Background: Gallbladder (GB) cancer is a rare malignancy with a variable incidence worldwide. Imaging detection at an early stage is elusive. Preoperative imaging for tumour recognition and non-invasive staging is essential to triage patients to appropriate care.
Objectives: To describe the CT imaging findings of GB cancer among Nigerians.
Methods: A retrospective review of the CT images of 15 patients who had gall bladder carcinoma between January 2015 and June 2017 at a private diagnostic facility in Lagos was done.
Results: The age of the patients ranged from 39 to 73 years with a mean age of 60.9 years. The male to female ratio was 1:4.3. Clinical presentations included abdominal pain (61.5%) and jaundice (38.5%). Irregular GB wall thickening (61.5%) and focal mass lesions in the GB (38.5%) were the main features on imaging while 38.5% had associated gall stones. Infiltration of the adjacent liver was found in 76.9% and 60 % of those who had local infiltration of the liver also had intrahepatic metastasis.
Conclusion: A majority of gall bladder cancer cases are still diagnosed in their late stages. CT scan readily delineates regional spread into adjacent organs which may be obscured in other imaging modalities due to adjacent bowel gas.
Phenotypic expression of the male internal and external genitalia is due largely to the interplay between the proper differentiation of the bipotential gonad, the production of testosterone from the Leydig cells and the response of the undifferentiated external genitalia to Dihydrotestosterone. When any of the pathways involved in the mechanisms described above are distorted, it results in the 46 XY Disorder of Sex Differentiation (DSD).The incidence of 46 XY DSD ranges from 20 to 41% among the cases of Disorder of Sex Differentiation (DSD) in Nigeria, though there is a paucity of data on this condition. This report describes an under-virilized genetically male child who presented with ambiguous genitalia in the neonatal period and was subsequently diagnosed as SRY positive 46 XY DSD with reduced testosterone synthesis. This report is necessitated by the need to create awareness and highlight the relevant medico-social challenges in the management of DSD in a resource-poor setting.
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