Evaluation of diagnostic performances of visual cervical inspection with acetic acid and colposcopy in Benin city, Nigeria

OBJECTIVE

To determine the performance indicators of visual inspection with acetic acid (VIA) and colposcopy to detect cervical premalignant lesions.

METHODS

A prospective cross-sectional study evaluating performance indicators of visual cervical inspection with acetic acid and colposcopy using directed biopsy for histopathology as the reference standard in a Colposcopy unit at a referral tertiary hospital in Nigeria. Consecutive sample of 212 apparently healthy, ambulant, asymptomatic women with an intact uterus and with no past history of cervical neoplasia were recruited.

RESULTS

A total of 195 women had VIA and satisfactory colposcopy with directed biopsy. Overall test positivity was 29.7% for VIA, 36.9% for colposcopy and 32.8% for histology of colposcopically directed biopsy. Using CIN 2 as the disease threshold; the sensitivity, specificity, positive predictive value and negative predictive value of VIA were 70.8%, 67.0%, 29.3% & 94.9% while those of colposcopy were 87.5%, 97.7%, 84.0% &98.2%,respectively.

CONCLUSION

Although the test characteristics of both VIA and colposcopy appear satisfactory in this study, the data suggests that colposcopy performs better than VIA in the diagnosis of cervical neoplasia. However, in view of its ease of administration and low logistic requirements, VIA still has a vital role to play in population-based screening in our environment.

Breast tumours of adolescents in an African population

BACKGROUND

Tumours of the breast are uncommon in childhood and adolescence. Patients in this age group often require a different approach to diagnosis and treatment. The purpose of this study is to highlight the clinicopathologic features of breast tumours in adolescents in a Nigerian city.

MATERIALS AND METHODS

Eighty-four breast tumour materials from patients aged 10-19 years were analyzed over a 10-year period at the Department of Pathology, University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Benin City, Nigeria.

RESULTS

A majority of the breast tumours were benign. Fibroadenoma was the most common tumour with 46 cases (54.8%), followed by fibrocystic changes with 15 cases (17%). Malignancy was extremely rare in this group, with only one case (1.2%) of an invasive ductal carcinoma. Histologically, most tumours were indistinguishable from the adult types.

CONCLUSION

Fibroadenoma is the most common breast tumour in adolescents in Benin City, Nigeria. Breast cancer and male breast tumours are rare in this age group. Routine complete physical examination of children and adolescents should include breast examination.

Small intestinal tubulovillous adenoma--case report and literature review

Benign small intestinal tumour, though rare, have been reported. We report a case of sessile and extensive tubulovillous adenoma in a 13-year-old girl. She presented in a private hospital with three months history of abdominal pain, abdominal distension, vomiting, constipation, weight loss and anorexia. Significant findings on examination were weight loss, dehydration, and a huge smooth, not tender, mobile and indentable mass which extended from the left lumbar region to right iliac fossa. Visible peristalsis coursing from left to right was seen on the mass. Erect and supine plain abdominal x-rays revealed features of partial intestinal obstruction and abdominal ultrasound scan revealed dilated and hypertrophied bowel segment but could not say the bowel segment affected. The affected segment was found to be a 55cm portion of terminal ileum at operation which was resected due to hypertrophied proximal and collapsed distal segments, features in keeping with chronic intestinal obstruction, and ileo-ileal anastomosis done. Histology report was that of benign tubulovillous adenoma and the girl has enjoyed stable health for more than a year on close follow up in surgical outpatient clinic. This case highlights the unusual presentation and unusual gross nature of this small intestinal adenoma, which was found to be a benign adenoma on histological examination.