BackgroundGlobally, the absence of a premalignant stage of ovarian cancer and a reliable screening tool make early diagnosis difficult. Locally, poverty, ignorance, and lack of organized cancer services make prognosis poor. We describe the epidemiological features of ovarian cancer seen at Ahmadu Bello University Teaching Hospital Zaria, Northern Nigeria, a tertiary referral center, over a 10-year period in this challenging setting.MethodsAll cases of histologically diagnosed ovarian cancer between January 1, 2004 and December 31, 2013 were included in the study. Case notes were retrieved to collect clinical data including age, parity, clinical stage of disease at presentation, and known associated factors. Results were analyzed using Epi info™.ResultsA total of 78 patients were included in the study. About 4–13 cases were seen every year with a tendency to increasing incidence. The patients were aged 8–80 years with mean of 37 years. Sixty-two (79.5%) patients were premenopausal while postmenopausal women accounted for only seven cases or 9.0%. There were 17 cases (22.3%) of aggressive cancers in patients aged ≤20 years. A majority of the patients, 65 (83.3%), were parous with only nine (11.5%) patients being nulliparous. Serous cyst adenocarcinoma accounted for 32 (41%) cases. Granulosa cell tumor was the second commonest with 18 cases (23.1%). The mean age of occurrence of serous cyst adenocarcinoma was 31 years and for epithelial ovarian cancers in general it was 33.5 years. Endometrioid adenocarcinoma was rare with only one case in 10 years. Factors like age, parity, and premenopausal status did not appear to be protective to the occurrence of malignant ovarian tumor in this group.ConclusionIncreasing numbers of patients with ovarian cancer were seen over the 10-year period. Young, premenopausal, parous women made up the majority of cases. Serous cystadenocarcinoma was the most common histological variant.

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Background: Carcinoma of the Cervix is one of the gynecologic cancers. Gynecological cancer is a scourge in the developing nations because of the burden of cervical cancer. Carcinoma of the cervix is the leading cause of cancer death in women. The costs of treatment of cancers generally are very high and this has made care very difficult in the developing nations. The question therefore is who bears the cost and whose responsibilities? Aims and Objective: To study the economic burden of cancers on the patient, and how they source for these funds. To determine how the lack of funds or otherwise has affected their care. To assess their perception of who should bear the cost of this care. Methodology: It is a prospective study of all consecutive patients that attended the Gynecologic clinic of our unit between 2 nd January 2010 and 30 th June 2010. Data were analyzed using Excel statistical package. Result: A total of 93 patients were interviewed. A majority of 70 (76%) of the patients had Carcinoma of the cervix. The mean age of there husbands was 58 years. Most of them were either farmers (21%) or retired civil/public servants (15%) and earn between 700-1700 dollars per year. A large group of the patients were full time House wives (48%), while Petty trading and farming account for 13.3% each. The women earn less than 500 dollars per year. Only 50% received assistance, from family members (35.8%) or relatives (29.6%). More than 50% of them have spent between 1000-3000 dollars for their health bills. It was sad to note that 40% of them have no hope of help/assistance from anywhere. A majority of 83.3% believe that the government should come to their aids. Conclusion: In the developing nations, poverty still remains major problem, where people still earn less than a dollar per day. In essence prevention is paramount; otherwise most of our women who escaped maternal mortality may end up being a victim of cancer death.

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Gynaecological malignancies frequently metastasize to contiguous structures, internal organs and bones. Cutaneous metastasis as a primary or recurrent presentation of these malignancies is rare and only a few cases have been reported in the literature. A twenty year (1991)(1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) retrospective search for umbilical metastasis from gynaecological malignancies in our departmental case records showed only four cases. Four postmenopausal females presented with painful cutaneous umbilical (Sister Joseph's) nodules. The clinical examinations of all four patients revealed well delineated nodules of varying sizes and degrees of ulceration. Other findings were matted axillary and inguinal lymph node enlargement, intra-abdominal and pelvic masses, vaginal discharge and vaginal bleeding. Incisional tissue biopsies from the nodules were processed in paraffin wax and stained with haematoxylin and eosin. Histology of the sections showed pigmented skin overlying metastatic malignant tumours consistent with adenocarcinoma from the endometrium and ovary in three cases, and squamous cell carcinoma, large cell keratinizing from the cervix uteri in the fourth case. Gynaecological cancers have a global spread and varied geographic distribution. Cervical cancer is the commonest in our setting and patients often present to hospital with advanced stage disease. Ovarian and endometrial cancers are infrequent and their diagnosis may be delayed by non-specificity of presenting clinical symptoms from other benign tumours at these sites. Although umbilical metastasis is commonly associated with gastro-intestinal malignancies, its presence may be the first harbinger of occult gynaecologic cancer. (J Turkish-German Gynecol Assoc 2012; 13: 204-7)Key words: Metastasis, umbilical, cervix uteri, squamous cell carcinoma, endometrial adenocarcinoma Received: 04 November, 2011 Accepted: 03 January, 2012Jinekolojik maligniteler sıklıkla komşu yapılara, iç organlara ve kemiklere metastaz yaparlar. Bu malignitelerin primer veya rekürren prezentasyonu olarak deri metaztazları enderdir ve literatürde sadece bir kaç olgu bildirilmiştir. Jinekolojik malignitelerden kaynaklanan umbilikal metaztazlar için departmanımızın olgu kayıtlarında yirmi yıllık (1991-2010) retrospektif taramada sadece dört olgu bulundu. Menopoz sonrası dört kadın deriyi tutan ağrılı umbilikal nodüllerle (Rahibe Joseph) başvurmuştu. Dört hastanın klinik muayenesi farklı büyüklükte ve farklı ülserasyon derecelerinde iyi sınırlanmış nodülleri ortaya koymuştu. Diğer bulgular aksillar ve inguinal lenf nodlarında paket halinde büyüme, karın içi ve pelvik kitleler, vajinal akıntı ve vajinal kanama idi. Nodüllerden insizyonla elde edilen doku biyopsileri parafin mumunda işlenmiş ve hematoksilin-eozin ile boyanmıştı. Kesitlerin histolojisi üç olguda endometriyum ve overden köken alan adenokarsinoma ile uyumlu metastatik malign tümör ve üstünü örten pigmente deriyi, dördüncü olguda servik...