క్యాన్సర్ సైన్స్ & థెరపీ

Background: Colorectal cancer, a disease that was once said to be rare among Nigerians and Africans, now has a rapidly growing incidence in Nigeria. In this review, factors that may be accounting for this trend are looked at, as well as the peculiarities of the disease in Nigeria. Colorectal cancer in Nigeria comes with its peculiarities such as; increasing adoption of disease risk factors such as unhealthy diets and lifestyle such as, consumption of high fat and low fiber diet, tobacco smoking and reduced physical activity and, late disease presentation. The aim of this article is to review theses changing trends and the clinical phenotype of Colorectal Cancer among Nigerians.

Methods: An electronic search of published literature was conducted via MEDLINE, PubMED and Google Scholar using a variety of search items such as ‘Colorectal Cancer in Nigeria’, ‘CRC in Nigeria’, ‘Risk Factors for Colorectal Cancer in Nigeria’ to find related articles. Bibliographies of retrieved papers were further examined for publications of interest. Articles that reported clinically significant findings and research reports using related to Colorectal Cancer were reviewed in detail. Data on the relative frequency of cancers in Nigeria in 1960 was gotten from the Ibadan Cancer Registry, while the 2018 data was gotten from the Globocan Cancer Statistics of 2018.

Results: The results of this review shows an upward trend in the prevalence of Colorectal Cancer. Colorectal Cancer as at 1960, was the 10^th most common cancer among Nigerians men and women respectively, and the 12^th most common cancer in both sexes in Nigeria. As at 2018, Colorectal Cancer was the 2^nd most common cancer among Nigerian men, and 3^rd most common cancer among Nigerian women, and the 4^th most common cancer in both sexes in Nigeria.

Conclusion: Colorectal cancer, which was once uncommon in Nigeria, has now become the 4^th most common cancer in both men and men in Nigeria. This is a call on the government and people to take necessary action in controlling this disease through screening, prompt treatment and adoption of preventive measures such as increased dietary fiber intake.

Background: Anorectal carcinoma includes tumors of the anal margin, the anal canal, and the low rectum. The incidence of rectal cancer is 40% of all colorectal cancers, but anal tumors represent 2.5% of all gastrointestinal tumors. The incidence of anal malignancy has been increased in the last 30 years, both in the USA and elsewhere. Adenocarcinomas are the most frequent pathological subtype.

Patients and methods: Our study is retrospective and was conducted for 5 years. Patient’s data were collected from the medical records through a predesigned sheet that included the following information: demographic data, medical history, past history, presenting symptoms, pathological data, treatment details and treatments outcomes in the form of PFS and OS.

Results: Of 181 cases, 11.6% were anal adenocarcinoma, 39.2% were rectal adenocarcinoma, 74% were anorectal adenocarcinoma, and 2.2% were anal squamous cell carcinoma. The median age for AA was 55 years, 52 years for RA, and 51 years for ARA. The median OS was lower for AA (41 months); compared with RA (62.3 months) and ARA (61.1 months) (P value 0.3) that needs further evaluation. Early stages had a better OS (63 months) while advanced and metastatic stages were associated with shorter OS (30.2 and 12.4months) respectively with highly statistically significant. Positive safety margin and positive lymphovascular/perineural invasion were associated with shorter OS (31.9 months) in comparison to higher survival in patients with the negativity of these two factors (61.6 months) and this was significantly high (p-value: 0.03). Univariate analysis for PFS revealed that the age only can affect PFS significantly as the younger age group has a median survival of 54 months in comparison to 33.5 months for the older age.

Conclusion: AA has poor prognosis than ARA, RA. The early-stage has a better OS that needs more effort for early diagnosis and treatment.

Primary intracranial germinomas (PIGs) are an extremely rare entity with usual location in the pineal and suprasellar regions. Adult cases are rare since they are commonly diagnosed in the second decade of life. Diagnosis is based on specific imaging features in addition to tumor markers, cerebrospinal fluid cytology and stereotactic biopsy. We report a rare case of pineal germinoma diagnosed in adult patient at department by cerebrospinal fluid cytology. The therapeutic strategy was based on neoadjuvant chemotherapy followed by radiotherapy. The patient received chemotherapy based on BEP regimen (bleomycine-etoposide-cisplatin) with a clear clinical benefit from the first cycle of chemotherapy by complete resolution of clinical symptoms. The evolution was marked after the third cycle of chemotherapy by severe febrile pancetopenia leading to septic complications and the death of patient. The aim of this work is to describe the rarity of this case, clinical radiological and histological features, in addition to therapeutic management and discuss them in comparison with literature.

Introduction: Subependymal giant cell astrocytoma (SGCA) is an uncommon benign brain tumour, usually histologically low grade with slow evolution. frequently associated to tuberous sclerosis complex which is a phacomatosis due to genetic mutations affecting specific tumor suppressor genes. Radical surgery whenever possible is the cornerstone of treatment, mTor inhibitors are also effective in the case of associated TSC when surgical resection is impossible.

Presentation of case: We report herein the case of a 12-year-old Arabian child presented with symptoms of increased intracranial pressure without other neurological complaints. Brain imagine discovered tumor located in the right lateral ventricle with ventricular dilatation. Pathological examination of stereotaxic biopsy confirmed the diagnosis of SGCA. The child died by the complications of intracranial hypertension.

Discussion: Subependymal Giant cell astrocytoma is a rare benign tumor that originates from the wall of the lateral ventricles near the foramen of Monro, associated with the tuberous sclerosis complex or Bourneville’s disease in 5 to 14%. The particularity of our case of SGCA, is the revealing aspect of TSC on the one hand, and the absence of typical cutaneous signs (present in 95% of TSC) and mental retardation on the other hand. The discovery of a huge renal mass suggestive of angiomyolipoma corroborated the diagnosis of TSC in our case.

Conclusion: Subependymal giant cell astrocytoma is a very rare benign tumor; so its diagnosis requires to realize a specific and orientated workup looking for other lesions associated with tuberous sclerosis complex.