ADVANCED, RECURRENT, INVASIVE CRIBIFORM CARCINOMA OF THE BREAST IN A 17-YEAR-OLD MALE: A CASE REPORT

INTRODUCTION

Male breast cancers (MBC) are relatively rare, accounting for about 1% of all male cancers in the US and 0.6% of breast cancers worldwide. In Nigeria, though the incidence varies per region, with a range of 3.4 to 9%, it is noted to be increasing. Gynaecomastia is a well-documented predisposing factor as well as endogenous and exogenous oestrogen. The most common histological subtype of male breast cancer is the invasive ductal carcinoma. Invasive cribriform carcinoma, ICC, is an extremely rare variant, with no more than 10 cases reported worldwide and, when present, has been diagnosed in patients above 40 years old.

CASE REPORT

We present the case of a 17 year-old, male undergraduate student, who presented to our clinic on account of a recurrent, painless, right breast lump. Three years earlier he had had a right breast lump excised at another health facilityand this was diagnosed histopathologicallyas invasive cribriform carcinoma. The only known predisposing factor was an initial lump, excised when he was 10 years old, and diagnosed histologically as gynaecomastia.He had surgical excision and axillary lymph node clearance,and histopathology re-confirmed high grade invasive cribriform carcinoma with multiple lymph node metastases, while immunohistochemistry showed a triple negative signature. He was thereafter referred for adjuvant treatment and has responded well to radiotherapy.

CONCLUSION

There is need for a high index of suspicion in all cases of gynaecomastia, and all such patients should be followed up. Prompt intervention, recourse to histology, and where indicated, immunohistochemistry, are important.

Prevalence and Correlates of ADHD Among Adolescent Students in Nigeria

OBJECTIVE

To determine the prevalence and psychosocial correlates of ADHD among adolescents in Jos, Nigeria.

METHOD

A cross-sectional descriptive two-stage study of 487 randomly selected participants using Kiddie-Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL), Raven's Standard Progressive Matrix (SPM) and the Children's Global Assessment Score (CGAS).

RESULTS

The prevalence of ADHD was 8.8%. The subtypes found were inattentive (3.08%), hyperactive-impulsive (2.05%), and combined (3.08%); male:female ratio of 1.4:1. ADHD was significantly associated with use of substance by father (odds ratio [OR] = 0.35; 95% confidence interval [CI] = [0.154, 0.781]), use of substance by mother (OR = 0.2; 95% CI = [0.055, 0.711]), and lower education of mother (OR = 0.3 95% CI = [0.116, 0.693]). Poor quality of handwriting (χ² = 8.120; p = .010) and impaired global functioning ( t test = 10.756; p < .001) were significantly associated with ADHD in the adolescents.

CONCLUSION

Given the burden of ADHD, efforts should be made to establish a system for the early identification and management.

A study of psychiatry morbidity and co-morbid physical illness among convicted and awaiting trial inmates in Jos prison

BACKGROUND

Having a psychiatric diagnosis is still considered a major burden in life. In addition to dealing with stigma regarding mental illness, persons with severe mental illness have an added risk of having co-morbid medical illnesses that can further impair their already turbulent life. The importance of detecting co-morbid medical illnesses is to ensure a holistic treatment. This study assessed the prevalence of psychiatric morbidity and co-morbid physical illness among convicted and awaiting trial inmates in Jos prison.

METHOD

A cross-sectional, descriptive study was carried out among 608 male inmates in Jos maximum security prison, Plateau State, Nigeria. They were screened with self administered GHQ-28 questionnaire and interviewed using CIDI.

RESULTS

More than half (57%) of the studied subjects had a psychiatric disorder with substance use disorder as the commonest (48.7%) diagnosis. Physical co-morbidity was found in (18%) of the subjects with infectious disease (A00-A99) as the commonest source 13 (3.7%) of physical co-morbidity among the subjects. A statistically significant relationship was found between psychiatric disorder and co-morbid physical illness (p = 0.000).

CONCLUSION

The study showed a high rate of psychiatric morbidity and co-morbid physical illness with infectious disease being the commonest source of physical co-morbidity; and substance use disorder the commonest psychiatric disorder among the prison inmates.