Aniefon Umana

Paucity of HPV-Related Head and Neck Cancers (HNC) in Nigeria

Introduction The burden of HPV-related Head and Neck Cancers (HNC) has been rising in the U.S. and other developed countries but this trend has not been reported in Africa. Objective of study was to evaluate the prevalence of HPV infection in HNC cancer cases seen between 1990 and 2011 at the tertiary health care institutions in Nigeria. Methods We retrieved 149 head and neck cancer formalin fixed, paraffin embedded tumor specimens diagnosed between 1990 and 2011 from four teaching hospitals in Nigeria. One hundred and twenty-three blocks (83%) contained appropriate HNC for analysis while DNA extraction was successful in 60% (90/149). PCR amplification was successful in 33% (49/149) and Linear Array genotyping for HPV was successful in 11% (17/149) of these cases. These were in tumors from the larynx (6), cervical lymph nodes (3), nasal cavity (2), parotid (1), palate (1), maxillary sinus (1) and mandible (1). Two cases were non-specific and none were from the oropharynx. Histologically, 41% (7/17) of the successfully genotyped blocks were squamous cell carcinomas (larynx 6, maxillary sinus 1). Results and Conclusion We were unable to detect HPV in any of the HNC samples in our study. Our result may suggest that there is a low prevalence of HPV-related HNC among the adult population in Nigeria. Our results provide a benchmark to compare future incidence of HPV -related HNC in this community in future. We had significant analytical challenges from possible poor tissue processing and urge that future studies should prospectively collect samples and ensure high quality sample processing.

Kaposi Sarcoma in Calabar, Southern Nigeria

OBJECTIVES There has been an increase in the prevalence of Kaposi sarcoma (KS) with the emergence of Human Immunodeficiency Virus (HIV). METHODS Patients with histologic diagnosis of KS seen in the University of Calabar Teaching Hospital, Calabar between January 2007 and December 2008 were studied. Diagnosis of HIV was based on enzyme linked immunosorbent assay (ELISA). RESULTS In total, 15 patients (10 males, 5 females, M: F=2:1) presented with KS and accounted for 33.0% of total skin malignancy and ranked second after squamous cell carcinoma, 42.0%. Their ages ranged from 5 and 60 years (mean 37.5 years). Twelve patients (M=8, F=4), 80%, were HIV seropositive, while 3 (M=2, F=1) were HIV seronegative. The lower limb was the commonest affected site, 57.9%. CONCLUSION The most common clinical type was HIV related KS. Ignorance, sociocultural beliefs, poverty, late presentation were underlying issues.

Giant Mucoepidermoid Carcinoma of the Parotid Gland: A Case Report and Review of Literature

Mucoepidermoid carcinoma is the most frequently encountered salivary gland carcinoma usually presenting as small, painless, asymptomatic mass. Presented is a 54-year-old male security personnel with a 5-year history of giant locally advanced, nodular, and ulcerated left sided facial tumour diagnosed as mucoepidermoid carcinoma on histology. Mucoepidermoid carcinoma can attain a grotesque dimension with management challenges. We present this case, as we have not encountered MEC as large as this and conclude that it should be considered as a differential diagnosis of facial tumours.

Rhinoscleroma with Malignancy- A Case Report and Review of Literature

Rhinoscleroma (scrofulous lupus, scleroma) is a rare, chronic, specific granulomatous disease of the nose and upper respiratory tract. It occurs most frequently in young female adults between the ages of 10-35 years in low socioeconomic class in developing countries. The course is usually chronic, relapse can occur and it is nonneoplastic. Inflammatory compressive destruction of bone and soft tissue may occur and thus could lead the clinician and radiologist to suspect malignancy. We report a 25-year-old woman who developed undifferentiated tumor three months after initial diagnosis of RS. She was the first case of RS with malignancy in our institution.

Acute rubella infections mimicking measles in children in Calabar, Nigeria

The clinical diagnosis of rubella is unreliable as the symptoms are often confused with other viral and non-viral exanthematic illnesses. Acquired forms are self-limiting whereas the congenital type has devastating consequences on the foetus. The aim of this study is to highlight rubella infections in children and to draw to the attention of relevant authorities the need for routine rubella immunization for children and women of childbearing ages. This was a prospective cross-sectional study conducted from February to December 2012. Thirty five children aged 2 to 18 years, were referred to selected health facilities in Calabar following reports of symptoms of fever and skin rash, clinically resembling measles. The demographic data of the children were obtained. Blood was collected from each child and sent for measles and rubella IgM ELISA. Data were analysed using SPSS version 16. Of the 35 children with fever and skin rash, 22 were males while 13 were females (1.7:1). Fourteen (40%) of the children were found to be IgM seropositive for rubella. Five (35.7%) of rubella IgM seropositive children were less than five years of age while 7 (50%) were 5-10 years old. There was no significant difference in the seropositivity for rubella IgM antibody according to age and sex of the patients and (P = 12.5). Only one child (2.8%) was positive for measles IgM. Acute rubella infection is clinically indistinguishable from measles and is confirmed to be present in Calabar, Nigeria. We therefore advocate for routine immunisation of children and women of childbearing ages to prevent the damaging effects of rubella to the unborn baby.