Histopathologic Patterns of Urological Malignancies in Calabar, South-Southern Nigeria: A Ten-Year Review

Background: Malignant diseases have become more prominent in Nigeria over the past years with urological malignancies contributing significantly to cancer related morbidity and mortality. Cancers of the prostate, bladder, kidney, testis and penis are documented as the most common group of non-cutaneous cancers. This study was carried out to document the pattern and distribution of urological malignancies seen in a tertiary hospital in Calabar, South-southern Nigeria over a 10-year period.

Materials and Methods: This was a retrospective study carried out in the Department of Urology, University of Calabar Teaching Hospital, Nigeria. Cases of all pathologically proven urological malignancies managed between January 2006 and December 2015 were included. Data were retrieved from patients' case notes, operation registers and histopathology records. The histological slides of all cases were retrieved and reviewed. Patients' demographic data, tumour site, histologic diagnoses as well as pathologic grades of malignancies were extracted and analysed.

Results: A total of 617 cases of urological malignancies were included in the study over the 10 years under review, comprising of 598 (96.9%) males and 19 (3.1%) females giving a male: female ratio of 31.5:1. There were 600 adults (97.2%) and 17 children (2.8%). The median age was 43 years with range of 1-100 years. The frequency of urological cancers showed prostate cancer to be the most common urologic cancer as follows: Prostate cancer constituted 564 (91.4%), Kidneys 27 (4.4%), Urinary bladder 9 (1.5%), Testis 8 (1.3%), Scrotum 5 (0.8%), Penis 2 (0.3%) and Urethra 2 (0.3%). The most common histologic type of prostate cancer was adenocarcinoma with Gleason Grade III being the commonest grade. Out of the 17 childhood urological malignancies recorded, 13(76.47%) were kidney malignancies, 3 (17.65%) were testicular malignancies and 1 (5.88%) was bladder malignancy.

Conclusion: Prostate cancer is by far the commonest urological malignancy, with renal cancer being a distant second in Calabar, ahead of bladder cancers. Childhood urological malignancies in Calabar are predominantly nephroblastomas. The need for increased effort in creating awareness about prostate cancer and for routine screening is reiterated.