scholarly journals Spectrum of Nasopharyngeal Cancers Seen in the Department of Radiation Oncology University College Hospital, Ibadan

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Aliyu U.M ◽  
Adenipekun A. ◽  
Oladapo B.C. ◽  
Ango U.M. ◽  
Isah A.R.
Keyword(s):  
Radiation Oncology ◽  
Data Extraction ◽  
Nasopharyngeal Cancer ◽  
Cervical Lymphadenopathy ◽  
Undifferentiated Carcinoma ◽  
Late Presentation ◽  
Steady Increase ◽  
Nasal Discharge ◽  
College Hospital ◽  
Undifferentiated Histology

Background: Nasopharyngeal cancer was initially thought to be an uncommon disease in Nigeria, but recent studies have shown a steady increase in the incidence of the disease with an associated increase in morbidity and mortality due to late presentation. Method: This was a retrospective review of patients with nasopharyngeal cancer seen in the department of Radiation Oncology U.C.H. Ibadan from 2000 to 2009. Patient's bio-data, clinical-pathologic presentation and site of referral were retrieved using data extraction form and subsequently analysed using Micrsoft Exel (2013). Results: A total of 205 patients with histologically confirmed nasopharyngeal cancer seen during the study period were analysed. The mean age of the patients was 41.7 years with 144 (70.2%) males and 61(29.8%) females. The commonest presenting complaint was cervical lymphadenopathy in 98.5% of patients followed by nasal blockade, nasal discharge and epistaxis with 82.0%, 78.0% and 51.2% respectively. Undifferentiated carcinoma was the commonest histologic type (68.8%). Majority of patients were civil servants (33.2%). The habit of smoking and alcohol ingestion were unspecified in majority of patients (43.4%). Ingestion of smoked fish has been found in majority of patients 122(59.5%) with the disease in this study. Most of the patients came from southern part of the country which coincide with geographic distribution of Burkitt lymphoma, hence the possibility of Ebsteinbarr virus (EBV) as one of the likely causative agents. Conclusion: Nasopharyngeal cancer is common. Cervical lymphadenopathy, nasal blockade with undifferentiated histology and late presentation were the norm. Referrals were from all the regions of the country.

scholarly journals Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria

2018 ◽  
Vol 2018 ◽  
pp. 1-9
Author(s):  
M. D. Dairo ◽  
D. B. Adamu ◽  
Y. A. Onimode ◽  
A. Ntekim ◽  
O. Ayeni
Keyword(s):  
Breast Cancer ◽  
Radiation Oncology ◽  
Late Presentation ◽  
Advanced Stage ◽  
Breast Cancer Patients ◽  
College Hospital ◽  
Stage Disease ◽  
Follow Up Care ◽  
Ibadan Nigeria

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 45yearsHR=1.415; 95% CI= 1.044 - 1.917, have metastasisHR=1.793; 95% CI=1.396 - 2.302, be anaemicHR=1.404; 95% CI = 1.120 - 1.760), and have late-stage diseaseHR=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.

scholarly journals Undifferentiated Nasopharyngeal Carcinoma Presenting with Shoulder Mass

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Cosphiadi Irawan ◽  
Rahmat Cahyanur ◽  
Reyhan Eddy Yunus
Keyword(s):  
Palliative Chemotherapy ◽  
Nasopharyngeal Cancer ◽  
Bone Tumour ◽  
Undifferentiated Carcinoma ◽  
Neck Mass ◽  
Definitive Treatment ◽  
Unknown Primary ◽  
Common Cancer ◽  
Stage Ivb ◽  
The Right

Nasopharyngeal cancer (NPC) is the most common cancer among head and neck cancer that usually presented with unilateral neck mass. Unusual symptoms of NPC can lead us to diagnosis misleading and delayed definitive treatment. We present a case of NPC with bone metastasis in the shoulder. A 33-year-old female presented with right shoulder mass caused by undifferentiated carcinoma of unknown primary, based on biopsy of shoulder mass. After four months, she was complaining painless neck swelling, headache, and hearing impairment in the left ear. Bone MRI showed malignant bone tumour in the right humerus. Neck CT scan showed mass in the nasopharyngeal and bilateral lymphadenopathy. Biopsy in nasopharyngeal revealed undifferentiated carcinoma of nasopharyngeal cancer (WHO-3 type A). The patient was diagnosed as NPC stage IVb and thus was treated with palliative chemotherapy. After three cycles of cisplatin docetaxel, patient condition improved.

Adjuvant chemotherapy with vincristine, cyclophosphamide, and doxorubicin after radiotherapy in local-regional nasopharyngeal cancer: results of a 4-year multicenter randomized study.

1988 ◽  
Vol 6 (9) ◽  
pp. 1401-1410 ◽  
Author(s):  
A Rossi ◽  
R Molinari ◽  
P Boracchi ◽  
M Del Vecchio ◽  
E Marubini ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Randomized Study ◽  
Nasopharyngeal Cancer ◽  
Distant Metastases ◽  
Undifferentiated Carcinoma ◽  
Treatment Groups ◽  
Distant Failure ◽  
Curative Radiotherapy ◽  
Significant Difference ◽  
Base Of The Skull

To evaluate the effect of adjuvant chemotherapy in patients with local-regional nasopharyngeal carcinoma (NPC) (squamous or undifferentiated) in complete remission at the end of curative radiotherapy (RT) 229 patients were randomized from 1979 to 1983 in a multicenter study to no further therapy (116 patients) or a combination of vincristine, cyclophosphamide, and Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) (VCA) for six monthly cycles (113 patients). The RT and RT + VCA groups were well balanced for median age (50 v 49 years), histology (undifferentiated carcinoma, 73% v 70%), tumor extent (tumor limited to nasopharynx, 57% v 57%), and nodal extent (negative nodes 26% v 24%, nodes in the lower cervical levels, 17% v 16%). RT was delivered to the nasopharynx, the base of the skull, and bilateral cervical nodes using a split course technique over 10 weeks up to the dose of 60 to 70 Gy in involved sites and 50 Gy to negative nodes. Response to RT was evaluated within 65 days post-RT treatment. Analysis at 48 months did not show significant difference between the two treatment groups in terms of relapse-free survival (RT, 55.8%, RT + VCA, 57.7%, P = .45) and overall survival (RT, 67.3%, RT + VCA, 58.5%, P = .13). The pattern of relapse was similar in the two treatment arms. Distant metastases were the cause of treatment failure in about 50% of relapsing patients. Although the results of the present study did not show any benefit from VCA administered after curative RT, combined systemic chemotherapy should be further explored due to the high incidence of local and distant failure after intensive RT.

scholarly journals Determinants of Timing of Presentation of Neurotrauma Patients to a Neurosurgical Center in a Developing Country

2018 ◽  
Vol 09 (04) ◽  
pp. 545-550 ◽  
Author(s):  
Toluyemi Adefolarin Malomo ◽  
Toyin Ayofe Oyemolade ◽  
Amos Olufemi Adeleye
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Late Presentation ◽  
Neurological Deficits ◽  
Delayed Presentation ◽  
Long Distance ◽  
College Hospital ◽  
Cross Sectional ◽  
Initial Care ◽  
Cord Injury

ABSTRACT Background: A major goal in neurotrauma management is the prevention of secondary neuronal injuries. This goal is time bound as neurological deficits once established are usually irreversible. Late presentation is the norm in most neurotrauma patients in developing countries. Aims: The aim of the study was to review the timing of presentation of neurotrauma patients and the possible causes of their late presentation for neurosurgical care in our practice. Methods: A cross-sectional study of a 4-month prospective database of neurotrauma patients presenting to the University College Hospital, Ibadan, was done. The participants’ biodata, injury characteristics, initial-care details before referral, and information on timing and causes of delay were analyzed. Results: The study subjects included 111 patients, 80.2% (89/111) were males, and 52.8% aged 21–40 years. Head injury (HI), spinal cord injury (SCI), and combined HI and SCI occurred, respectively, in 80.2%, 14.4%, and 5.4%. Road accidents followed by falls were seen in 73.9% and 14.4% (16), respectively. Just 46.8% (52/111) cases presented within 12 h of injury and only 37 (33.3%) within 4 h. Majority, 83.8% (93/111) were referrals from primary care. These referrals were delayed in 81.7% (76/93) of these. The referring health facilities were located intracity with our center in 54%. Other causes of delayed presentation of these study participants included long-distance travel to our center, lack of funds, or a combination of the above factors. Eighty-nine patients (80.2%) were brought in by family members and the remaining minority by passers-by and road safety personnel. Conclusions: Delayed referral from primary care features prominently in timing of presentation of neurotrauma patients in Nigeria. There is a need for collaboration as well as continuing medical education between the neurotrauma specialists and primary care physicians.

Primary nasopharyngeal tuberculosis in a patient with the complaint of snoring

2002 ◽  
Vol 116 (4) ◽  
pp. 301-303 ◽  
Author(s):  
Bülent Aktan ◽  
Erol SelimoĞlu ◽  
Harun Üçüncü ◽  
Yavuz Sütbeyaz
Keyword(s):  
Tuberculin Skin Test ◽  
Skin Test ◽  
Histopathological Examination ◽  
Cervical Lymphadenopathy ◽  
Rare Condition ◽  
Endoscopic Examination ◽  
Nasal Discharge ◽  
Common Presentation ◽  
Mucosal Oedema ◽  
Tuberculosis Therapy

Isolated nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. The most common presentation of nasopharyngeal tuberculosis is with a cervical lymphadenopathy followed by nasal discharge or obstruction.Here we present a 58-year-old patient with nasopharyngeal tuberculosis whose only complaint was snoring. Her oropharyngeal and anterior rhinoscopic examination was normal. On endoscopic examination, mucosal oedema and hyperaemia of the nasopharynx was observed. There was no cervical lymphadenopathy. The tuberculin skin test was positive and histopathological examination of the biopsy taken from posterior nasopharyngeal wall supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the snoring stopped and the nasopharyngeal examination was normal.

scholarly journals Dermal Metastasis from Nasopharyngeal Carcinoma: A Rare Form of Metastasis

2011 ◽  
Vol 26 (1) ◽  
pp. 42-45
Author(s):  
Johanna Patricia A. Cañal
Keyword(s):  
Lymph Node ◽  
Nasopharyngeal Carcinoma ◽  
Cervical Lymphadenopathy ◽  
Undifferentiated Carcinoma ◽  
Metastatic Carcinoma ◽  
University Hospital ◽  
Selective Neck Dissection ◽  
Rare Form ◽  
Nasopharyngeal Biopsy ◽  
Four Quadrant

Objective: To report a rare form of metastasis from a primary nasopharyngeal carcinoma, a creeping form of dermal metastasis.   Methods: Design: Case Report Setting: Tertiary Public University Hospital Patient: One   Results: A 47-year-old male referred for radiotherapy after having undergone a selective neck dissection for multiple cervical lymphadenopathy with histopathologic diagnosis of undifferentiated carcinoma and no known primary underwent a four-quadrant nasopharyngeal biopsy which confirmed the presence of nasopharyngeal carcinoma. Subsequent radiotherapy resolved the primary mass , and a new posterior cervical lymph node that appeared five months after completion of radiotherapy also resolved with additional radiotherapy. He was asymptomatic for two years until he noted thickening of the skin in his left supraclavicular area. A Computed Tomography (CT) scan showed deep cervical adenopathy and skin thickening, and biopsy confirmed dermal metastatic carcinoma. Two courses of radiotherapy to the affected skin and left axilla where a lymph node had developed resulted in resolution and he was referred for chemotherapy.   Conclusion: Dermal metastasis from nasopharyngeal carcinoma is rare and does not present with pathognomonic symptomatology. It may therefore be confused for a benign side effect (dermatitis), not the malignant manifestation that forebodes a bad prognosis. Patients with dermal metastasis should receive treatment, and radiotherapy may play a significant part. Chemotherapy may also play a role in its management.   Keywords: Nasopharyngeal carcinoma, dermal metastasis

scholarly journals Efficacy and safety of Ayurveda interventions for sinusitis: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Azeem Ahmad ◽  
Manohar S. Gundeti ◽  
Parth P. Dave ◽  
Sophia Jameela ◽  
Shruti Khanduri ◽  
...  
Keyword(s):  
Data Extraction ◽  
Meta Analysis ◽  
Nasal Discharge ◽  
Efficacy And Safety ◽  
Inclusion Criteria ◽  
Clinical Trial Registries ◽  
Significant Difference ◽  
Registration Number ◽  
Published Research ◽  
Positive Results

Abstract Objectives To provide a broad evaluation of the efficacy and safety of Ayurveda interventions for the management of sinusitis. Methods Five electronic databases for published research articles, three databases for the dissertation/doctoral thesis works, clinical trial registries, and hand searches were done till May 2021. All comparative clinical trials recruiting sinusitis patients of any age group, receiving Ayurveda intervention, regardless of forms, dosages, and ingredients, for not less than one week were included. The data extraction and the risk of bias (RoB) assessment were done by two reviewers independently. Results A total of 2,824 records were identified, of which 09 randomized parallel arms trials met inclusion criteria. No studies were found comparing Ayurveda vs. placebo or non-Ayurveda interventions. Combined Ayurveda therapy (CT) was statistically more beneficial compared with either procedural or non-procedural Ayurveda therapy alone in reducing symptoms nasal discharge (standardized MD −0.71, 95% CI −1.16 to −0.26, I 2 58%, 210 participants) and headache (standardized MD −0.44, 95% CI −0.86 to −0.02, I 2 56%, 218 participants), however, no significant difference was found in reducing symptoms nasal obstruction and loss of smell. No data related to the safety of Ayurveda intervention was found. All the trials (09) were having ‘high’ to ‘some concern’ overall bias. Conclusions Although individual studies appeared to produce positive results, very low certainty of total effect hindered to arrive at any conclusion regarding efficacy or safety of Ayurveda interventions for sinusitis. There is a need for well-designed-executed-reported clinical studies on clinically relevant outcomes. PROSPERO registration number CRD42018103995

scholarly journals Malignancy in Clinically Non-toxic Multinodular Goiter

2021 ◽  
Vol 10 (1-2) ◽  
pp. 84-88
Author(s):  
Mohd Shahjahan Ali ◽  
Md Habibullah Sarkar ◽  
Syeda Momena Hossain
Keyword(s):  
Total Thyroidectomy ◽  
Multinodular Goiter ◽  
Histopathological Examination ◽  
Follicular Adenoma ◽  
Cervical Lymphadenopathy ◽  
Follicular Carcinoma ◽  
Chronic Thyroiditis ◽  
College Hospital ◽  
Toxic Multinodular Goiter ◽  
Thyroid Swelling

Objective: Goiter is a common form of thyroid swelling among population living in areas of iodine deficiency. Of the goiters, non-toxic multinodular goiter (MNG) is the most common and benign form of thyroid disease. However, studies have shown that long-standing MNGs may harbour malignancy. The present study was, therefore, undertaken to ascertain the prevalence of malignancy in clinically diagnosed non-toxic MNGs. Methods: This cross-sectional study was conducted in the Department of Surgery (all four-units) and ENT Department, Rajshahi Medical College Hospital, Rajshahi from July 2007 to June 2008 on 100 patients of clinically non-toxic MNG who underwent thyroid surgery. Biopsy materials were taken from the excised nodules and were sent for histopathological examination to see what proportion of them harboured malignancy. Result: The findings of the study showed that 40% of patients were 30-40 years old with mean age of the patients being 35.5 ± 10.1 (range: 14-75) years. Majority (87%) of the patients was female. Half of the patients with non-toxic MNGs had a history of thyroid swelling for 1-5 years and the rest half for > 5 years with median duration of illness being 5.5 years (range: 1-30 years). Of the 100 patients 4% had stridor and 6% dyspnoea; dysphagia and cervical lymphadenopathy each was 6%. Nearly 60% of the patients had goiter of size 15 sq-cm or below. Sub-total thyroidectomy was the most common operation performed (33%) followed by right hemi-thyroidectomy (24%), near total thyroidectomy (20%), left hemi-thyroidectomy (18%) and total thyroidectomy (5%). Histopathological examination of resected specimens revealed that 15% of the MNGs had malignancy with papillary to follicular carcinoma ratio being 4:1. Histopathological typing showed that 79% was simple MNGs, 4% follicular adenoma, 12% papillary carcinoma, 3% follicular carcinoma and 2% chronic thyroiditis. Neither age nor sex was found to be associated with presence of malignancies in MNGs (p = 0.865 and p = 0.647 respectively). The goiter-size was also not associated with presence of malignancies (p = 0.691). However, the mean duration of thyroid swelling in patients who had malignancy was much higher (8.5 years) than that in patients who did not haveany malignancy (5.7 years) (p = 0.024). Conclusion: The study concluded that a small proportion of long-standing non-toxic MNGs may turn into malignancy. Therefore, routine operative treatment without confirming that the cases are malignant does not seem to be justified. Ibrahim Card Med J 2020; 10 (1&2): 84-88

scholarly journals Etiologies of Pediatric Cervical Lymphadenopathy: A Systematic Review of 2687 Subjects

2019 ◽  
Vol 6 ◽  
pp. 2333794X1986544 ◽  
Author(s):  
Ankita Deosthali ◽  
Katherine Donches ◽  
Michael DelVecchio ◽  
Stephen Aronoff
Keyword(s):  
Systematic Review ◽  
Differential Diagnosis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Case Series ◽  
Cervical Lymphadenopathy ◽  
Granulomatous Disease ◽  
Cross Sectional ◽  
Barr Virus ◽  
Common Diagnosis

Background. Cervical lymphadenopathy in children is common and its etiologies diverse. No systematic review of the differential diagnosis of pediatric cervical lymphadenopathy has been conducted. Objective. To determine the prevalence rate of specific etiologies of pediatric cervical lymphadenopathy. Data Sources. EMBASE, PubMed, and SCOPUS were searched electronically. Bibliographies of select studies were reviewed as well. Study Selection. (1) Any clinical trial, observational study, or cross-sectional case series with 10 or more subjects that included delineation of etiologies and/or associated conditions with lymphadenopathy; (2) subjects aged 0 to 21 years with enlarged lymphoid tissue on body; (3) lymphadenopathy was confirmed by clinical evaluation; and (4) no specific diagnoses were excluded. Data Extraction. Year and location of publication, definition of lymphadenopathy, percentage of lymphadenopathy that was cervical, total number of subjects, gender distribution of subjects, age range of patients, and specific etiologies. Results. Of the 1790 studies, 7 studies that were combined resulted in 2687 subjects that were selected. Nonspecific benign etiology was the most common diagnosis occurring at a rate of 67.8%. Epstein-Barr virus was the next most prevalent (8.86%), followed by malignancy (4.69%) and granulomatous disease (4.06%). The most common malignancy etiology was non-Hodgkin’s lymphoma (46.0%), and the most common granulomatous disease was tuberculosis (73.4%). Conclusions. This systematic review and meta-analysis provides a rate-based differential diagnosis of pediatric cervical lymphadenopathy. Although the most common causes of pediatric cervical lymphadenopathy are nonspecific, the etiologies are diverse. Rates and credible intervals are provided to enable a probability-based diagnostic approach to palpable cervical lymphadenopathy in this age group.

Sign in / Sign up

Export Citation Format

Share Document