FACULTY OF BASIC MEDICAL SCIENCES
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Item Hormone–receptor expression status of epithelial ovarian cancer in Ibadan, South-western Nigeria(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.Item Malignant ameloblastoma: a challenging diagnosis(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.Item Malignant ameloblastoma: a challenging diagnosis(Hospital Universitário, Universidade de São Paulo (USP), São Paulo, Brazil, 2018) Salami, A.; Ezenkwa, U.; Salami, M.; Ajani, M. A.; Okolo, C.Ameloblastoma is an uncommon and locally aggressive, benign, odontogenic tumor, with local recurrence when not adequately excised. A rare variant of this neoplasm with the benign features but accompanied with metastases has been described. This rare variant is malignant ameloblastoma and is known to have a poor prognosis. We present the case of a young woman who had recurrent mandibular tumors, which were resected twice and histologically reported as ameloblastoma. Four years later, she presented with pulmonary metastasis and atelectasis. A review of the literature on this very rare neoplasm was also performed.Item Proliferaton index in pituitary adenomas from a black African population(Elsevier B.V., 2016) Salami, A.; Ajani, M.; Adeolu, A.; Ogun, O.; Adeleye, A.; Ogun, O.; Okolo, C.; Malomo, A.; Akang, E.Background: The WHO has recognized a variant of pituitary adenomas with potential aggressive behavior which have been termed atypical pituitary adenomas. This group of tumours are recognized by their mitotic rate of more than >3%, p53 expression and invasion of surrounding structures. There has however been no study of the occurrence of these tumours in a black African population. This study is a preliminary attempt to examine this group of tumours in blacks. Methods: This study retrospectively reviewed fifty-seven histologically diagnosed and immunohistochemically characterized pituitary adenomas received in our department over a twenty-one year period. Specimens were stained with ki67, a nuclear marker of cell proliferation which has been identified as the single best predictor of atypical pituitary adenoma. Results: Twelve of the tumours showed atypical features with eight (67%) of these tumours being prolactinomas. Two of the tumours were gonadotrophs and two were null cell adenomas. There was no correlation with age or gender. Two of the tumours required neurosurgical re-exploration with one of these showing a higher mitotic index in the second biopsy. Conclusion: The study suggests similarity in the rate of occurrence of pituitary adenomas with atypical features in a black African population with what is seen in Caucasians. Prolactinomas constitute a significant percentage of the tumours with this featureItem Brain weights in adult africans(The Brazilian Society of Anatomy (SBA), 2017) Salami, A.; Ajani, M.; Orhorho, I.; Ogun, G.; Adeoye, A.; Okolo, C.; Oluwasola, A.; Ogunbiyi, J.Introduction: The average brain weight of adult humans, using Caucasian figures, is said to be between 1300g to 1400g. Few studies have however been done to make actual evaluations of brain weights in adult Africans. This study seeks to examine the weight of brains from people of African descent with respect to variations in sex and age in decades using autopsy specimens. Materials and Methods: Analysis of the weight of brains removed from both male and female adult patients during fresh autopsy of their bodies in our center over a ten year period was done. The study criteria required non-involvement of the central nervous system in the cause of death. The brains were grouped based on age in decades and further grouped into early, middle and late age groups. Descriptive statistical analysis was done using SPSS 20 statistics software. Results: A total of one hundred and sixteen brains were included in the study and the mean brain weight was 1280g with a range between 1015g to 1590g. There was no statistically significant difference in the mean brain weight of the different age groups. The average male brain was heavier than those of females and the difference was statistically significant. Conclusion: The brain weight of adult Africans in our study is similar to that seen in Caucasians. There is no statistically significant difference in the brain weight of adults from early adulthood to the elderly adults. Male adults have statistically heavier brains than the femalesItem Sudden death in giant pituitary adenomas: two case reports with literature review(Wolters Kluwer - Medknow, 2017) Salami, A.; Babatunde, T.; Ogun, O.; Lawan, A.; Abubakar‑Akanbi, S.; Nweke, M.Pituitary macroadenomas are rare tumors constituting <1% of intracranial tumors. The giant macroadenomas are even rarer and have the potential to cause fatality due mostly to mass effects within the intracranial space. Most cases are nonfunctional and are either null cell adenomas or gonadotroph adenomas in which symptoms may have been ignored by the patient. Sudden deaths from intracranial tumors are uncommon and pituitary adenomas are very rarely associated with unexpected deaths. Here, we present two cases of giant pituitary adenomas both of which were undiagnosed before demise of the patient. The autopsy report showed no other findings except the sellar tumor. Immunohistochemistry of both tumors showed null cell adenomaItem Hormone–receptor expression status of epithelial ovarian cancer in Ibadan, South-western Nigeria(Pan African Medical Journal, 2017) Ajani, M. A.; Salami, A.; Awolude, O. A.; Oluwasola, A. O.Introduction: epidemiological evidence strongly suggests that steroid hormones are implicated in the pathogenesis of ovarian cancer. Estrogen receptor (ER) and Progesterone receptor (PR) are prognostic indicators for a number of epithelial tumors and may play the same role in ovarian cancers. This study aims to evaluate the expression of ER and PR in epithelial ovarian cancer (EOC) in an African population and compare it with other prognostic factors such as age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade and histological subtype. Methods: ninety cases of histologically confirmed EOC were reviewed. Immunohistochemistry was used to assess their ER and PR expression status and was then compared with other demographic variables using statistical methods, with level of significance set at p < 0.05. Results: 30.2% and 8.3% of serous and mucinous carcinomas respectively were ER positive while 41.2% and 22.5% of both tumour types were PR positive. One of the two endometrioid carcinomas showed PR expression but neither were positive for ER. The only case of Brenner tumour in the series was ER positive but negative for PR. There was a significant association between ER and the histological subtypes (p=0.042) while no significant association was found between PR expression and histological subtypes (p =0.650). No significant association was found between hormone receptor status, age and stage of the EOC. Conclusion: the study showed a lower ER expression in serous carcinoma compared to large cohorts from developed countries. Future translational studies could be used to determine response of EOC to endocrine therapyItem Central nervous system tumours in children in Ibadan, Nigeria: a histopathologic study(Pan African Medical Journal and African Field Epidemiology Network, 2016) Ogun, G. O.; Adeleye, A. O.; Babatunde, T. O.; Ogun, O. A.; Salami, A. A.; Brown, B. J.; Akang, EIntroduction: Contrary to some earlier teachings that central nervous system (CNS) tumours are uncommon in black children, these neoplasms are the fourth most common paediatric tumours in Ibadan. Our centre is the major referral centre for CNS tumours in Nigeria. The last major study of paediatric CNS neoplasms from Ibadan was in 1985. An update of the data on paediatric CNS neoplasms at our centre is presented. Methods: A retrospective review of all histologically diagnosed CNS tumours in children (0-14 years) from January 2001 to December 2010 from the database of the Department of Pathology, University College Hospital, Ibadan, Nigeria was done. The cases were classified using the 2007 WHO Classification of Tumours of the Central Nervous System and were also based on their supratentorial and infratentorial locations. Results: Seventy-seven tumours, 44 in males, were included in the study. Astrocytic tumour comprised 20 cases, embryonal tumours 15, ependymal tumours 15, germ cell tumours 6, sellar tumours (all craniopharyngiomas) 9 and other histological types- 12 cases. Thirty-seven were WHO Grade 1, eleven Grade 2, ten Grade 3 and nineteen Grade 4 neoplasms. Thirty-six cases were supratentorial and thirty-eight were infratentorial in location. The most common tumours in this series were pilocytic astrocytomas, medulloblastomas, craniopharyngiomas and ependymomas in that order. Conclusion: Childhood CNS tumours are being increasingly diagnosed in our centre. This is largely explained by the recent expansion of the available neurosurgical servicesItem Pattern of triple negative epithelial ovarian cancer in indigenous African women [version 1; referees: 2 approved(F1000 Research Ltd, 2016) Ajani, M. A.; Salami, A. A.; Awolude, O. A.; Oluwasola, A. O.Background: Triple negative epithelial ovarian cancer (TNEOC) refers to ovarian carcinomas that do not express estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-type 2 (HER-2/neu). The aim of this study is to determine the pattern of triple negative epithelial ovarian cancer in indigenous African women. Methods: We performed a retrospective review of ER, PR, and HER-2/neu expression in 90 Nigerian patients with histologically diagnosed epithelial ovarian cancer. Lack of expression of ER, PR, and HER-2/neu antigens was used to determine carcinomas that are among the TNEOC. We also compared the clinicopathological parameters (age, International Federation of Gynaecology and Obstetrics (FIGO) stage, grade, and histological subtype) in patients with TNEOC and non-TNEOC. Results: Thirty-eight (42.2%) of the 90 tumours diagnosed as EOC were negative for ER, PR, and HER-2/neu expression. There was no significant association between TNEOC with other parameters such as age, FIGO stage, and histological grade. Sixteen (66.7%) of the 24 mucinous carcinomas were triple negative, while only 21 (33.3%) of the 63 serous carcinomas were triple negative, and one (50%) of the two endometrioid carcinomas was triple negative. There was a significant association between triple-negative tumours and histological subtypes of EOC (p = 0.034). Conclusions: A subtype of epithelial ovarian cancer that is negative for ER, PR, and HER-2/neu has been discovered in indigenous African women. TNEOC expression is high and is comparable to the triple negative breast cancer subtype seen in people of African ancestry. Future study of TNEOC in a large sample size should be considered.Item Histopathological pattern of primary ovarian neoplasms in south‑western Nigeria(Association of Resident Doctors of Jos University, 2016) Ajani, M. A.; Aramide, K. O.; Salami, A. A.; Okolo, C. A.Background: Ovarian tumours are common forms of neoplasms in women. This study aims to determine the histopathological pattern of primary ovarian neoplasms in south-western Nigeria. Method: A retrospective study was undertaken to review the histopathology reports of all primary ovarian neoplasm specimens submitted to the Department of Pathology, University College Hospital, Ibadan from January 1991 to June 2013. Patients’ biodata were extracted from request forms and surgical day books. Results: There were 821 cases of primary ovarian neoplasms. Surface epithelial neoplasms accounted for 359 (43.7%) of cases and were found in patients aged 10–89 years. Germ cell tumours numbered 313 (38.0%) in patients aged 0–70 years, while sex cord stromal tumours numbered 146 (17.8%) in patients aged 0–99 years. Among benign ovarian neoplasms, Mature Cystic Teratoma was the most common (54.7%) with the 20–29 year age range having the highest frequency. Among primary malignant ovarian neoplasms, serous cystadenocarcinoma was the most common (33.2%) and most frequent in the 50–59 year age group. Conclusion: Surface epithelial tumours were the most common ovarian neoplasms followed by germ cell tumours. This histopathological pattern is observed in most parts of Nigeria, some African and Asian countries, and in the Western world.
