Background
Prostatic carcinoma is emerging as the most common male malignancy in Nigeria and the second most common male cancer worldwide. Patients often present with locally advances stages, and common sites of metastasis are the spine, pelvis, chest, and long bones. Metastases to the testes and spermatic cords are reputed to be rare and may be indicative of a worse outcome, when they occur. We recently encountered a clinical case of bilateral testicular, epididymal and spermatic cords prostatic cancer metastases.
Case presentation
A 71-year-old Nigerian man, who presented at our hospital with 1-month-old complaints of inability to walk together with low back and bilateral thigh pains. This presentation had been preceded by a 5-month history of lower urinary tract symptoms. On examination, the prostate was hard and nodular as were the left testis and spermatic cord. On histological assessment of a needle biopsy, prostatic adenocarcinoma (Gleason score 5 + 5 = 10) was diagnosed. A subsequent therapeutic bilateral total orchidectomy specimen was found to contain metastatic prostatic carcinoma deposits, in the testes, epididymides, and spermatic cords. Although our patient is currently doing well postoperatively on zoledronic acid, ketoconazole, bicalutamide, and tamsulosin, he is being re-evaluated periodically for any feature of recurrence.
Conclusion
Since it has implications for eventual outcome, every clinically suspicious therapeutic orchidectomy specimen should be subjected to a detailed histopathological examination in order to exclude secondaries from the primary prostatic malignancy.
Introduction: Childhood cancer is fast becoming a growing global challenge and gaining global attention especially in low and middle-income countries (LMIC) where there is associated high morbidity and mortality. This review is to determine the patterns of malignant childhood solid tumours in our hospital and to compare this with previous studies.
Methods: A 10-year retrospective review in which all histologically diagnosed malignant solid tumours between ages 0-15 years were analysed. The surgical daybook and the histopathology request cards were retrieved and the patients biodata, nature of specimen and tumour sites were extracted. Subgrouping of the various types of tumour was done based on the third edition (2005) of International Classification of Childhood Cancers (ICCC-3).
Results: There were 124 cases of malignant childhood solid tumours with an average of 12.4 cases per year. Seventy-eight cases (62.9 %) were male, while 46 cases (37.1%) were female, hence a male to female ratio of 1.7:1. The age ranges were from 4 months to 15 years.
The five most common tumour subgroups according to ICCC-3 were nephroblastoma (25 cases; 20.2%), non-Hodgkin lymphoma (NHL) (21 cases; 16.9%), retinoblastoma (11 cases; 8.9%), rhabdomyosarcoma (10 cases; 8.1%), and Burkitt lymphoma (9 cases; 7.2%).
Conclusion: Nephroblastoma is the most common childhood solid tumour in our centre, while Burkitt lymphoma is the 5th most common. There seems to be a decline in the diagnosis of Burkitt lymphoma and retinoblastoma in our Department over the last 10 years, whether this represents a true decline in the incidence need further studies.
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