IntroductionBone tumours are relatively rare in comparison with neoplasms in other parts of the body. Previous studies have noted higher frequencies of these tumours in young adults with potentially devastating consequences.MethodsThis study aimed to demonstrate the histopathological pattern of primary bone tumours and tumour-like lesions in Ile-Ife, Nigeria with emphasis on relative frequencies and distribution according to age, sex and anatomical location. A 13 year (1991-2003) retrospective study was carried out on 100 cases of primary bone tumours and tumour-like lesions. Records were retrieved from the surgical registers of the Histopathology Department, Qbafemi Awolowo University Teaching Hospitals Complex, Ile-Ife. Original histopathological slides were retrieved for examination and when they were unavailable, the paraffin blocks were searched out and new slides were made.ResultsA total of 100 cases met the inclusion criteria for this study accounting for 1.55% of the 6,464 cases of all neoplasms seen within this period. Of the 100 cases, 50 were malignant (50%), 28 were benign (28%) and 22 had tumour-like lesions (22%). The male to female ratio was 1.3:1 and the most common benign and malignant tumours were osteochondroma and osteosarcoma respectively. The femur was the most frequently involved bone in primary malignant lesions (24%) followed by the pelvis and the maxilla (14% each).ConclusionThe age, sex and morphological distribution of benign and malignant bone tumours is similar to earlier reports in other African and international journals. Tumour-like lesions occur more frequently in females than in males. The femur is the most favourable site for malignant primary bone tumours and the jaw bones for tumour-like lesions.

Bellini Duct Carcinoma (BDC) of the Kidney is a rare type of Renal Cell Carcinoma. It usually presents with features of local advancement or metastasis and rarely diagnosed incidentally. We present a case report of a young man who was found to have BDC of the Right Kidney following presentation with an iliac bone tumour. A 40 year old man presented to the Orthopaedic outpatient clinic on account of right sided pelvic pain and limping following a trivial fall at home. There was no antecedent history of loin pain, loin mass or haematuria. On evaluation, he was found to have a huge right iliac bone tumour invading the contiguous muscles. An incidental hypodense central ipsilateral renal mass with enlarged peri-hilar lymph nodes were found. He subsequently had right radical nephrectomy via a right sub-coastal approach and wide local excision of the Iliac bone tumour in two separate procedures. The resection margins were negative for tumour cells. Histology of the resected specimens were consistent with a metastatic right BDC of the kidney. He had a smooth post-operative recovery. One third of BDC of the kidney presents with metastasis. A high index of suspicion is required in order to diagnose BDC following such unusual presentations.

Hypercalcemia and hypercalciuria secondary to immobilization can be occasionally severe, producing an array of symptoms. This study looked at possible determinants of hypercalcemia and hypercalciuria in immobilized trauma patients. This is a prospective observational study carried out over a period of 7 months. Fifty-five immobilized trauma patients were evaluated weekly for 4 weeks for symptoms of hypercalcemia, total serum calcium and 24-h urinary calcium. The number of limbs immobilized had a significant relationship with hypercalcemia at the end of week 1 (Po0.001) and week 4 (P ¼ 0.008) and with hypercalciuria at the end of week 1 only (Po0.001). The number of bones fractured also had a significant relationship with hypercalcemia at the end of week 1 (P ¼ 0.005) and week 4 (P ¼ 0.019), as well as with hypercalciuria at the end of week 1 (Po0.001) and week 2 (P ¼ 0.036). Weight loss was significantly associated with hypercalcemia at the end of week 4 (P ¼ 0.014) and with hypercalciuria at the end of week 3 (Po0.001) and week 4 (Po0.001), whereas polyuria and polydipsia had a significant association with hypercalciuria at the end of week 2 (Po0.001) and week 3 (P ¼ 0.030). The number of limbs immobilized and bones fractured showed an early significant relationship with the development of hypercalcemia and hypercalciuria. Weight loss showed late association with hypercalcemia and hypercalciuria, whereas polyuria and polydipsia showed early association with hypercalciuria.

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Background:Extended-spectrum beta-lactamase (ESBL)-producing Gram-negative bacteria are emerging and impacting significantly on the management of patients and hospital costs. Besides, they are not being routinely sought after in diagnostic laboratories thus contributing to treatment failure.Materials and Methods:Bacterial isolates from wounds of 45 patients were identified using commercial identification kits and antibiotic susceptibility was evaluated by the Bauer-Kirby method. Screening and phenotypic confirmation of ESBL production were done as prescribed by the Clinical and Laboratory Standards Institute. The conjugation experiment was performed by the mating assay in broth between the ESBL producers and E. coli ATCC 25922 as the recipient.Results:Out of 102 Gram-negative bacteria isolated, 36 were positive for ESBL mainly of the Enterobacteriaceae family (33) and the rest were oxidase-positive bacilli (3). The predominant bacteria were Klebsiella spp. and E. coli. Others were Serratia rubidae, Citrobacter freundii, Morganella morgannii, Proteus spp., Providencia stuartii, and Enterobacter spp. There was a significant association between treatment with third-generation cephalosporins (3GCs) and isolation of ESBLs (P=0.0020). The ESBL producers were multiply resistant and moderately sensitive to colistin. The conjugation experiment showed that the ESBL gene was transferred horizontally and tetracycline, cotrimoxazole, nitrofurantoin, gentamicin, and aztreonam resistance genes were co-transferred. No mortality was recorded but the mean length of stay in the hospital was 82 days.Conclusion:The development and spread of ESBL among Gram-negative bacteria and possible horizontal transfer calls for concern, especially in view of treatment failure, high treatment cost, and consequent discomfort to patients.