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Introduction: Thyroiditis may be induced by goserelin (a long acting analogue of gonadotropin - releasing hormone) prescribed for the treatment of pain and bleeding of endometriosis. Goserelin induced thyroiditis has a possibility of affecting thyroid function and hence may cause poor uptake on sodium pertechnetate Tc-99m thyroid scan. Results: This case report highlights a rare instance of a middle-aged woman with symptomatic toxic goitre whose sodium pertechnetate Tc-99m thyroid scan uptake was inhibited by goserelin therapy. Conclusion: Medical personnel caring for patients on goserelin need to be aware of the possibility of it affecting thyroid function.
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The ingestion of smoked foods has been linked to the development of cancer. Polycyclic aromatic hydrocarbons have been recognized as carcinogenic compounds which contaminate smoked foods; their ingestion has been linked to the development of cancers such as breast cancer. Breast cancer may be evaluated using the nuclear bone scan as an imaging modality. This study reviewed bone scan results of patients with a positive history of consumption of smoked foods who presented at a Nuclear Medicine facility in South-West Nigeria. Our results show a significant association between a positive history of consumption of smoked foods and the presence of advanced breast cancer on the bone scan ((χ2 = 11.190, p = 0.001, df = 2; Crude Odds Ratio (95% CI) = 1.692 (1.242-2.304). Thus, those patients with a history of eating smoked foods have between 50-100% increase in the risk of having abnormal scan findings. In a logistic regression, this association was retained (AOR=0.591 (0.434-0.805). Recommendations are made to address the significance of these findings
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Humanos , Hidrocarburos Policíclicos Aromáticos , Medicina Nuclear , Neoplasias de la Mama , Cintigrafía , AlimentosRESUMEN
OBJECTIVES: The aim of this study is to describe the characteristics and predictors of discontinuation during follow-up care among breast cancer patients at the Radiation Oncology Department, University College Hospital (UCH), Ibadan, Nigeria. METHODOLOGY: This is a retrospective cross-sectional study of 504 patients with histological diagnosis of breast cancer referred for radiotherapy to the breast or chest wall. Data extraction form was used to obtain information on sociodemographic and disease related variables and time to discontinuation of care. Discontinuation rates and its predictors were estimated using Kaplan-Meier, Log rank test, and Cox's regression method of analyses. RESULTS: Five hundred and four breast cancer patients were studied. The mean age was 47.7years, 58.2% presented late with advanced stage disease, and 40% and 39% had metastasis and anaemia, respectively. Seventy-seven percent of patients discontinued follow-up care before completion of ten-year period. The 5-year and 10-year discontinuation rates were 69.8% and 92.6%, respectively. The median discontinuation time was 44 months. Discontinuers were more likely to be older than the age of 45years {HR=1.415; 95% CI= 1.044 - 1.917}, have metastasis {HR=1.793; 95% CI=1.396 - 2.302}, be anaemic {HR=1.404; 95% CI = 1.120 - 1.760)}, and have late-stage disease {HR=1.310; 95% CI = 1.407-1.639)}. CONCLUSION: Breast cancer care discontinuation is associated with late presentation and advanced stage of disease. Therefore a system of community follow-up care and public awareness about breast cancer symptoms is recommended to reduce late presentation and discontinuity of care.
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BACKGROUND: The bone is the commonest site of metastases from breast carcinoma. Radionuclide isotope scanning is a sensitive scanning procedure for the demonstration of bone pathology. In May 2006, a gamma camera was introduced into clinical use for skeletal scintigraphy at the University College Hospital, Ibadan, Nigeria. OBJECTIVE: To review the first five years findings of skeletal scintigraphy in our breast cancer patients. METHODS: We retrospectively reviewed the clinical data and scintigraphic bone studies of patients with histology proven breast carcinoma managed in the Surgical Oncology Division, University College Hospital, Ibadan, Nigeria between May 2006 and April 2011. RESULTS: Within the period, a total of 597 breast cancer patients had skeletal scintigraphy (SS). Of the 594 (99.5%) SS reports available for review, scintigraphic evidence of bone metastases was found in 232 (39.1%) patients. Correlation of bone involvement and clinical stage showed that a large majority of the patients had stage IV (83.3%) and III (15.7%) disease. Most patients (71.6%) had multiple bone lesions. The bone lesions were osteoblastic in 88.9% of the patients; only 1.8% had purely osteolytic lesions with the remainder being a mix of both. CONCLUSION: There was scintigraphic evidence of bone metastasis in most of our patients with stage four breast cancer and in some with locally advanced disease. Multiple bone lesions were found in many of them and almost all the lesions were osteoblastic. Moreover, both the truncal and axial skeletal bones were involved in similar proportions.
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Neoplasias Óseas/diagnóstico por imagen , Neoplasias de la Mama/secundario , Diagnóstico por Imagen/métodos , Adulto , Anciano , Anciano de 80 o más Años , Neoplasias Óseas/epidemiología , Neoplasias Óseas/secundario , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/epidemiología , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Metástasis de la Neoplasia , Nigeria/epidemiología , Cintigrafía , Estudios Retrospectivos , Adulto JovenRESUMEN
BACKGROUND: Graves' disease is an autoimmune disorder characterized by hyperthyroidism and associated features. Management of this disease condition for many decades has been largely by surgical and medical intervention. Usage of anti thyroid medication ameliorates the symptoms and effects of excessive production of thyroid hormones. Recently in Nigeria, Nuclear medicine facility became available with the option radioiodine ablative therapy for the management of Graves disease. This study highlights the benefits of radioiodine therapy against the background of equally viable medical and surgical practice. PATIENTS MATERIAL AND METHOD: All the 36 patients seen from the inception of Nuclear Medicine facility at the University College Hospital from June 2006 to May 2010 were included in this study. Sources of referral were compiled. All the patients were on anti thyroid medication at presentation. Thyroid scan was performed by Siemens E- cam gamma camera 20 minutes after intravenous injection of 3-5 mCi of Tc-99m-Pertechnetate. The patients with "diffuse toxic goiter" on thyroid scan were given 10 mCi of Iodine-131 orally and discharged home with radiosafety precautions. Most of the patients were treated 5 days post discontinuation of antithyroid medication. The patients were followed-up monthly with thyroid function tests to determine commencement of replacement therapy. RESULT: Peak incidence of Graves' disease was at 6th decade (38.9%) of all patients studied. This disease was commoner in women with a ratio of 8 to 1. Ten (27.8%) patients became hypothyroid at the 3rd month post radioactive iodine-131 treatment, while the remaining 20 (55.6%) patients became hypothyroid at the 5th month. Six patients were lost to follow up. There was no recurrence of hyperthyroidism in all patients treated. Twenty eight (93.3%) patients were maintained on 100 mcg of levo-thyroxine daily, while 2 (6.7%) patients had more than 100 mcg of levo- thyroxine daily as maintenance dose. CONCLUSION: Radioactive iodine therapy presents a safe and effective alternative to the older conventional mode of management of Graves' disease