Browsing by Author "Abraham, Z. S"

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Aneurysmal bone cyst of the mandible: a rare case report and literature review
(Annals of Medicine & Surgery, 2023) Yahaya, J. J; Morgan, E. D; Abraham, Z. S; Othieno, E
Introduction and importance: Aneurysmal bone cysts (ABCs) are benign, non-neoplastic cystic lesions composed of multiple blood-filled cavities, which are separated by connective tissue septa and they constitute ~6 and 1.5% of all cases of the skull and jaws lesions, respectively. Case presentation: Herein, the case of an 80-year-old male with a histologically confirmed diagnosis of ABC involving the body of the left mandible was presented. The patient underwent partial mandiblectomy after confirmation of the diagnosis using orthopantomography, a computed tomography scan, and a tissue biopsy. The patient was free from pain after 1-year of follow-up, and the control orthopantomography showed no evidence of recurrence. This was followed by reconstruction of the healed part of the bone with titanium plates and a piece of bone from the lateral two-thirds of the left femur and thereafter he was cosmetically well. Clinical discussion: Patients with ABCs present with expansile and radiolucent bone lesions, which may be associated with displacement and loss of teeth due to alveolar bone erosion. Complete excision of the lesions is mandatory for the prevention of recurrence and increased morbidity. Conclusion: ABCs that involve the jaws are extremely rare and are more likely to pose a diagnostic challenge as they are more likely to be confused clinically with other expansile radiolucent bone lesions such as ameloblastoma, osteoblastoma, and giant cell tumor among many others. Also, those with extensive bone matrix formation may sometimes be confused histologically with other bone forming tumors including osteosarcoma. Recurrence is common but it can be avoided or minimized by complete resection of the lesion.
Endometriosis of the umbilicus in a 36-year-old woman: a case report and literature review
(Annals of Medicine and Surgery, 2023) Yahaya, J. J; Morgan, E. D; Abraham, Z. S
Introduction and importance: Extrapelvic endometriosis is quite rare, with a reported prevalence ranging between 0.5 and 1%, and the condition is more likely to pose diagnostic challenges. This condition is more likely to pose clinical diagnostic challenges as it may mimic metastasis such as Sister Mary Joseph’s nodule. Case presentation: Herein is reported the case of a 36-year-old woman who presented with a hard nodular dark-bluish umbilicus mass that had a tendency to increase in size and was accompanied by severe pain during menstruation for ∼2 years is reported. Laparotomy revealed a normal uterus without involvement of any other pelvic organ by the endometrial tissue except the umbilicus part. Histological evaluation revealed endometriosis of the umbilicus. Clinical discussion: By far, primary endometriosis of the umbilicus is extremely rare, and most of the time, extrapelvic endometriosis involving the umbilicus would be secondary to surgical procedures involving the abdominal cavity as it was for the presented patient. Although endometriosis is rare, it should always be considered among women of reproductive age presenting with cyclic pains. Conclusions: Meticulous investigation of patients suspected to have umbilical endometriosis helps to confirm the diagnosis and hence expedites proper management of the patients; this also prevents chances of malignant transformation of the condition despite such possibilities being extremely rare.
Immunohistochemical expression of Ki-67 and p53 and their prognostic role in ameloblastoma: A longitudinal study.
(Oman Medical Journal, 2024) Yahaya, J. J; Bwambale, P; Morgan, E. D; Abraham, Z. S; Owor, G; Wabinga, H
Objectives: Ameloblastoma, comprising approximately 11% of all odontogenic tumors, is a locally aggressive tumor with a high recurrence rate. This study aimed to assess the immunohistochemical expression of Ki-67 and p53 and their association with clinical and pathological factors among patients with ameloblastoma. Methods: Retrospective follow-up data of patients histologically confirmed with ameloblastoma at Makerere College of Health Sciences in Kampala, Uganda from January 2012 to December 2018 were retrieved. Factors associated with Ki-67 and p53 immunohistochemical expression were determined using one-way one-way analysis of variance. Chi-square and Fisher’s exact statistical tests were used to assess factors associated with recurrence. A two-tailed p < 0.05 was considered statistically significant. Results: A total of 40 patients confirmed histologically with ameloblastoma were included in the analysis. The majority (62.5%) of cases were of the conventional type of ameloblastoma. The expressions of Ki-67 and p53 were 52.5% and 85.0%, respectively. Recurrence was found in 47.5% of patients and it was associated with conventional histological type (p = 0.042), segmental resection (p < 0.001), tumor size (p < 0.001), and high p53 expression (p = 0.041). Conclusions: Almost half the cases in this study had recurrence. The immunohistochemical expression of p53 was significantly higher than that of Ki-67.
Invasive ductal carcinoma of breast in a 73-year old male: A rare case report and literature review
(International Journal of Surgery Case Reports, 2023) Yahaya, J. J; Ngaiza, A. I; Morgan, E. D; Abraham, Z. S; Othieno, E
Introduction and importance: Male breast cancers despite being similar to female breast cancers in various aspects; however, they have important distinctive characteristics such as molecular biology, increased tendency for axillary lymph node metastasis and late age at presentation. Presentation of case: We present the case of a 73-year old indigenous African male who had a 3-year history of right breast swelling which was associated with episodes of pain and tenderness. The assigned clinical stage for the patient was T2aNoMo. The mass was histologically confirmed to be invasive ductal carcinoma, not specified type (NST) without axillary lymph node involvement or distant metastasis. Immunohistochemistry also showed positive results for ER and PR hormonal receptors but negative for HER2. Clinical discussion: Considering the rarity nature of male breast cancers, this contributes to lack of evidence of the specific treatment approaches despite the noticeable difference in clinical presentation and even biological characteristics of male breast cancers, which are more likely to contribute to poor prognosis. Conclusion: The prevalence of male breast cancers has been reported to be less than 1 % of all male cancers. This contributes to the lack of analytical large studies that address the comprehensive data regarding the clinical outcomes of breast cancer among men and their predictors. Therefore, having prospective multicenter studies in future would help in providing high level of evidence on prognosis.
Predictors of recurrence and disease‑free survival for salivary gland tumors among children and young adults in Kampala, Uganda: a retrospective follow‑up study
(The Egyptian Journal of Otolaryngology, 2023) Vuhahula, E. A; Yahaya, J. J; Ngaiza, A. I; Morgan, E. D; Abraham, Z. S
Background: Salivary gland tumors are a group of tumors which are highly heterogeneous, and they are uncommon among children and young adults. We aimed to investigate the predictors of recurrence and disease-free survival for salivary gland tumors among children and young adults. Methods: We retrospectively extracted clinical, pathologic, and follow-up data of patients who were diagnosed histologically with salivary gland tumors from January 2013 to December 2018 at the department of pathology, Makerere University in Kampala, Uganda. Then, we applied Cox regression analysis to determine the predictors of disease-free survival using hazard ratio as the measure of probability of the survival with 95% confidence interval. We also used Kaplan–Meier curves to analyze the disease-free survival. P ˂ 0.05 was considered significant. Results: A total of 144 patients with salivary gland tumors were included in the present study who were aged not more than 20 years with mean age of 13.9 ± 4.5 years. Over one quarter (26.4%, n = 38) of the salivary gland tumors that were analyzed in the present study were malignant. The prevalence of recurrence was (27.1%, n = 39), and the mean disease-free survival was 58.7 ± 1.9 months. Category of the salivary gland (AHR = 1.36, 95% CI = 0.137–0.942, p = 0.037) and behavior of the tumors (AHR = 1.82, 95% CI = 0.729–0.990, p = 0.023) were the potential predictors of disease-free survival. Conclusion: Over one quarter of the patients had malignant salivary tumors, and also, one-third of the patients developed recurrence at the end of the follow-up period of 6 years. Involvement of minor salivary glands and having a malignant salivary gland tumor both have shown increased risk of recurrence as well as short disease-free survival. Therefore, patients with minor salivary gland involvement and those with malignant variants require optimal surgical resection of the tumors for possible prevention of early recurrence and increasing the survival of the patients without relapse of such tumors after initial resection of the primary lesions.