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Annals of African Medicine
Annals of African Medicine Society
ISSN: 1596-3519
Vol. 5, Num. 3, 2006, pp. 129-131
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Annals of African Medicine, Vol. 5, No. 3, 2006, pp. 129-131
Orbito-Ocular Malignant Tumours in Zaria, Nigeria: A 10-Year Review
1A.
Mohammed, 1S. A. Ahmed, 2N. E. Ahmedu and J. S. Maisamari
1Department
of Pathology, Ahmadu Bello University Teaching Hospital, Zaria and 2National
Eye Centre, Kaduna, Nigeria
Reprint requests to: Dr. A. Mohammed, Department of
Pathology, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. E-mail: medvisory@yahoo.com
Code Number: am06030
Abstract
Background: Malignant orbito-ocular tumours are common, frequently affect the young and cause
morbidity and mortality. There was no prior published report from our centre.
Method:This study was a ten-year
retrospective histopathological analysis of orbito-ocular malignant tumours
seen at the Department of Pathology of the Ahmadu Bello University Teaching
Hospital Zaria (January 1993 to December 2002). Histopathology diagnosis of
specimens of the eye and adnexae were retrieved from the laboratory bench books
and relevant information on the age of the patient and histopathologic type
were analysed.
Results: A total of 124 orbito-ocular malignant tumours were recorded. There were 2480
malignant tumours and these constitute 5% of all malignant lesions seen. The
most frequent histological types encountered were retinoblastoma (40.3%),
squamous cell carcinoma (33.1%) and Burkitts lymphoma (9.6%). There was equal
sex distribution and infants were affected in 49.2% of cases with a mean age of
4.5 years. The most common sites in 82 cases were intraocular (54.8%), the orbit
(23.2%) and conjunctiva in 17.1% of cases.
Conclusion: Malignant orbito-ocular tumours are not uncommon in this environment and
frequently affect infants; therefore appropriate medical facilities should be
put in place to aid in diagnosis and management of these lesions.
Key words:Orbito-ocular, malignancies
Résume
Arrière-plan : Les tumeurs malignes orbito-ocullaires sont fréquent
et affectent les jeunes et est une cause de mortalité et de morbidité. Aucune
étude na été publiée de ce centre.
Méthode : Cette étude est une analyse histopathologique rétrospective, des
tumeurs malignes orbito-ocullaires vues au Département dAnatomie Pathologie du
centre Hospitalier Universitaire Ahmadu Bello Teaching Hospital Zaria, durant
dix ans, de Janvier 1993 à Décembre 2002. Les données utilisées ont étaient
récupérées de la banque des données du Département dAnatomie Pathologie et les
informations telles que lage des patients et le type de cancer a été
analysé.
Résultats : Un total de 124 tumeurs orbito-ocullaires a été
enregistré sur un total de 2480 tumeurs vues durant la période détude. Ceci
représente 5% de toutes les tumeurs malignes. Le type histologique fréquemment
rencontre fut le retinoblastoma (40.3%), les carcinome cellulaire squameux
(33.1%), et les lymphome de Burkitt (9.6%). La distribution entre sexe été
égale et les enfants étaient les plus affectes, 49.2% de toute les tumeurs avec
une age moyen de 4.5 ans. Les sites les plus affectés fut la conjonctive 17.1%
des cas, lorbit 23.2% des cas et il intraoculaire 54.8%.
Conclusion : les tumeurs orbito0ocullairs ne sont pas rare dans
cette région et affectent fréquemment les enfants, il est donc nécessaire de
mettre sur place des structures sanitaire capable de diagnostiquer et de
prendre en charge ces lésions.
Mots clés : orbito-ocullaires, malignes
Introduction
Orbito-ocular
malignancies are unsightly and may contribute to visual disturbances. Although thought
to be rare, they contribute to significant morbidity and mortality.1 - 3 Visual loss in children has implications for all aspects of the childs
development.4
The
most common histopathological types are retinoblastoma, squamous cell carcinoma
and Burkitts lymphoma.5, 6
Materials
and Method
This
study was a ten-year retrospective histopathological analysis of orbito-ocular
malignant tumours seen at the Department of Pathology, Ahmadu Bello University
Teaching Hospital Zaria, Nigeria (January 1993 to December 2002), using the
laboratory bench book.
Results
One
hundred and twenty four (5%) orbito-ocular malignancies were seen out of a
total of 2480 malignancies.
Retinoblastoma which accounted for 50 (40.3%), squamous
cell carcinoma 41 (33.1%) and Burkitts lymphoma 12 (9.6%) of the cases (Table
1).
The M:F ratio was 1:1, with a peak age in the first
decade (mean 4.5 years) (Table 2). The pattern of anatomic distribution of 82
cases is shown in Table 3. The commonest site was intraocular 45 (54.8%),
orbital in 19 (23.2%) and conjuctiva in 14 (17.1%).
Table 1: Histology of
orbito-ocular malignancies in 124 patients
Histological diagnosis |
Total (%) |
Retinoblastoma |
50(40.3) |
Squamous cell carcinoma |
41(33.1) |
Burkitts lymphoma |
12(9.6) |
Rhabdomyosarcoma |
4(3.2) |
Lymphoma(other) |
3(2.4) |
Adenocarcinoma |
4(3.2) |
Astrocytoma |
2(2.6) |
Melanoma |
2(2.6) |
Basal cell carcinoma |
2(2.6) |
Kaposi sarcoma |
1(0.8) |
Lacrimal gland carcinoma |
1(0.8) |
Metastatic nasopharyngeal carcinoma |
1(0.8) |
Osteogenic sarcoma |
1(0.8) |
Total |
124(100) |
Table 2:Age and sex of 124 patients with orbito-ocular
malignancies
Age |
M |
F |
Total (%) |
0 - 10 |
31 |
30 |
61(49.2) |
11 -20 |
7 |
5 |
12(9.7) |
21 - 30 |
9 |
10 |
19(15.3) |
31 - 40 |
9 |
5 |
14(11.3) |
41 - 50 |
3 |
7 |
10(8.1) |
51 - 60 |
0 |
3 |
3(2.4) |
61 - 70 |
2 |
2 |
4(3.2) |
71 80 |
1 |
0 |
1(0.8) |
Total |
62 |
62 |
124(100) |
Table 3: Anatomical site of 82 orbito-ocular malignancies
Anatomical site |
No. (%) |
Intraocular |
45(54.8) |
Orbit |
19(23.2) |
Conjunctiva |
14(17.1) |
Eyelid |
3(3.6) |
Lacrimal gland |
1(1.2) |
Total |
82(100) |
Discussion
One
hundred and twenty four malignant orbito-ocular tumours were analysed during a
ten-year period. This constituted 5% of all malignant tumours seen in the
department during the study period. This figure however is higher than the 2.2%
reported in Ibadan5 and 3.3% in Kampala.7
Retinoblastoma was the commonest tumour encountered which
constituted 40.3%, and this is followed by squamous cell carcinoma (33.1%) and Burkitts
lymphoma in 9.6% of cases. The predominance of these three malignancies are
similar with reports from Kaduna and Uganda5, 8and several reports
from Ibadan.7, 9, 10 This contrasts a report from Ile-Ife where no
case of orbito-ocular Burkitts lymphoma was recorded in a ten-year study.1 Basal cell carcinoma and choroidal melanoma which constituted 2% each in this
report contrasts a Caucasian report6 which showed it to be common
and is similar to other reports in Nigeria.9, 10
Retinoblastoma occurs in sporadic and familial forms,
both require mutation involving the Rb gene located on chromosome 13q14.11 However, Burketts lymphoma has been well characterized in malarial endemic
regions and it involves translocation at 14q32 following complex mechanisms in
B cell lymphocytes.12
The equal sex distribution observed in this study is
comparable to studies from Ile-Ife1 and Ibadan, 5, 10 but
contrasts with the male to female ratio of 3.4:1 from Maiduguri, North Eastern
Nigeria.13 Orbito-ocular malignancies are found to be commoner within
the first decade with a mean age of 4.5 years. This conforms to previous
reports from Ile-Ife, Maiduguri and Ibadan.1, 5, 13
The predominant site of orbito-ocular malignancies in
82 cases was intraocular constituting 54.8%, followed by the orbit in 23.2% and
conjunctiva in 17.1% of cases. Malignancies of the lacrimal glands are rare
accounting for 1% of cases. No case of eyelid malignancy was seen in this
study. This report however agrees with a study in Ibadan by Olurin et al.4
One case of uveal melanoma (2.6%) was encountered in
this study. Another African5 study show similar trend; where 3.7% of
Ocular melanoma was reported. While reports from Caucasian series show that melanoma
arising from the pigmented or
potentially pigment producing cells of the uvea are the most frequent primary
intraocular neoplasms in adults; and can occur in children and adolescents,
even in neonates.14, 15 Most of them arise from pre-existing benign
nevi.16-18
Orbito-ocular malignancies are common and frequently
affect infants. Retinoblastoma, squamous cell carcinoma and Burkitts lymphoma
are the commonest histopathological types encountered and most of these
malignancies are intraocular. Further researches into the clinical behaviour
and management options of these malignancies in Nigerian patients should
therefore be encouraged.
Acknowledgement
We
are grateful to Mrs. Aishetu Umar of Mathematics and Mr. Raoul Dasi of
Pathology Departments, for preparation of the manuscript.
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