Victor Nwagbara

Giant simple hepatic cyst: a case report and review of relevant literature

BACKGROUND Giant cysts of the liver are uncommon. Symptoms are related primarily to the mass effect of the enlarging cyst. OBJECTIVE To highlight the challenges of management of giant simple hepatic cyst in a resource limited setting. CASE REPORT Presented is a 58-year-old seamstress with a 5-year history of an enlarging abdominal mass with easy satiety. Surgery revealed an exophytic giant simple hepatic cyst arising from liver segment IV that drained 4.6 litres of serous fluid. CONCLUSION Simple hepatic cyst can attain giant dimensions and should be considered in the differential diagnosis of intraabdominal masses.

Marjolin’s Ulcer: Mismanaged Chronic Cutaneous Ulcers

Background: In developing countries, chronic cutaneous ulcers, scars, and osteomyelitic sinuses are common lesions. Marjolin’s ulcer is a malignant tumour that may arise from any of the above lesions. It may be misdiagnosed for infection and mismanaged as such. Method: We evaluated the clinical histories, treatment, and outcomes of patients who presented to the University of Calabar Teaching Hospital, Calabar with histologic diagnosis of Marjolin’s ulcer from January 2010 to December 2012. Results: The seven patients were 4 males and 3 females whose ages ranged from 28-70 years (mean 45.7 years). Trauma was the leading cause of injury resulting in ulceration [road traffic injuries- 4(57%), burns-2(29%)] while the other patient suffered diabetic foot ulcer. All the injuries involved the limbs [upper-1(14%), lower -6(86%)]. The histologic diagnosis in all the patients was squamous cell carcinoma with a mean latency period of 16.3 years. Late presentation with advanced loco-regional disease precluded curative surgery with poor outcomes. Conclusion: Marjolin’s ulcer is preventable and areas of intervention have been highlighted. Educations concerning prevention, risk of chronic ulceration, early presentation, prompt and proper treatment is advocated for improved outcome.

Recurrent benign schwannoma of the scalp: Case report.

INTRODUCTION Schwannomas are benign neoplasms arising from Schwann cells. Malignant change is rare. PRESENTATION OF CASE A 42-yearold man presented with a 6-year history of a recurrent right sided multinodular scalp lesion. DISCUSSION Surgery revealed multiple ovoid masses in a scalp lesion. Histology revealed benign schwannoma. CONCLUSION Schwannoma may present as multiple lesions in a multilobulated scalp lesion and should be considered as differential diagnosis.

Cholecystectomy: indications at University of Calabar Teaching Hospital, Calabar, Nigeria.

BACKGROUND/OBJECTIVE The relative rarity of gallbladder disease has been documented in various parts of Africa. Recently the incidence has been reported as rising in some African countries. We undertook this study to evaluate the indications for cholecystectomy in our center and compare with others. METHODS This is a retrospective study of 18 open cholecystectomies in 10 years. RESULTS The ages ranged from 13 and 65 years (mean 39.2 years). There were 15 females and 3 males (F:M? = ?ratio 5:1). Calculous cholecystitis 9 (50%) in patients, acalculous cholecystitis 8 (44.4%) and a patient with carcinoma of the gallbladder were offered cholecystectomy. The commonest stone was mixed multiple stones. CONCLUSION The numbers of cholecystectomies attest to the rarity of gallbladder disease in this environment. This may be due to the high fiber and low cholesterol diet predominant in this costal population in southern Nigeria.

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.

Tuberculous Axillary Lymphadenopathy: A Case Report

Isolated axillary tuberculous lymphadenopathy is rare and described in patients without evidence of previous or ongoing tuberculosis anywhere in the body. Presented is a 26-year-old female with one-year history of axillary swelling, clinical examination and investigations revealed no evidence of tuberculosis elsewhere. Diagnosis was by histology. Tuberculosis should be considered in patients residing in endemic areas with axillary lympha denopathy.

Giant Cell Tumour of Soft Tissue of the Finger: A Case Report

Giant cell tumour of soft tissue resembling osseous giant cell tumour is a distinct and uncommon entity. Presented is a 52-year old man with a 3-year history of swelling located on the dorsum of the right middle finger diagnosed on histology as giant cell tumour of soft tissue. The need for high index of suspicion by physicians is emphasized, as giant cell tumour of soft tissue should be considered as differential diagnosis of finger lumps.

Giant Solitary Intramuscular Cystic Plexiform Neurofibroma of the Thigh: A Case Report and Literature Review

Objective: To report a rare occurrence of giant, solitary, cystic, intramuscular plexiform neurofibroma in the thigh. Case Report: A 45-year-old architect presented with a 5-year history of painless, progressively enlarging soft tissue mass in the right thigh, which was diagnosed on histology as cystic plexiform neurofibroma after excision biopsy. Conclusion: A plexiform neurofibroma should be considered in the differentials of a solitary cystic mass in the thigh even in the absence of usual manifestations of Neurofibromatosis.

Prevalence of Adenocarcinoma of Prostate in Southern Tertiary Hospital of Nigeria from Jan.2005- Dec.2012.

Aim/objectives: This is to determine the frequency/age of predilection/factors that might have contributed to a particular age/range of age that is seen to be vulnerable to the lesion. Materials and Method: A eight(8) years study of histologically diagnosed adenocarcinoma of prostate results from January, 2005-december,2012 were extracted from the departmental result register. They were a total of 330 patients were seen and analysed using SPSSversion 16.The data was presented as per age range and charts. A few of the results excluded were with no age specification – only inscribed with term ‘AD’ signifying Adult. Results: From our comparison among the years of study-the age range of 60-70 years appeared to be the most frequent age affectation of the lesion when compared with all age range. This is closely followed byage range greater than 70 years. The study also showed the presence of the malignant lesion on age range of 40-50years even when one may be thinking that at this age range the prostate starts enlargement processes. Conclusion/Recommendation: This showed the most vulnerable age range was 60-70 years as it appeared in all the year of study. This is closely followed by 70 years and above. We think that there is a great need for awareness through media education and provision of screening centres for early detection and intervention.

Transmesenteric (Internal) Hernia with an Ileal Volvulus in Pregnancy: A Case Report and Literature Review

Abstract: Introduction: Transmesenteric hernia describes an internal abdominal herniation through an opening in the mesentery. It is a very rare finding especially in pregnant women. Case Report: We report a case of acute intestinal obstruction in a 30-year-old pregnant woman with a rare finding of transmesenteric hernia and gangrenous ileal volvulus at exploration. Despite a delay due to a precipitated labour and delivery successfully managed her. Conclusion: Clinicians when faced with similar features in a pregnant woman should consider transmesenteric hernia.