surgery. Our study revealed that most of our patients with sacrococcygeal teratoma present early to hospital with benign lesions and the immediate post-operative results were excellent. However, the follow-up was poor as such long-term post-operative results are difficult to study. It is to be recommended that sacrococcygeal teratoma presenting early to hospital should have prompt surgical intervention.
This study was conducted to verify the status of patients with negative appendicectomies in our practice and thus assess possible ways of reducing it. Of a total of 554 appendicectomies done in UMTH from January 1997 to December 2001, 27 (4.9 %) of these appendices were reported at histology as normal. 21 (77.8 %) were females and 6 (22.2 %) were males giving a female to male ratio of 3.5 to 1. The age range of the female patients was between 18 and 47 years with a mean 28.8 (SD) of (8.2) years. The age range of the male patients was between 11 and 47 years with a mean 31.5 (SD) of (12.6) years. The diagnostic alternatives depict the common scenario: Gynaecological conditions, urinary problems, peptic ulcer disease and non specific abdominal pain which are some of the major known differential diagnosis of acute appendicitis. Therefore careful clinical assessment of the patient should be depended upon for the diagnosis of appendicitis especially in our environment where sophisticated aids to diagnosis remains scarce.
Ameloblastoma is characteristically considered to be a benign but locally aggressive and infiltrative odontogenic tumour with a high recurrence rate. Most recurrences of the solid or multicystic ameloblastoma occurred at the edges of the initial tumour or at the bony cavity left after the excision of a tumour. A case of an isolated soft tissue recurrence of ameloblastoma of the mandible in a 58-year-old man is presented. The report illustrates the need to take into consideration the adjacent soft tissue in cases of tumour with cortical bone perforation during surgical treatment. This is especially important in an environment where patients are not likely to attend follow-up review for a long period. It also demonstrates the ability of intraosseous ameloblastoma to grow in soft tissues.
The study is aimed at classifying liver diseases diagnosed by fine needle aspiration cytology (FNAC) in our environment and to emphasize the importance of the procedure for management of our patients. Forty-two patients were referred by the physicians for fine needle aspiration cytology diagnosis in Histopathology Department, University of Maiduguri Teaching Hospital between January 2001 and December 2003. There were 30 males and 12 females (2.5:1) with mean age of 44.7 years. The peak age is in the 5th decade of life. The commonest hepatic disease is primary hepatic malignancy, which accounted for 78.6% (33 patients); 3 suspicious of malignancy, one case each of metastatic carcinoma, amoebic liver abscess; liver storage disease and large cell dysplasia. The technique has gained popularity in our center because it is cheap, convenient, minimally invasive, quick and has high precision in obtaining samples. We therefore recommend this procedure in centers where liver diseases are common as a means of initial investigation.
A 40-year-old woman presented with subcutaneous masses on her chest wall, abnormal vaginal bleeding and an enlarged uterus. Chest X-ray and liver ultrasound revealed metastatic disease to these sites, respectively. A urine human chorionic gonadotrophin assay was positive. A biopsy of the chest wall lesion and endometrium revealed choriocarcinoma. Treatment with methotrexate, actinomycin-D and cyclophosphamide led to complete resolution of the disease on examination, X-ray and ultrasound scans. The urinary pregnancy test became negative.
BACKGROUND: The objective of this paper is to highlight the importance of tissue biopsy for histopathological diagnosis. METHOD: A report of a 46-year-old farmer with post-thyroidectomy metastatic thyroid cancer. RESULT: A post-thyroidectomy patient presenting with extensive skull and lumbar spine metastasis, paraparesis, huge occipital swelling and good healed scar without tumour residue. The thyroidectomy specimen was not subjected to histopathological diagnosis. Fine needle aspiration cytology of the occipital swelling revealed metastatic follicular carcinoma. Patient was placed on thyroxine 0.5mg daily with great improvement of lower limb muscle power. CONCLUSION: These bony metastases could have been reduced if proper investigation was done. There is need for continuous medical education for all clinical medical personnel.