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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 16  |  Issue : 2  |  Page : 134-136

A review of primary malignant cutaneous soft tissue tumors seen in a tertiary institution


1 Department of Anatomic Pathology, Irrua Specialist Teaching Hospital, Irrua, Nigeria
2 Department of Pathology, University of Benin and Department of Morbid Anatomy, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

Date of Submission06-Mar-2019
Date of Decision11-Sep-2019
Date of Acceptance09-Oct-2019
Date of Web Publication19-Nov-2019

Correspondence Address:
Dr. Dele E Imasogie
Department of Morbid Anatomy, University of Benin Teaching Hospital, P.M.B 1111, Ugbowo, Benin City, Edo State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/njbcs.njbcs_5_19

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  Abstract 


Introduction: The baseline data of primary malignant cutaneous soft tissue tumors in this environment had been determined. It is important that as the years roll by, data collection and analyses are indispensable to determine the current trend of this tumor on one hand and compare it with the baseline data from previous studies on the other hand. The aim of this study is therefore to determine the frequency and the histopathological types of primary malignant cutaneous soft tissue tumors at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria. Methodology: This was a retrospective study of all primary malignant cutaneous soft tissue tumors that were histologically diagnosed from 1st of January 2004 to 31st of December 2013 in the Department of Morbid Anatomy, UBTH. Data were obtained from departmental archives. Data analysis was done using the SPSS statistical package version 16 (V.16.0). Results: A total of 187 malignant cutaneous tumors were diagnosed over the study period, and 87 (46.52%) of these cases were primary malignant cutaneous soft tissue tumors. Their mean age was in the fourth decade of life. Females were slightly more affected with a male:female ratio of 1:1.2. The histopathological types were angiosarcomas (2.3%), dermatofibrosarcoma protuberance (10.3%), and Kaposi's sarcoma (87.4%) in increasing order of frequency. Conclusion: The earlier determined reference point data of primary cutaneous soft tissue tumors in our environment were updated to include cutaneous angiosarcoma, thus bringing this rare tumor to the attention of both the pathologist and dermatologist. An increase in the frequency of dermatofibrosarcoma protuberance and Kaposi's sarcoma was also noted.

Keywords: Baseline data, cutaneous angiosarcoma, dermatofibrosarcoma protuberance, Kaposi's sarcoma, primary malignant cutaneous soft tissue tumors


How to cite this article:
Azeke AT, Imasogie DE. A review of primary malignant cutaneous soft tissue tumors seen in a tertiary institution. Niger J Basic Clin Sci 2019;16:134-6

How to cite this URL:
Azeke AT, Imasogie DE. A review of primary malignant cutaneous soft tissue tumors seen in a tertiary institution. Niger J Basic Clin Sci [serial online] 2019 [cited 2019 Dec 9];16:134-6. Available from: http://www.njbcs.net/text.asp?2019/16/2/134/271125




  Introduction Top


Malignant soft-tissue tumors are abnormal mesenchymal proliferations.[1] Some of them have predilection for the skin.[2] These include Kaposi's sarcoma (KS).[3] Others are dermatofibrosarcoma protuberance (DFSP), cutaneous angiosarcoma, and cutaneous leiomyosarcoma.[2]

Forae and Olu-Eddo over a 25-year period (1982–2007) reported that primary malignant cutaneous soft tissue tumor (PMCSTT) represents 34.2% of primary malignant cutaneous tumors (PMCTs).[4] They also observed that KS and DFSP) were the PMCSTTs in this environment.[4] KS was by far the most common and accounted for 89.1%, while DFSP accounted for 10.9%.[4] Their mean ages for the former and latter were in the fifth and fourth decades, respectively.[4] A peak incidence in the fourth decade for KS and the third decade for DFSP was noted.[4] The age range for KS span from the second to the eighth decade, while that for DFSP was from the third to seventh decade.[4] Both tumors were slightly more common in males.[4] Paucity of data on similar studies has greatly limited the comparison of this finding with other studies.

The baseline data of PMCSTTs in this environment hitherto were elucidated by Forae and Olu Eddo. It is important that as the years roll by, data collection and analyses are indispensible in elucidating the current trend of these tumors, more so that the baseline data are available for comparison. The aim of this study is to elucidate the frequency and the histopathological types of PMCSTTs at the University of Benin Teaching Hospital (UBTH), Benin City, Edo State, Nigeria.


  Methodology Top


It was a retrospective study of all PMCSTTs that were histologically diagnosed from 1st of January 2004 to 31st of December 2013 in the Department of Morbid Anatomy, UBTH. Data for this study were obtained from the surgical pathology registers, histology request cards, subjects' case notes, duplicate copies of histology reports, hematoxylin-and-eosin-stained slides, and stored paraffin embedded tissue blocks stored in the departmental archives.

The above sources provided the following information on the cases: the age, sex, nature of specimen, hospital number, histology laboratory number, clinical presentation, and clinical diagnosis of each subject. Histology slides were retrieved, reviewed under the light microscope, and the diagnosis was recorded against the corresponding patient's name on a data spread sheet. The data obtained from this study were analyzed using the SPSS statistical package version 16 (V.16.0). The analyzed data were compared primarily with the baseline data of PMCSTTs generated from a previous study in the same environment by Forae and Olu Eddo, over a 25-year period (1982–2007). It was also compared with data from other studies on PMCTs where feasible.


  Results Top


A total of 187 malignant cutaneous tumors were diagnosed over the study period. Eighty-seven (46.52%) of these cases were PMCSTTs. Their mean age was 39.24 years [standard deviation (SD) ±13.53] and they were slightly more common in the females with a male:female (M:F) ratio of 1:1.2 [Table 1]. The histopathological types [Table 2] of the PMCSTTs found in this study were angiosarcoma, DFSP, and KS. KS was the most common and accounted for 87.4% (76) of cases. Forty were males, while 36 were females with their mean (39 years) and peak ages in the fourth decade. The second most common PMCSTT was DFSP. It accounted for 10.3% (nine cases) of these tumors. Six were males and three were females. Their mean (33 years) and peak ages were in the fourth and third decades, respectively. Angiosarcoma was the least common and it accounted for two cases (2.3%). The M:F ratio was 1:1. The age range was 61–68 years with a mean age of 64.54 years (SD = 4.95).
Table 1: Mean, median, and modal ages of primary malignant cutaneous soft tissue tumors

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Table 2: Histopathological types, frequency, and percentage of primary malignant cutaneous soft tissue tumors

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  Discussion Top


This study noted an increase in the frequency of PMCSTTs when compared with a previous study in this environment by Forae and Olu-Eddo that reported 64 cases.[4] Although the frequency of KS in this study (76 cases) was noted to be higher than that of Forae and Olu-Eddo[4] that reported 57 cases, the percentage of KS in both studies was comparatively similar. In their study, KS accounted for 89.1% of the cases with PMCSTT. Paucity of data has limited the comparison of the frequency of KS in PMCSTT in this study with other study. Like most previous studies,[4],[5],[6],[7],[8],[9],[10],[11],[12] this study noted a male predilection; however, the majority of these comparative studies looked at KS in relation to other PMCTs, unlike this study that looked at KS in relation to other PMCSTTs. Despite this, the sex predilection would suffice because the individual data for KS with respect to sex remain unchanged irrespective of whether the data were used for PMCTs or PMCSTTs. This study noted a peak age that is similar to previous studies done by Forae and Olu-Eddo,[4],[8] who noted a peak age in the fourth decade. It also falls within the range of peak age (third to fifth decades) as noted by Mandong et al.[5] in their study. The age range for KS in this study is comparatively similar to the study by Forae and Olu-Eddo;[4] however, this study brought to fore the occurrence of KS in the first decade in this environment as opposed to the aforementioned comparative study that noted its occurrence from the second decade. The frequency of DFSP in this study is comparatively the same with the findings of a study of similar nature by Forae and Olu-Eddo.[4] Paucity of data from similar studies has limited the comparison of this finding with other research works. Males were more affected by this lesion, which is in keeping with the findings of previous studies done on malignant cutaneous tumors.[4],[8],[13] The peak age of DFSP in this study was similar to that of Forae and Olu-Eddo[4],[8] who reported a peak age in the third decade. Unlike this study, Nggada et al.[13] reported a bimodal peak incidence in the fourth and sixth decades, while Adeyi and Banjo[14] reported a peak incidence in fourth decade. The age range for DFSP in this study is comparatively similar to that reported by Forae and Olu-Eddo.[4],[8]

In this study, cutaneous angiosarcoma was rare accounting for 2.3% of PMCSTTs. This rarity is in keeping with previous studies in Nigeria on PMCTs and PMCSTTs.[4],[8],[13],[15],[16],[17],[18],[19] These studies did not report a case of cutaneous angiosarcoma. The two cases of cutaneous angiosarcoma seen in this study occurred in the seventh decade, and this is in keeping with previous studies that reported the lesion in the elderly.[20],[21] This study noted no sex predilection unlike Albores-Saavedra et al.[20] who reported a slight male preponderance in the whites.


  Conclusion Top


The previously elucidated baseline data of primary cutaneous soft tissue tumor in our environment were updated to include angiosarcoma, thus bringing this rare tumor to the attention of both the pathologist and dermatologist. Furthermore, an increase in the frequency of cases of PMCSTTs (KS and DFSP) and the occurrence of KS in the first decade was observed.

The importance of periodic data collection and analyses has been brought to fore, and hence recommended in elucidating the current trend of a particular lesion especially when compared with the preexisting baseline data in that environment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Rosenberg AE. Bones, joints, and soft-tissue tumours. In: Kumar V, editor. Pathologic Basis of Disease, 8th ed. Philadelphia: Saunders Elsevier; 2010. p. 1248.  Back to cited text no. 1
    
2.
LeBoit PE, Burg G, Weedon D, Sarasain A, editors. World Health Organization Classication of Tumours. Pathology and Genetics of Skin Tumours. Lyon: IARC; 2006. p. 229-30.  Back to cited text no. 2
    
3.
Lamovec J, Knuutila S. Kaposi sarcoma, In: Fletcher CM, Unni KK, Mertens F, editors. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of Soft Tissue and Bone. Lyon: IARC Press. p. 170-3.  Back to cited text no. 3
    
4.
Forae GD, Olu-Eddo AN. Morphological patterns of primary skin Sarcoma in Benin-City, Nigeria. Sahel Med J 2015;18.  Back to cited text no. 4
    
5.
Mandong BB, Chirdan LB, Anyebe AO, Mannaseh AN. Histopathology of Kaposi's sarcoma in Jos: A 16-year review. Ann Afr Med 2004;3:174-6.  Back to cited text no. 5
    
6.
Asuquo ME, Ogunkeyede A, Bassey EE, Ebughe G. Kaposi's sarcoma: Changing trend in Calabar, South Eastern Nigeria. Ann Afri Med 2008;7:98-101.  Back to cited text no. 6
    
7.
Mseddi M, Marrekchi S, Abdelmaksoud W, Bouassida S, Meziou TJ. Epidemio-clinical profile of skin cancer in southern Tunisia. La Tunisie Medicale 2007;85:505-8.  Back to cited text no. 7
    
8.
Forae GD, Olu-Eddo AN. Malignant skin tumours in Benin City, South-South, Nigeria. Oman Med J 2013;28:311-5.  Back to cited text no. 8
    
9.
Chalya PL, Gilyoma JM, Kanumba ES, Mawala B, Masalu N, Kahima KJ, et al. Dermatological malignancies at a University Teaching Hospital in Northwestern Tanzania: A retrospective review of 154 cases. Tanzanian J Health Res 2012;14.  Back to cited text no. 9
    
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Ahmed A, Muktar HM, Bugaje MA. Epidemiological and clinical features of AIDS-associated Kaposi's sarcoma in Northern Nigeria. Arch Int Surg 2013;3:29-34.  Back to cited text no. 10
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11.
Ahmed A, Isa MS, Garba HA, Kalayi GD, Muhammad I, Egler LJ. Influence of HIV infection on presentation of Kaposi's sarcoma. Trop Doctor 2001;31:42-5.  Back to cited text no. 11
    
12.
Iregbu KC, Elegba OY. Prevalence of Kaposi's sarcoma among adult HIV-seropositive patients seen in a designated HIV treatment and care center in Abuja, Nigeria. J Int Assoc Physicians AIDS Care 2006;5:115-8.  Back to cited text no. 12
    
13.
Nggada HA, Na'aya HU, Ali N. A histological analysis of malignant tumours of the skin in University of Maiduguri Teaching Hospital, Nigeria. Highland Med Res J 2003;1:38-40.  Back to cited text no. 13
    
14.
Adeyi O, Banjo A. Malignant tumours of the skin: A 6-year review of histologically diagnosed cases (1990-1995). Nig Qt J Hosp Med 1998;8:99-102.  Back to cited text no. 14
    
15.
Asuquo ME, Ebughe G. Cutaneous cancers in Calabar, Southern Nigeria. Dermatol Online J 2009;15.  Back to cited text no. 15
    
16.
Nnabuko RE, Otene CI, Otei OO, Okwesili CI. Pattern of skin cancer at the National Orthopaedic Hospital, Enugu Nigerian. J Plast Surg 2008;4:13-8.  Back to cited text no. 16
    
17.
Ochicha O, Edino ST, Mohammed AZ, Umar AB. Dermatological malignancies in Kano, northern Nigeria: A histopathological review. Ann Afri Med 2004;3:188-91.  Back to cited text no. 17
    
18.
Mandong BM, Orkar KS, Sule AZ, Dakun NL. Malignant skin tumours in Jos University Teaching Hospital, Jos, Nigeria (hospital based study). Nig J Surg Res 2001;3:29-33.  Back to cited text no. 18
    
19.
Gana JY, Ademola SA. Skin malignancies in Ibadan: A comparative study. NJPS 2008;4:1-6.  Back to cited text no. 19
    
20.
Albores-Saavedra J, Schwartz AM, Henson DE, Kostun L, Hart A, Angeles-Albores D, et al. Cutaneous angiosarcoma. Analysis of 434 cases from the Surveillance, Epidemiology, and End Results Program, 1973-2007. Ann Diagn Pathol 2011;15:93-7.  Back to cited text no. 20
    
21.
Requena C, Sendra E, Llombart B, SanmartÃn O, Guillén C, Lavernia J, et al. Cutaneous angiosarcoma: Clinical and pathology study of 16 cases. Actas Dermosifiliogr 2017 108:457-65.  Back to cited text no. 21
    



 
 
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