A 10-year review of the clinicopathological patterns and prevalence of head and neck lesions in a tertiary health facility in Uyo, South-South Nigeria

Objectives: Head and neck (HN) lesions occur globally, with remarkable morbidity and mortality. However, in our setting, relevant data are lacking to show its clinicopathologic nature. Hence, we aimed to review the clinicopathological patterns and incidence of HN lesions within a 10-year (January 2010 to December 2019) period as well as provide useful data/information to help in better future management of patients with HN lesions. Material and Methods: A retrospective cross-sectional study of HN lesions (with respect to age, gender, site of lesion, and histopathological diagnosis) at the University of Uyo Teaching Hospital Uyo from January 2010 to December 2019. Results: A total of 276 HN lesions were analyzed over a 10-year period, with a prevalence of 0.004. Patients with the highest volume of HN lesions were within the 30–<40 age group. The lesions were more in females (53.6%) with M: F ratio of 1:1.2. There were more neoplastic HN lesions (85.1%) than non-neoplastic HN lesions (14.9%). The benign HN lesions (67.7%) were also more frequent than the malignant HN lesions (32.3%). And the benign neoplastic HN lesions (79.5%) were more than benign non-neoplastic HN lesions (20.5%). Conclusion: The most common HN lesions, respectively, in different subcategories, found in this study were squamous cell carcinoma, nodular goiter, inflammatory nasal polyps, and cystic hygroma. We recommend study of HN lesions’ possible etiologic/risk factors as well as a nationwide survey to determine a national prevalence of HN lesions.

Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study

Introduction: This study aimed to investigate the clinicopathological patterns and survival outcomes of young-onset colorectal cancer (CRC) in Malaysia. Methods: The study consisted of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,921 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002–2016. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009–2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients. Results: The overall proportion of young-onset CRC was 10.7%. Mean age for young-onset CRC was 39.5 ± 7.4 years, with male-to-female ratio of 1.2:1.0. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRC were diagnosed at advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and treatment modality were independent prognostic factors. Conclusion: The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, prognosis between both groups were equivalent.

Clinicopathological patterns of oesophageal cancer patients attending thoracic surgery Department of Dhaka Medical College Hospital

Background: Esophageal cancer is one of the most serious gastrointestinal cancer worldwide, owing to its rapid development and fatal prognoses in most cases. There is a paucity of published data regarding esophageal cancer the study area in particular. This study was conducted to describe the endoscopic and clinicopathological patterns of esophageal cancer in this part of the world. The study provides baseline local data for future comparison. Objectives: The present study is done to highlight the increasing incidence of oesophageal cancer in the population. Methods: Detailed informations were obtained in each cases according to protocol. Complete history was taken either from patient or accompanying attendants. Thorough clinical examination was done. Relevant investigation reports were collected. All the informations were recorded according to fixed protocol. Collected data were classified, edited, coded and entered into the computer for statistical analysis by using SPSS version 19. Results: Among the 50 cases, mean age was 52.92(±10.60) years, minimum age was 30 years and maximum age was 80 years. Maximum 76% were male and 24% were female, male: female ratio was 3.17:1. Socio-economic status of the study population, majority 48% were of lower middle class and 40% were of lower class. Common clinical presentations were dysphagia, regurgitation, significant weight loss and nausea and vomiting which were 100%, 96%, 80% and 14% respectively. Common personal history were smoking, white tobacco chewing, betel nut, betel leaf and alcohol consumption which were 66%, 20%, 92%,92% and 10% respectively. Anatomical site of oesophageal cancer, 48% were middle and lower third oesophageal cancer each. Histopathological type of oesophageal cancer, majority 56% were squamous cell carcinoma of different grades and 40% were adenocarcinoma of different grades. Common clinical staging (TNM) of the oesophageal cancer, T2 disease was 58% followed by T3, 26% and T1, 6%. Considering nodal status most of the cases were NO, 60% with Ni, 24% and N2, 16%. Regarding metastasis, only 18% cases had evidence of metastasis. Regarding treatment options of the esophageal cancer, majority 76% were selected for operative procedure, 10% for chemotherapy, 2% for radiotherapy and the rest of 12% for palliation. Conclusion: In conclusion, common clinical presentations of oesophageal cancer were dysphagia, regurgitation, significant weight loss and nausea and vomiting. Predominant personal history were smoking, white tobacco chewing, betel nut, betel leaf and alcohol consumption. Most of the oesophageal cancers were middle and lower third. Majority of oesophageal cancers were squamous cell carcinoma of different grades. Regarding TNM staging most of the oesophageal cancers were T2 disease. J Dhaka Medical College, Vol. 29, No.1, April, 2020, Page 69-76

Skin Manifestations in COVID-19: Prevalence and Relationship with Disease Severity

Background: Data on the clinical patterns and histopathology of SARS-CoV-2 related skin lesions, as well as on their relationship with the severity of COVID-19 are limited. Methods and Materials: Retrospective analysis of a prospectively collected cohort of patients with SARS-CoV-2 infection in a teaching hospital in Barcelona, Spain, from 1 April to 1 May 2020. Clinical, microbiological and therapeutic characteristics, clinicopathological patterns of skin lesions, and direct immunofluorescence and immunohistochemical findings in skin biopsies were analyzed. Results: Fifty-eight out of the 2761 patients (2.1%) either consulting to the emergency room or admitted to the hospital for COVID-19 suspicion during the study period presented COVID-19 related skin lesions. Cutaneous lesions could be categorized into six patterns represented by the acronym “GROUCH”: Generalized maculo-papular (20.7%), Grover’s disease and other papulo-vesicular eruptions (13.8%), livedo Reticularis (6.9%), Other eruptions (22.4%), Urticarial (6.9%), and CHilblain-like (29.3%). Skin biopsies were performed in 72.4%, including direct immunofluorescence in 71.4% and immunohistochemistry in 28.6%. Patients with chilblain-like lesions exhibited a characteristic histology and were significantly younger and presented lower rates of systemic symptoms, radiological lung infiltrates and analytical abnormalities, and hospital and ICU admission compared to the rest of patients. Conclusion: Cutaneous lesions in patients with COVID-19 appear to be relatively rare and varied. Patients with chilblain-like lesions have a characteristic clinicopathological pattern and a less severe presentation of COVID-19.