Surgery

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Skin malignancies in ibadan: a comparative study
(2008) Gana J.Y; Ademola S.A.
Background: The incidence of skin cancers is on the rise in Caucasians. There is also an observed increase in the diagnosis of basal cell carcinoma in blacks. This study evaluated the pattern of skin cancers in Southwestern Nigeria and compared the trends with what obtained three decades earlier. Patients and Methods: A retrospective study of skin malignancies in Ibadan, Nigeria, based on Cancer Registry data was performed. Between January 1981 and December 2000, four hundred and ninety four (494) histologically confirmed cases of skin malignancies were recorded in the Ibadan Cancer Registry. Result: The commonest lesion recorded was squamous cell carcinoma accounting for 40.5% (200) of the cases. This was followed by malignant melanoma (25.1%), dermatofibrosarcoma protuberance (9.5%), Kaposi's sarcoma 8.3% and basal cell carcinoma (6.7%). Less common histological types included adenocarcinoma, undifferentiated carcinoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, fibrosarcoma and mycosis fungoides. Conclusion: Though squamous cell carcinoma is still the leading cause of skin malignancy in Ibadan. There is a statistically significant decline in its proportion and a statistically significant increase in the proportion of basal cell carcinoma, compared to proportions documented three decades earlier. This change is due to subtle differences in aetiology. The proportion of Kaposi's sarcoma has also increased probably due to increasing HIV infection rate. Hospital prevalence for basal cell carcinoma and malignant melanoma did not show the progressive increase in incidence noted among Caucasians.
Primary osteogenic sarcoma of the breast
(2006-12) Ogundiran T.O; Ademola S.A.; Oluwatosin O.M.; Akan E.E; Adebamowo C.A
Background: Primary extra-osseous osteogenic sarcomas have been reported in many tissues of the body but their occurrence in the breast is extremely rare. It can arise as a result of osseous metaplasia in a pre-existing benign or malignant neoplasm of the breast or as non-phylloides sarcoma from the soft tissue of a previously normal breast. Case presentation: A 40 year-old Nigerian woman was clinically diagnosed to have carcinoma of the left breast. The histology report of core-needle biopsy of the mass showed a malignant neoplasm comprising islands of chondroblastic and osteoblastic stromal cells. This report changed the diagnosis from carcinoma to osteogenic sarcoma of the breast. She had a left modified radical mastectomy, however there was significant post surgery skin deficit. A latissimus dorsi musculocutaneous flap was used to cover the anterior chest wall defect. Sections from the mastectomy specimen confirmed the diagnosis of osteogenic sarcoma. She died six months after mastectomy. Conclusion: A diagnosis of osteogenic sarcoma of the breast was made based on histology report and after excluding an osteogenic sarcoma arising from underlying ribs and sternum. This is the second documented case of primary osteogenic sarcoma of the breast coming from Nigeria
Focal palmoplantar keratoderma in 2 children leading to gait abnormalities.
(2006) Adebola. O.; Ademola S.A.
Hereditary focal palmoplantar keratoderma are a heterogeneous group of disorders of keratinization characterized by focal areas of thickening of the palms and soles Different genetic abnormalities have been identified for the disorders under this group. However most of them have palmoplantar keratoderma as a common manifestation. This report is about Nigerian children who presented with focal palmoplantar keratoderma without associated disorders. They presented with gait abnormalities resulting from the plantar hyperkeratosis. One of the children had surgical excision of the lesions with skin grafting, which greatly improved the gait abnormality. Perhaps surgical intervention should be carried out earlier in this group of children in case of absence of other treatment modalities available so as to prevent permanent gait abnormalities. have a similar problem. Examination revealed a young boy with normal scalp hair. His dentition and buccal mucosa were normal. His palms and nails were also found to be normal. The soles of the feet showed bilateral striate hyperkeratosis warty in appearance with well defined edges. Both ankle joints were hyper extended. All other systems were within normal limits. Histology of the excised tissue showed marked hyperkeratosis, acanthosis, hypergranulosis and acanthosis. Histologic features of epidermolytic hyperkeratosis and human papilloma virus were absent. A diagnosis of focal palmoplantar keratoderma without associated features was made, most likely of the striate type. In view of the extent of the lesions and the gait problems. Surgical excision of the hyperkeratosis was suggested. The areas with warty hyperkeratoses were excised bilaterally and skin was taken from the thighs and grafted to the feet. Both grafts healed well. He was then encouraged to bear weight gradually on the graft with the help of physiotherapy. The graft keratinized gradually in the pressure bearing areas and he was adviced to use well padded shoes and take extra care of his feet. He also started physiotherapy to encourage ambulation.

Surgery

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