Browsing by Author "Ajani, M. A."

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A histomorphological pattern of gallbladder lesions in a tertiary hospital in Southwestern Nigeria: a retrospective descriptive study
(Rwanda Biomedical Centre (RBC), 2021) Ajani, M. A.; Onakpoma, F. A.; Fatunla, E. O.; Adegoke, O. O.; Salami, A. A.
BACKGROUND: The gallbladder is one of the most common specimens encountered in the surgical pathology laboratory, and gallstone related diseases are among the most common medical problems requiring surgical intervention. This study's objective was to determine the histomorphological patterns and frequency of gall bladder lesions from cholecystectomy specimens received in our institution for over twenty years. METHODS: We carried out a retrospective review of all cholecystectomy specimens received at the pathology department for 20 years from January 1999 to December 2018. The specimens were obtained from within and outside the hospital facility. The demographic data, clinical details, and histological diagnosis were retrieved from the departmental records and were analyzed with SPSS version 23. RESULTS: A total of 211 cholecystectomy specimens were received during the study period. Patients’ age ranged from 14 to 84 years, with a mean age of 47.6 ± 0.899 years. There was a female preponderance with male to female ratio of 43:168 (1:3.9). Surgery for gallbladder disease was most commonly performed in the age range of 41-50 years. Out of the 211 specimens, 153 (72.5%) had calculi and 58 (27.5%) were acalculous. Chronic calculous cholecystitis was the most common histopathological diagnosis (65.4%). Others were chronic acalculous cholecystitis (18.0%), acute on chronic acalculous cholecystitis (2.4%), adenocarcinoma (3.3%), metastatic adenocarcinoma (0.1%), adenocarcinoma with chronic calculous cholecystitis (0.5%), klatskin tumour (0.5%), and normal gallbladders (1.9%). CONCLUSION: This study revealed that the commonest indication for cholecystectomy in our hospital was gall stone disease. Malignancy of the gallbladder is uncommon in our center.
A surveillance of estrogen receptor (er), progesterone receptor (pr) and human epidermal growth factor receptor-2 (her-2) status in malignant female breast lesions in Bayelsa state, Nigeria.
(IJSER Publishing, 2019) Oduma-Sandy, C. I.; Achukwu, P. U.; Ajani, M. A.
A three (3) year retrospective study of Estrogen Receptor (ER), Progesterone receptor (PR) and Human Epidermal growth factor receptor-2 (HER2) status of previously diagnosed female breast cancers was done using immunohistochemistochemistry. Formalin fixed paraffin embedded (FFPE) tissue blocks of breast cancer cases from 2009-2011 were retrieved from the tissue block archives of the two major tertiary health institutions in the state; Federal Medical Centre, Yenagoa and Niger Delta University Teaching Hospital, Okolobiri. The result of this research work revealed the incidences of the receptor status as it occurred among 36 malignant female breast lesions in Bayelsa State as follows; ER+ve=13.8%, ER-ve=86.2%, PR+ve=19.4%, PR-ve=80.6%, HER2+ve=33.3% HER2-ve=66.7%, TR+=13.3% while TR-=55.7%. The statistical analysis of the result revealed that no significant relationship exists between the various age groups and the respective incidences of the receptor status. In the same vein, no significant relationship exists between the respective histopathologic diagnosis of the samples used and the incidences of the respective receptor status except for ER+ve and ER-ve whose incidences were found to have a significant relationship with the histopathologic diagnosis. This by implication means that the incidences of ER+ve and ER-ve respectively maybe dependent on the histopathologic diagnosis at P < 0.05. In conclusion, it is worthy of note here that while researches are on to tackle cancers and breast cancer in particular, there is need for even distribution of IHC facility or other molecular studies in the nation because of its role in breast cancer prevention strategies and patient management.
Assessment of serological markers of genital chlamydia trachomatis infection among the gynaecology patients attending Babcock University teaching hospital, Ilishan-Remo, Ogun state, Nigeria.
(2019) Ajani, T. A.; Elikwu, C. J.; Nwadike, V.; Babatunde, T.; Anaedobe, C. G.; Opeoluwa S.; Okangba, C.; Oluwasola, T. A. O.; Omeonu, A.; Faluyi, B.; Thompson, T. E.; Ebeigbe, E.; Ajani, M. A.; Joshua, A. K.; Kolawole, T.; Kristilere, H.; Meremikwu, C. M.; Mgbemena, L.; Nwaejike, C. S.; Salami, A.; Tantua, A.; Timothy, M.; Akagbusum, T.; Coker, A. O.
Genital Chlamydia trachomatis infection causes significant morbidity and mortality in women. A number of epidemiologic studies have suggested that Polymerase Chain Reaction (PCR) is more accurate as a diagnostic tool for Chlamydia trachomatis.However, the use of serological markers may be cost effective and practical in diagnosing and estimating the burden of the disease in resource limited countries.This study was aimed at determining the serological markers (IgG, IgM and IgA) of Chlamydia trachomatis, evaluate the association between Chlamydia trachomatis infection and the sociodemographic characteristics and clinical diagnosis of the participants. This was a cross sectional hospital-based study in which blood samples from 145 consenting participants were tested for IgG, IgM and IgA antibodies against Chlamydia trachomatis using enzyme linked immunosorbent assay and their clinical diagnosis, retrieved from their case notes. The cumulative prevalence of seropositivity for Chlamydia trachomatis (IgG, IgM, IgA) was 112 (77.2%) while 33 (22.8%) were seronegative. The overall predominant seromarker was IgG 91(62.8%) while IgM and IgA accounted for 85(58.6%) and 54(37.2%) respectively. A statistically significant association was found between Chlamydia trachomatis infection and PID (p value = 0.031), primary infertility (p value 0.011) and level of income (p value= (0,045).
Bilateral ovarian serous cystadenocarcinoma in a teenager: a case report.
(2019) Ajani, T. A.; Oluwasola, T. A. O.; Anaedobe, C. G.; Ajani, M. A.; Fayemiwo, S. A.; Bakare, R. A.
Epithelial ovarian cancers are uncommon among young girls and teenagers compared to germ cell tumors. We report a case of bilateral ovarian serous cystadenocarcinoma in a teenage girl with the attendant challenges of diagnosis, management and follow up. HT, 19 year old had presented at a secondary care level with features suggestive of benign ovarian tumor and had ovariectomy done. However, histology report revealed a malignant epithelial cancer, necessitating a repeat exploration. She was found to have surgical stage 3c disease and subsequently has total abdominal hysterectomy with bilateral salpingectomies, right oophorectomy and omentectomy. She was further managed with paclitaxel-carboplatin combination chemotherapy but defaulted after the 3rd cycle on account of financial constraints. She succumbed to the disease 11 months post diagnosis. Though uncommon, detailed evaluation of teenage patients for malignant ovarian cancer is expedient. The financial burden of cancer care in our environment is also highlighted.
Calcified bilateral ovarian fibroma in a 15 year old female: case report and literature review
(Sciencedomain International, 2019) Adesina, A. M.; Imaralu, J. O.; Yusuf, A. O.; Ajani, M. A.
Aim: To highlight the potential for misdiagnosis of ovarian fibromas and need for careful evaluation especially when fertility altering decisions need to be taken in the young adolescent. Presentation of Case: The authors here review literature and present the case of a 15 year old pre menarchal patient with bilateral, solid hard ovarian tumors with marked ascites, who had bilateral salpingo-oophorectomy, in whom the tumors turned out to be bilateral calcific ovarian fibromas. Discussion: Ovarian neoplasia are often misdiagnosed because of their non-specific symptoms and similarities to other pathologies on radiological imaging. The management of adolescents with ovarian tumors poses peculiar challenges as there is need for a balance between the risk of malignancy and the need to preserve fertility. About 1/3 of pelvic masses in pre-pubertal girls are malignant. This fact in addition to the non-specific features of malignancy in this patient such as weight loss, ascites, necessitated further evaluation which included laparotomy. Conclusion: Ovarian fibromas occur in adolescents and can pose a diagnostic dilemma; a high index of suspicion is required to plan fertility-sparing and cancer-limiting management.
Cervical Lymphadenopathy in Ibadan, Nigeria.
(Association of Resident Doctors, University College Hospital, Ibadan, Nigeria, 2017) Aramide, K. O.; Ajani, M. A.; Okolo, C. A.
Aim: To determine the pattern and causes of lymph node enlargement of cervical region in Ibadan, Nigeria. Materials and Methods: A 10-year (2003-2012) retrospective study was conducted on all head and neck lymph node biopsies received at the Department of Pathology, University College Hospital, Ibadan, Nigeria. Results: A total of 101 lymph node biopsies of cervical region were received within this period of study. 59.4% cases were seen in Males. Second decade of life has the highest number of cases (22.8%) followed by 3rd decade (17.8%). The common cause of cervical lymphadenopathy include non - specific hyperplasia, tumour metastasis and Non Hodgkin’s lymphoma seen in 27 (26.7%), 22 (21.8%) and 20 (19.8%) respectively. Granulomatous and Hodgkin’s Lymphoma constitute 17 (16.8%) and 11 (10.9%) respectively. The granulomatous causes were all due to tuberculosis. A single case of Rosai-Dorfman disease was seen in a male in the 3rd decade of life. Conclusion: This study shows that metastatic tumours, Hodgkins lymphoma and Non Hodgkins lymphoma constituting 52.4% of all cases of cervical lymphadenopathy are common in this environment therefore highlighting the need for early and proper evaluation of patients.
Childhood ovarian neoplasms in Ibadan, South‑western Nigeria.
(Wolters Kluwer - Medknow, 2016) Ajani, M. A.; Aramide, K. O.; Ajani, T. A.; Salami, A. A.; Okolo, C. A.
Childhood ovarian neoplasms are very rare. Little information is available on the relative pattern and frequency of these tumors in Nigerian children. Earlier study done in Ibadan involved ovarian neoplasms in children and adolescents. The aim of this study is to review cases of ovarian neoplasms in childrenMaterials and Methods: This was a retrospective study. Twenty four cases of childhood ovarian neoplasms were seen in patientsResults: Childhood ovarian neoplasms accounted for 2.8% of all cases of ovarian tumors seen in this period. Fourteen (58.3%) cases of childhood ovarian neoplasms were benign, and 10 (41.7%) were malignant. Mature cystic teratoma occurring in 13 (54.2%) was the most common childhood ovarian neoplasm and was most prevalent between 10 and 14 years of age. Burkitt lymphoma was the most common 4 (40%) malignant childhood ovarian tumor and prevalent between 5 and 14 years of age. Conclusion: Mature cystic teratoma remains the single most common childhood ovarian neoplasms, and Burkitt’s lymphoma is the most malignant childhood ovarian tumor in Ibadan, South western Nigeria.
Clinicopathological pattern of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 over-expression of epithelial ovarian carcinomas in Nigeria
(Makerere University, Medical School, 2023) Ajani, M. A.; Lawan, A.; Oke, T.; Khramtsova, G.; Nwanji, I.; Salami, A.; Awolude, O.; Ebili, H.; Onwukamuche, M. E.; Sveen, E.; Yoshimatsu, T.; Olopade, O. I.
Background: Ovarian cancer is the leading cause of death from all gynaecological malignancies. Only few biomarkers of epi thelial ovarian cancer (EOC) prognosis have been studied so far among Nigerian patients. Objective: To determine the pattern of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) expression in patients with EOC seen in Nigeria Materials and Methods: This was a retrospective multicentre study of 102 cases of epithelial ovarian cancers. Relevant clinical information was obtained from hospital-based records in the 3 participating centres. Tissue microarrays were constructed using representative tumour tissue and the ER, PR and HER2 immunohistochemical staining was carried out at the University of Chicago, United States of America. Results: Serous carcinomas predominated (71% of cases). ER positivity was observed in 31.4%, PR positivity in 21.5% and HER2/neu in 16.7% of tumours. Fifty-two percent of tumours were triple negative. Serous tumours were significantly asso ciated with ER positivity (p=0.001). Mean patient age for EOC was 52.6 ± 13.1 years. There were no statistically significant associations between hormone receptor status and histological grade, FIGO staging or survival. Conclusion: Serous tumours were significantly associated with ER expression while non-serous tumours tended to be triple negative.
Colonic polyps in Nigerians, a change in trends: A retrospective single‑center clinicopathological study
(Wolters Kluwer - Medknow, 2022) Adegoke, O. O.; Ajani, M. A.; Nwanji, I. D.
Background: Adenomatous polyps in the colon are recognized precursors of colorectal carcinoma; however, the low incidence of these polyps in sub Saharan Africans has led many to believe that the pathway of colorectal cancer may differ in this region. The objective of this study was aimed to determine the change in trends of colonic polyps in Nigeria. Methods: This was a 10 year retrospective review of all colonic polyp specimens received at the Department of Pathology in our hospital utilizing the histopathology request cards and hematoxylin and eosin stained slides. The data were analyzed using the IBM SPSS Statistics (version 23; IBM Corporation, Armonk, New York, USA). Results: A total of 131 cases were reviewed. The age of patients ranged from 5 to 86 years with a mean age of 55 years. The male to female ratio was 1.6:1. The mean age was 59.4 years. Of the 131 cases reviewed, 62 patients had adenomatous polyps, 49 had inflammatory polyps while 20 others included juvenile polyps, hyperplastic polyps, and hamartomatous polyps. Conclusion: Adenomatous polyps are increasingly being seen among Africans in the sub Sahara region and perhaps they are not as rare as it was once thought provided the facilities for the diagnosis are available. They may yet play a more important role than has been ascribed to them in the pathogenesis of colorectal carcinomas in Africans.
Comparative efficacy of visual inspection with acetic acid versus cytology for cervical cancer screening in Ogbomoso, Nigeria.
(2017) Abiodun, A. B.; Durodola, A. O.; Ajani, M. A.; Amole, I. O.; Abiodun, A. D.; Oluwasola, T. A. O.
Background: Screening test for cervical cancer using visual inspection with acetic acid (VIA) has been advocated by World Health Organization as a suitable, low cost and feasible alternative modality for control of cervical cancer in resource-poor settings as compared to cytological and colposcopic screening. The need for reproducibility, accuracy and comparable efficacy will influence the acceptability of VIA as primary screening modalities for cervical cancer. Methods: A cross–sectional comparative study conducted at BUTH. Data were obtained from 318 consenting women aged 30–65 years using a systematic random sampling method and an interviewer–administered structured questionnaire. Pap smear samples were taken followed by visual inspection with acetic acid. Using Statistical Package for Social Sciences (SPSS) version 23.0, Frequencies were obtained and Chi-square test (X2) was used to compare rates and proportions with the level of statistical significance set at less than 0.05. Results: Positive results for premalignant cervical lesion was 1.3% and 4.1% for VIA and Pap smear respectively (X2=4.52; p=0.034). The sensitivity of VIA was 7.7% with positive predictive value of 25% while specificity was 99.0% with a negative predictive value of 96.2%. The prevalence of abnormal cervical lesion in the population studied was 4.1% (95% CI 2.2% – 6.9%). Conclusions: The detection rate for pre-cancerous lesions of the cervix using VIA was significantly lower than that of Pap smear in this study. There may be needed to exercise caution in adopting VIA as primary screening modality for cervical cancer.
Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan
(College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria, 2015) Oluwasola, A. G.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T. S.; Salami, A.; Ajani, M. A.; Ogundiran, T. O.; Obajimi, M. O.
Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre. Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement. Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign. Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.
Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan
(College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria, 2015) Oluwasola, A. G.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T. S.; Salami, A.; Ajani, M. A.; Ogundiran, T. O.; Obajimi, M. O.
Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre. Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement. Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign. Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.
Diagnostic accuracy of tru-cut biopsy of breast lumps at University College Hospital, Ibadan
(College of Medicine, University of Ibadan and University College Hospital, Ibadan, Nigeria, 2015) Oluwasola, A. G.; Adeoye, A. O.; Afolabi, A. O.; Adeniji-Sofoluwe, A. T. S.; Salami, A.; Ajani, M. A.; Ogundiran, T. O.; Obajimi, M. O.
Background: Tru-cut needle biopsies form an integral part of Triple assessment of breast cancer and include clinical assessment, mammography and core needle biopsy. No study has been done to evaluate the validity of the procedure in our environment. This study was done to evaluate the validity of core needle biopsies in our centre. Method: A retrospective study of patients with tru-cut needle biopsies of breast lumps and follow-up excisional biopsy or mastectomy done in the Department of Surgery, University College Hospital, Ibadan over a ten year period was done. Fifty one patients who fulfilled the inclusion criteria had their records obtained from the Department of Pathology. The diagnosis was classified into benign and malignant with the excisional biopsy or mastectomy diagnosis used as the gold standard. The sensitivity, specificity and accuracy were calculated and kappa was also done to evaluate the degree of agreement. Results: A total of 51 cases were included in this study. The average age of the patients was 47 ± 13 years with a range from 19 to 81 years. Thirty of the biopsies (59%) had a definitive diagnosis of malignancy while twenty one (41%) were benign. The overall sensitivity, specificity and accuracy were 86%, 71% and 80.4% respectively. The specificity of malignant biopsies was 68% while benign was 35%. The level of agreement for malignant biopsies was higher than benign biopsies with a kappa of 0.39 for malignant diagnosis as against 0.29 for benign. Conclusion: Tru-cut needle biopsies have a comparable sensitivity and specificity to excisional biopsies. Diagnostic accuracy can be further enhanced with the adoption of image guided biopsies.
Diagnostic Utility of EMA, Vimentin and CD117 Immunohistochemical Markers in Subtyping Renal Cell Carcinoma in a Nigerian Tertiary Hospital: A 10-year Retrospective Study.
(West African College of Physicians and the West African College of Surgeons, 2023) Nwadiokwu, O. O; Adegoke, M. A.; Ajani, C. A.; Okolo, B. L.; Awosusi, V. C.; Okebalama J. I.; Adegoke, O. O.; Ajani, M. A.; Okolo, C. A.; Awosusi, B. L.; Okebalama, V. C.
BACKGROUND: Renal cell carcinoma is the most lethal urological cancer and contributes significantly to morbidity and mortality due to cancers of the urogenital tract. In routine diagnostic surgical pathology practice of renal tumours, immunohistochemistry is a helpful ancillary technique after routine H & E. The role of renal immunohistochemistry is explored in this study. MATERIALS AND METHODS: The paraffin-embedded tissue blocks of all the confirmed cases of renal cell carcinoma seen at the University College Hospital (UCH), Ibadan, during the 10-year study period of 2007 to 2016 were retrieved, sectioned and immunohistochemistry done using monoclonal antibodies for EMA, Vimentin and CD117 following standard protocols. Frequency statistics and chi-square were applied to data to determine proportions and associations using the Statistical Package for the Social Sciences (SPSS) version 23. RESULTS: A total of 48 cases of renal cell carcinoma were seen within the study period that met the inclusion criteria for the study. The age range of the patients was between 3 to 76 years with an average age of 44.17 years. The male-to-female ratio was 1:1.3. Fuhrman Grade 2 nuclei were predominant (43.75%) while Fuhrman Grade 4 nuclei had the lowest frequency (6.25%). EMAstaining patterns for the different histological patterns of RCC showed no statistically significant difference while Vimentin and CD117 staining patterns showed a statistically significant difference. There was no statistically significant difference observed between the staining patterns of all three markers and the nuclear grades of the cases of RCC. CONCLUSION: This study demonstrated the usefulness of Vimentin and CD117 in differentiating chromophobe variant of renal cell carcinoma from other subtypes while EMA showed variable expression across the various subtypes. WAJM 2023; 40(10); 1035 -1040.
Distribution and characteristics of endometriotic lesions in South- Western Nigeria: A single institutional experience
(African Journals OnLine, 2019) Ajani, M. A.; Salami, A.; Nwanji, I. D.; Olusanya, A. A.; Fatunla, O. E.
Background: Endometriosis poses a significant burden mainly to women of child bearing age. Historically, endometriosis was thought to be of low prevalence among African women. However, recent studies have documented an increased prevalence than previously thought. This study aimed to determine the distribution and characteristics of endometriotic lesions among Nigerian women. Methods: A retrospective study of all histologically diagnosed cases of endometriosis from the records of the Department of Pathology, University College Hospital, Ibadan from 1st January, 1997 to 31st October, 2018.The age of the women, location and distribution of the lesions were analysed. Results: A total of 85 cases of endometriosis were diagnosed histologically in the period under review. The mean age was 35 years with an age range of 18 to 52 years. The most commonly affected age groups were those between 30-39 years (47.1%) and 20-29 years (30.6%). The most commonly affected site was the ovary (58.8%) followed by the umbilicus (11.9%) and fallopian tubes (9.4%). Fourteen patients (28%) had bilateral ovarian involvement. Left sided ovarian lesions predominated (61.1% versus 38.9%). Eighteen (21.2%) patients had lesions at more than one site frequently involving both ovaries. Conclusion: Endometriosis affected mainly women of childbearing age with particular predilection for the ovaries. Endometriosis affecting the umbilicus is not uncommon among Nigerian women.
Endometrial cancer in Ibadan: epidemiological and clinico-pathological features -10 year review
(Marsland Press, 2016) Adekanbi, A. O.; Jimoh, M. A.; Ajani, M. A.; Fawole, A. O.
Endometrial cancer is the commonest cancer of the female genital tract, it accounted for about 6 percent of all female cancers in United States. It is not as common in Africa; it was the third commonest gynaecological malignancy in an African study. The aim was to enumerate the characteristics of endometrial cancer patients: socio demographic characteristic of the endometrial cancer patients, and the association of the patients’ profile with endometrial cancer. This was a retrospective, cross sectional study of histologically diagnosed endometrial cancers at the University College Hospital (UCH), Ibadan. The data obtained were analyzed using SPSS. Endometrial cancer accounted for 3.1% of the female genital cancers; Obesity was a factor in most the patients; Poorly differentiated adenocarcinoma was the commonest observed pattern. Majority of the patients were elderly obese, they never engaged in contraception.
Endometriosis misdiagnosed as a metastatic ovarian tumour
(Scientific Research Publishing, 2019) Imaralu, J. O.; Ajani, M. A.; Adesina, M. A.; Ojo, N. K.
Endometriosis is a debilitating problem with pain in the short term and high risk of infertility later. It is an oestrogen-dependent condition found in about 10% of women of reproductive age, about 1/3 of infertile women and as high as 80% of women with chronic pelvic pain. The condition is not well understood and thus associated with misdiagnosis and delayed diagnosis. Higher rates of misdiagnosis occur in blacks and this is especially for pelvic tumors-fibroids and ovarian tumors. We present here the case of a 30-year-old nullipara, who had an umbilical nodule (Sister Mary Joseph’s) and was found on imaging to have a pelvic tumor which was suspected to be an ovarian cancer. Diagnostic laparoscopy during the menstrual phase however revealed endometriosis in early stage. Misdiagnosis of endometriosis has potential to distort the course of the disease and endanger fertility prospects; early laparoscopic evaluation of patients with unclear pelvic pathologies would help to prevent this occurrence.
The expression status of human epidermal growth factor receptor 2 in epithelial ovarian cancer in Ibadan, Nigeria
(2016) Ajani, M. A.; Salami, A.; Awolude, O. A.; Oluwasola, A. O.; Akang, E. E. U.
Background: It has been proposed that the overexpression of the human epidermal growth factor receptor 2 (HER2/neu protooncogene) could be a possible therapeutic target in epithelial ovarian cancer, as has been the case in breast carcinomas. However, there is lack of knowledge on the status of the gene in neoplasms which occur in black women. The objective of this study was to determine HER2/neu expression status in EOC in black women. Method: Ninety cases of EOC were evaluated for HER2/neu protein expression using immunohistochemistry. Results: HER-2/neu expression was observed in 33 of the 90 cases (37%), of which 15 EOC cases (17%) were weakly or moderately positive, and 18 (20%) strongly positive. A significant association was not found between HER-2/neu expression and age, International Federation of Gynecologists and Obstetrics (FIGO) stage, grading and histological subtypes (p-values of 0.463, 0.360, 0.975 and 0.168, respectively). However, there were more cases of advanced-stage disease (III/IV) with HER-2 expression than early-stage EOC (I/II). In this study, 21%, 36% and 42% of HER2/neu-positive tumours were grades 1, 2 and 3, respectively. A higher proportion of serous carcinomas (as opposed to mucinous carcinomas) was also observed to be ER2/neu positive. Conclusion: HER2/neu expression was observed to increase with advanced stages of cancer, and was more commonly seen in serous, rather than in mucinous, carcinomas.
Extensive Right Pleural and Chest Wall Malignant Fibrous Histiocytoma at an Unusual Age: Computed Tomography Features
(BMJ Group, 2015) Adekanmi, A. J.; Ajani, M. A.
Aims: To describe a rare case of malignant fibrous histiocytoma at an unusual age of sixteen (16) years. Also to sensitize the medical community to the need for thorough evaluation of an opaque hemithorax and to describe the imaging features of this rare neoplastic disease. Presentation of Case: This was a 16 year old girl who presented with progressive swelling and recurrent right chest pain of 10 months duration and difficult breathing of 6 weeks duration. There was associated weight loss, dry cough and low grade intermittent fever. She had solitary cervical lymphadenopathy, grade II finger clubbing and low hematocrit. Discussion: Malignant fibrous histiocytomas (MFHs) are tumors of adulthood with a mean age of 59 years. It has predilection for the extremities, the abdominal cavity and the retroperitoneum. Primary pleural occurrence is relatively rare. This is a rare case of an extensive malignant fibrous histiocytoma of the right pleura with chest wall involvement presenting at an unusual young age of 16 years, at variance with the ages documented in the literatures. Imaging findings of the histologically proven tumor were also described on high resolution chest Computed Tomography. Conclusion: Malignant fibrous histiocytomas may occur much earlier than the age documented in most literatures. This case showed that not all cases of extensive opaque hemithorax are due to massive pleural effusion and further and better diagnostic imaging will be necessary for prompt and proper management.
Fracture of the humeral bone as the first clinical presentation of metastatic papillary thyroid carcinoma in Ibadan
(Sciencedomain international, 2019) Ajani, M. A.; Awosusi, B. L.; Fatunla, E. O.; Adegoke, O. O.; Salami, A. A.
Papillary thyroid carcinoma is the commonest type of thyroid cancer representing 75 to 85 per cent of all thyroid cancer cases. It is often well-differentiated, slow-growing, and localized, although it can metastasize. This is a case of a 49-year-old male who presented with a pathological fracture of the left humerus. A bone biopsy was done at the surgery which had a histological diagnosis of metastatic thyroid carcinoma. A total thyroidectomy was subsequently done and was histologically reported as a follicular variant of papillary thyroid carcinoma. The patient was clinically stable post thyroidectomy and was discharged home on the 10th postoperative day and he is currently being followed-up in the surgical outpatient clinic. Pathological fracture as the initial clinical presentation is an unusual manifestation of metastatic thyroid carcinoma; therefore a high index of suspicion is needed to make this diagnosis. In any patient presenting with a pathologic fracture, the possibility of metastatic carcinoma from the thyroid gland should always be considered.