BackgroundThe prevalence and distribution of histologically diagnosed breast disease are not well documented in low income countries, Uganda inclusive. Although the greater majority of breast lesions globally are benign, breast cancer is the most frequently diagnosed cancer all over the world. We aimed at documenting the prevalence of different breast diseases histologically diagnosed at the histopathology laboratory of the Department of Pathology of the Makerere University College of Health Sciences (MakCHS Lab) over a decade (2005–2014). We also describe the demographic characteristics of the patients in Uganda diagnosed with breast disease at the MakCHS Lab during the same period.MethodsThis was a 10 year retrospective study of histologically diagnosed breast disease between 2005 and 2014 inclusive at the MakCHS Lab. We extracted information from hard copies of all 2510 histopathology reports retrieved from archives of the Department of Pathology at the MakCHS Lab. 640 records that were either damaged beyond recognition of key details, were duplicated, were implausible or had no conclusive diagnosis made were excluded. Information to be analyzed was then entered into Epidata (version 3.1) on a password protected laptop. Data analysis was done using SPSS software (v16 for Windows × 64).ResultsFrom the 1870 patients’ records eventually analyzed, breast disease was most diagnosed in female patients (97.1%). The overall mean age for breast disease diagnosis was 33 years (S.D ± 16.46) and median age 26 years (IQR: 20–43). Fibroadenoma (40.1%) was the most diagnosed breast disease overall. We noticed steadily increasing frequency of diagnosis of cancerous breast diseases over the last half of the study period. Invasive ductal carcinoma was the most diagnosed breast cancer (326 cases, 55.6%). A high female to male breast cancer ratio of 48:1 was observed. The highest regional breast cancer proportion was from the Western region of the Country.ConclusionsThere is need for more research into the picture of breast disease in the country, covering various demographic characteristics of the country’s population for all regions and informing about its incidence rates and prevalence and also the breast cancer risk estimate for benign breast disease.

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The role of pathology in improving cancer in resource‐limited countries is essential, yet many barriers exist. FNA is a rapid, low‐cost and efficient method for diagnosing cancer, planning treatment, and building a cancer registry.

Background: Penile cancer is uncommon in Liberia with no record of its occurrence so far in the literature. Its occurrence worldwide is significantly affected by cultural or religious practices like childhood circumcision. Smoking, poor penile hygiene and inflammatory processes in the presence of smegma increase the risk of its occurrence. Objective: To review the first case of penile cancer treated in Liberia. Materials and Method: Case report. Case Presentation/Report: Our index patient is a 65-year old man referred from a peripheral centre in acute urinary retention. He also presented with a year history of progressively expanding ulcerative penile lesion affecting the glans and penile shaft. Local examination of the genitalia revealed an ulcerated lesion extending from the glans up to the mid shaft of the penis. The peno-bulbar urethra was free of induration. The external urethral meatus was infiltrated by the lesion. The scrotum and testes were normal and digital rectal examination revealed a moderately enlarged benign prostate. Bilateral inguinal lymph node enlargement was elicited. A diagnosis of advanced penile cancer with benign prostatic hyperplasia was made. The patient had partial penectomy, reconstruction of new external urethral meatus and inguinal lymphadenectomy. The specimen was histologically confirmed to be Squamous cell Carcinoma of the penis; the resection margins and lymph nodes biopsied were found to be adequate and tumor free respectively. Patient's post operative recovery was uneventful and he was discharged after a week. His follow up status after 6 months has remained satisfactory. Conclusion: Though rare, penile cancer does occur in Liberia and specialist staff with capacity for diagnosing and surgical intervention remains critical to patients' outcome. Early intervention improves the chances of better outcome; counseling is critical to prevent treated patient lapsing into depression.

Background: The incidence of posterior gastric perforation worldwide is low; the literature has no previous record of its occurrence in Liberia. The diffuse symptoms of a perforated posterior gastric ulcer, delay by patients before they present to hospital, and the lack of skilled personnel and facilities in Liberia to diagnose and treat this condition increase the mortality associated with posterior gastric perforation. Objective: To report the first case of posterior gastric perforation encountered in Liberia. Materials and Method: Case report. Case Presentation/Report: A 44 year old male was referred to John F. Kennedy Memorial Hospital (Liberia's principal teaching hospital) with a diagnosis of gastritis after six days of worsening epigastric pain. He had a history of NSAID use for a chronic leg and foot ulcer. Physical examination revealed a moderately distended, markedly tender abdomen characterized by guarding, rigidity and low-pitched bowel sounds. Patient was resuscitated with intravenous fluids, antibiotics and analgesics. An emergency exploratory laparotomy subsequently performed revealed a large collection of purulent peritoneal fluid, a 3 × 4 cm perforation on the posterior wall of the stomach and a 3 × 2.5 cm perforation of the transverse mesocolon. The perforations were repaired and the patient recovered satisfactorily. Conclusion: Though relatively rare and associated with a high morbidity and mortality, this case report shows that the paucity of reported cases of posterior gastric perforation may also be attributable to lack of specialist staff with capacity for clinical diagnosis and surgical intervention in a resource poor setting. Identifying patients with gastric perforation and having the skill to repair the perforations significantly enhance the clinical outcome.

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