Browsing by Author "Fatunla, E. O."

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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.
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.
Histopathological analysis of male breast cancer in Southwestern Nigeria: A single center retrospective study
(Wolters Kluwer - Medknow, 2021) Ajani, M. A.; Odetola, S. S.; Awosusi, B. L.; Fatunla, E. O.; Salami, A. A.
Background: Breast cancer in men is still an uncommon and largely understudied disease. It accounts for 1% of all breast cancers. The aim of this study was to review all the male breast cancer cases diagnosed at the tertiary medical institution in South West Nigeria over a 10 year period and to compare the findings with other similar studies done in Nigeria and globally. Methods: We retrospectively reviewed all histologically diagnosed cases of male breast cancers in the Department of Pathology, Tertiary Medical Institution in South West Nigeria over a 10 year period from January 1, 2009, to December 31, 2018. Clinicopathological parameters including patients’ age, laterality, and specific histological sub types were extracted from surgical day book and Cancer Registry of the Department. The data were analyzed using the IBM SPSS Statistics (version 22; IBM Corporation, Armonk, New York, USA). The results were subsequently presented in tables, relative frequencies, group percentages, and photomicrographs. Results: Forty two cases of male breast cancer were seen accounting for 1.7% of all breast cancer cases. The age range was between 22 and 91 years with a mean age of 60.3 years, and a peak occurrence was in the 8th decade. The right breast was more affected than the left accounting for 52% of the total number of cases seen. The most common histological sub type found was invasive ductal carcinoma accounting for 88% of all the cases. Conclusion: Male breast cancer is relatively uncommon compared to female breast cancer. It is more common in the older age group, and invasive ductal carcinoma is still the most common histological subtype.
Impact of axillary node-positivity and surgical resection margins on survival of women treated for breast cancer in Ibadan, Nigeria
(ecancermedicalscience, 2020) Ayandipo, O. O.; Ogun, G. O.; Adepoju, O. J.; Fatunla, E. O.; Afolabi, A. O.; Osuala, P. C.; Ogundiran, T. O.
Introduction: Oncologic surgical extirpation, the mainstay of loco-regional disease control in breast cancer, is aimed at achieving negative margins and lymph node clearance. Even though axillary lymph nodal metastasis is a critical index of prognostication, establishing the impact of lymph node ratio (LNR) and adequate surgical margins on disease specific survivorship would be key to achieving longer survival. This study examines the prognostic role of pN (lymph nodes positive for malignancy), LNR and resection margin on breast cancer survival in a tertiary hospital in Ibadan, Nigeria. Methods: We conducted a longitudinal cohort study of 225 patients with breast carcinoma, documented clinico-pathologic parameters and 5-year follow up outcomes – distant metastasis and survival. Chi-square test and logistic regression analysis were used to evaluate the interaction of resection margin and proportion of metastatic lymph nodes with patients’ survival. The receiver operating characteristic curve was plotted to deter mine the proportion of metastatic lymph nodes which predicted survival. The survival analysis was done using Kaplan–Meier method. Results: Sixty (26.7%) patients of the patients had positive resection margins, with the most common immuno-histochemical type being Lumina A. 110 (49%) patients had more than 10 axillary lymph nodes harvested. The mean age was 48.6 + 11.8 years. Tumour size (p = 0.018), histological type (p = 0.015), grade (p = 0.006), resection margin (p = 0.023), number of harvested nodes (p < 0.01), number of metastatic nodes (p < 0.001) and loco-regional recurrence (p < 0.01) are associated with survival. The overall 5-year survival was 65.3%. Conclusion: Unfavourable survival outcomes following breast cancer treatment is multifactorial, including the challenges faced in the multimodal treatment protocol received by our patients.
Inflammatory pseudotumor: a 20‑Year single institutional experience
(Wolters Kluwer - Medknow, 2020) Ajani, M. A.; Fatunla, E. O.; Onakpoma, F. A.; Salami, A. A.
Background: Inflammatory pseudotumor (IPT) is a relatively rare benign disease. The aim of the study was to demonstrate the demographic distribution, clinical presentation, and histomorphological characteristics of IPT while highlighting its associated diagnostic challenges. Materials and Methods: A retrospective cross sectional review of all the IPT diagnosed in our institution between January 1999 and December 2018 was conducted. The samples were received from within and outside the hospital facility. The demographic data, clinical history, and histologic reports were reviewed. Results: A total of 25 cases of histologically confirmed IPT were seen. Patients’ age ranges from 7 to 74 years with a mean age of 38.96 years and standard deviation ± 17.94 years. There was a bimodal peak occurrence in the third and fifth decades. Most of the patients were adults (23, 92%), whereas only 2 (8%) were children. There was a female preponderance with a male to female ratio of 1:2.6. The head and neck had the highest number of cases (44%), followed by the gastrointestinal tract (GIT) (40%). Eight (73%) of head and neck cases occurred in the orbit. The presenting complaints depended on the site of the lesion with pain and swelling being the commonest symptoms irrespective of the site of the lesions. Two cases of bilateral IPT were observed. Immunohistochemistry was used in a certain condition of diagnostic dilemma. Conclusion: This study showed a female preponderance of IPT with the head and neck and GIT being the most common location. It is important to rule out other differentials in the diagnosis of IPT.
Nasopharyngeal carcinoma in Ibadan, Nigeria: a clinicopathologic study
(Pan African Medical Journal, 2020-06-20) Ogun, G. O.; Olusanya, A. A.; Akinmoladun, V. I.; Adeyemo, A. A.; Ogunkeyede, S. A.; Daniel, A.; Awosusi, B. L.; Fatunla, E. O.; Fasunla, A. J.; Onakoya, P. A.; Adeosun, A. A.; Nwaorgu, O. G.
Introduction: nasopharyngeal carcinoma is relatively common in our environment. It is one of the most difficult malignancies to diagnose at an early stage. The aim of the study was to determine the clinical features, clinical disease stage of nasopharyngeal carcinoma at presentation and at diagnosis as well as the histologic types at the University College Hospital, Ibadan, Nigeria. Methods: this was a ten year retrospective study of all histologically confirmed nasopharyngeal carcinoma between January 2007 to December 2016 using clinical and pathology records and files. Results: there were 73 cases. The male: female ratio was 1.7. The age of patients ranged from 12 to 80 years with a mean age of 39 ± 16 years. The median age at diagnosis was 40 years. The peak age group of occurrence was 40-49 years. The most common symptoms were namely epistaxis in 67.1% of patients at presentation, neck mass/swelling (64.4%) and nasal mass/obstruction (63.0%). Majority (54.8%) of the patients presented late with stage 3 or 4 disease. Most (94.5%) of the tumours were of the non-keratinizing squamous cell carcinoma subtype. The keratinizing and basaloid variants accounted for 4.1% and 1.4% of the tumours respectively. Conclusion: vague, non-specific symptoms make patients present at late stages of the disease, making it almost impossible to attempt cure. The dominant histopathological type is non-keratinizing squamous cell carcinoma and resembles that seen in most parts of Nigeria and endemic areas of the world
One year of breast cancer in Ibadan, Southwestern Nigeria: a histopathological review
(African Journal of Open Libraries, 2021) Jimoh, M. A.; Ajani, M. A.; Folorunso, S. A.; Fatunla, E. O.; Aruah, C. S.; Abdus-Salam, A. A.; Ogunbiyi, J. O.
Background: Breast cancer is a major public health problem in most low- to medium-income countries of the world because of its high morbidity and mortality rate. Histopathological features are vital in risk assessment, selection of treatment and prognostication in breast cancer patients. This study aimed to assess the histopathological features of all breast cancer cases seen in a tertiary hospital in the year 2018. Methods: This is a retrospective review of all breast cancer cases histologically diagnosed and confirmed by three Pathologists at the University College Hospital (UCH), Ibadan over a one-year period from 1st January 2018 to 31st December, 2018. Results: A total of 236 breast cancer cases were seen during this period, 234 (99.2%) were females while only 2 (0.8%) were male. 163 (69.7%) patients were between the fourth and sixth decades of life, 65 (27.8%) patients were above sixth decade while 6 (2.5%) patients were below fourth decade. Invasive ductal carcinoma of No Special Type (NST) was the commonest histological subtype 212 (89.8%). Grade 1 cases were 25 (10.6%), Grade 2 129 (54.7%) and Grade 3 cases were 40 (16.9%) while 42 (17.8%) were not graded. Lymphovascular invasion observed in 98 (41.5%) of the cases. 54 (22.9%) had immunohistochemistry out of which 23 (43.4%) were triple negative while 8 (3.4%) were triple positive. Conclusion: Histopathological features suggesting aggressive disease was predominantly observed. Efforts should be made towards early diagnosis, adequate evaluation and prompt treatment. Cancer care should be fully incorporated in the National Health Insurance Scheme (NHIS).
Overexpression of human epidermal growth factor receptor 2 protein in urothelial carcinoma of the urinary bladder in Ibadan: a single-institutional experience
(Faculty of pathology, national postgraduate medical college of nigeria, 2020) Fatunla, E. O.; Ajani, M. A.; Onakpoma, F. A.; Takure, A. O.; Okolo, C. A.
Background: Overexpression of human epidermal growth factor receptor 2 (HER 2) protein has been shown to have both prognostic and therapeutic values in several malignancies including urothelial carcinoma of urinary bladder (UCB). Aims: This study aimed to determine HER 2 protein overexpression and evaluate its correlation with clinico pathological parameters in UCB. Materials and Methods: This was a descriptive-analytical study involving the immunohistochemical review of all histologically diagnosed urinary bladder malignancy in the Department of Pathology, University College Hospital, Ibadan, between January 2002 and December 2016. Urinary bladder malignancies whose tissue blocks could not be found and/or demographic data were not available were excluded. Immunohistochemistry analysis was done using rabbit anti HER 2 antibody (Biocare) and American Society of Clinical Oncology/College of American Pathologists guidelines established for breast cancer were used for HER 2 status scoring. The statistical analysis was carried out usingthe Statistical Package for the Social Sciences, version 22 (SPSS Inc, Chicago, Illinois, USA). Results: HER 2 overexpression was found in four (6.3%) cases. All the HER 2 positive cases were males. One (2.9%) of the 35 high grade UCB showed positive HER 2 overexpression, whereas three (10.7%) of the 28 low grade tumor were positive for HER 2 protein overexpression.There was no statistically significant association between HER 2 protein overexpression and histological grades of UCB and muscle invasion by the tumor. Conclusion: Our study demonstrated the low percentage of HER 2 overexpression in UCB with no significant association with tumor grades and muscle invasion. Larger samples involving multiple centers can provide more robust information and further evaluate HER 2 overexpression in urothelial carcinoma in our environment.