RESUMEN

OBJECTIVE: We report a case of plasma cell variant of Castleman's disease confined to the meninges. CLINICAL PRESENTATION AND INTERVENTION: A 53-year-old woman presented with severe headache lasting a few months, which was insidious in onset but followed a progressive course with associated vomiting, blurring of vision and diplopia. Investigations revealed a dural-based mass that was considered both radiologically and intraoperatively as a meningioma. Total surgical excision of the mass was performed. Histologically, it was a plasma cell variant of Castleman's disease with kappa light chain restriction. Laboratory investigations and whole body computerized tomography scan showed no significant abnormality. A short course of local radiotherapy was given. The patient is well 2 years after treatment. CONCLUSION: This report highlights the rarity of solitary intracranial Castleman's disease and the difficulty in radiological and intraoperative diagnosis.

Asunto(s)

RESUMEN

The major objective of this study is to analyze the histological findings in emergency obstetric hysterectomy specimens and correlate them with the clinical diagnosis, epidemiological factors and number of tissue blocks examined. The records of all peripartum hysterectomy specimens examined between 1995 and 2001 in the Department of Pathology, Al-Sabah Hospital Kuwait were analyzed. A minimum of ten blocks from the cervix or lower uterine segment was arbitrarily regarded as adequate. Fifty-eight patients had peripartum hysterectomies (incidence of 0.07% of all deliveries) out of which 65% were aged between 30 and 40 years. The number of hysterectomy increased with parity up to five and then declined. The number of blocks examined varied from 2 to 53. Satisfactory pathology was found in 40 and absent in 18 cases. There were 33 adherent placentas. Amniotic fluid embolism (AFE) was found in seven patients. Adequate tissue blocks (>or=10) were significantly associated with positive pathological findings. P value <0.05.

Asunto(s)

RESUMEN

Between 1995 and 2004, 142 malignant bone tumours comprising 76 primary and 66 secondary tumours were identified in the Pathology Department of Al-Sabah Hospital, Kuwait. Pathological fracture was the presenting sign in 35% of the cases. The mean incidence of primary tumours/year was 3.3 cases/million inhabitants. The primary tumours showed a male predilection and 42% occurred below the age of 20 years. The most frequent in the descending order of frequency were Ewing's sarcoma, multiple myeloma, osteosarcoma, chondrosarcoma and non-Hodgkin's lymphoma. The femur was the most common site for secondary tumours; more than half of the tumours with metastases at this site originated in the breast. The high frequency of Ewing's sarcoma is noteworthy and requires further investigation.

Asunto(s)

RESUMEN

OBJECTIVE: To document the first case of clear cell adenocarcinoma of the rectum (a rare entity) in Kuwait. CLINICAL PRESENTATION AND INTERVENTION: A 36-year-old female presented with a 1-year history of constipation and bleeding per rectum. Colonoscopy revealed an ulcerated mass 2 cm above the anal verge. After multiple biopsies an abdomino-perineal resection was performed for the rectal mass. Gross examination of the resected specimen revealed an anorectal mass measuring 5 cm in its long axis. Histopathological examination showed the tumor to be composed of lobules of mostly clear polygonal cells with round vesicular nuclei. Glandular formation was occasional. The tumor was rich in glycogen, focally displayed luminal mucin, and was associated with regional lymph node metastasis. CONCLUSION: This report illustrates a case of intestinal clear cell adenocarcinoma with lymph node metastasis that suggested a poor prognosis.

Asunto(s)

RESUMEN

OBJECTIVE: To document a retroperitoneal angiosarcoma with a 12-year disease-free period. CLINICAL PRESENTATION AND INTERVENTION: A 50-year-old farmer was referred to the Urology Clinic, Al-Sabah Hospital, Kuwait, with a 1-year history of recurrent left renal colic. Radiological investigations revealed 2 renal cysts at the lower pole and an extrarenal soft tissue mass, presumably of adrenal origin, at the upper pole. Laparotomy confirmed both the renal cysts and a circumscribed soft tissue mass. The latter was separate from the adrenal gland but had a vascular connection with an adrenal vessel. Pathological examination showed an encapsulated angiosarcoma. The patient did not have any adjuvant therapy after surgery but was followed up with annual radiological investigations for 12 years. No evidence of recurrence or metastasis was seen. CONCLUSION: The 12-year disease-free period in this case is exceptional for angiosarcomas, which is a high-grade sarcoma.

Asunto(s)

Asunto(s)

RESUMEN

We discuss the reconstruction of an orbit destroyed by an invasive fungal infection. Sino-nasal mucormycosis is usually associated with a poor prognosis, and occurs almost exclusively in immunocompromised patients. Serial imaging leading to repeated radical debridement, along with intravenous amphotericin, helped the patient to recover from this serious disease. A well-vascularised galeal frontalis-pericranial flap from the mid-forehead region was used to reconstruct the orbital defect.

Asunto(s)

RESUMEN

The pattern and clinical features of 45 ovarian tumours seen in a Southern Nigeria hospital between 1984 and 1987 were examined. The results indicate that germ cell tumours are relatively more common in this part of Nigeria than in North America and Europe. A reduced incidence of surface epithelial tumours was also observed. Most patients with either benign or malignant tumours were less than 40 years old. Two of the five tumours associated with pregnancy were malignant. The ratio of benign to malignant tumours, presenting complaints of the patients and the late stage of most malignant tumours at the time of diagnosis were consistent with what has been observed in other parts of the world.

Asunto(s)

RESUMEN

Between January 1984 and December 1987, out of a total gynecological admission of 1706 patients at the University of Port Harcourt Teaching Hospital, 72 had primary cancers of the female genital organs (excluding malignant trophoblastic diseases). Of those, 53 had cervical, 10 ovarian, 6 endometrial and 3, vulval cancers. There were no cases of vaginal or fallopian tubal cancers. Ovarian cancer was the commonest gynecological cancer before the age of 40 while cervical cancer was commonest after 40. Germ cell tumors of the ovary were frequent. Patients with endometrial cancer reported early to hospital for treatment but those with other types of cancers generally reported late. On account of late arrival to hospital, inadequate medical facilities and a high defaulting rate, the outcome of treatment was very poor. Since evidence exists to the effect that cervical cancer may be sexually transmitted, a plea is made for the promotion of the widespread use of condoms in order to reduce the prevalence of invasive carcinoma of the cervix in developing countries.

Asunto(s)

RESUMEN

In this study, the clinico-pathological features of breast cancers seen in Rivers State of Nigeria were retrospectively analysed. Nine out of 67 patients (13%) were younger than 30 years of age. Only 13% of 46 patients presented within one month of the onset of symptoms. The mean duration of symptoms varied from 3.7 months in patients under 30 years of age to 13.3 months in those in the 50-59 years age range. Most patients, 40 out of 51, presented with axillary lymph node metastases, the incidence of which varied directly with both the duration of symptoms and age. It is suggested that the rise in the incidence of axillary lymph node metastasis with age is determined by increase in the duration of symptoms. These results highlight the need to intensify cancer education in the population. The presenting complaints and the distribution of the various histological types did not differ from other reports.

Asunto(s)

RESUMEN

Brenner tumor is an uncommon ovarian tumor whose etiology and hormonal activity have aroused controversies. The salient features of three cases of this tumor seen at the University of Port Harcourt Teaching Hospital, Nigeria, between March 1981 and March 1987 are discussed. In one case, the tumor was bilateral and was associated with secondary polycythemia. Another case was associated with a full term pregnancy and here the tumor contained luteinized stromal cells. Although such cells are usually associated with estrogenic activity, the full term pregnancy in this case will suggest at best a low level of hormonal activity. The last case was an incidental microscopic lesion in a postmenopausal woman.

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

Asunto(s)

RESUMEN

Autopsy findings of a case of Lassa fever from the Eastern part of Nigeria are presented. The authors suggest that in Lassa fever there is an involvement of the brain in the nature of encephalitis.

Asunto(s)