Histological Patterns of Gynecological Lesions in Enugu, Nigeria. A Five-Year Review from January 1, 2000 to December 31 st 2004.

The paper characterizes the histological types of gynecological lesions in Eastern Nigeria. 2. Highlights the sex and age variations of these lesions as a base line data and compares results with similar studies from other places for planning of gynecological cancer education, screening programs and health resource allocations in Eastern Nigerian States. The records of the Department of Morbid Anatomy UNTH, Enugu. Nigeria was reviewed. Seven hundred and seventy seven gynaecological samples were received and analyzed over a period of 5years i.e., from January 1, 2000-December 31, 2004. Seven hundred and seventy seven gynecological specimens were received. Benign lesions contributed a majority with 642 cases (82.6%). The breakdown of this figure is as follows; uterine leiomyomas 201cases (25.9%) presenting at a mean age range of 28.5years-47.7years. Retained product of conception 161(20.7%), seen at a mean age range of 24.9-36.9years. Cervicitis mostly Human papilloma virus related 33(4.2%) was seen at 28.7years-54.3years on the average. Cervical cysts and polyps 65(8.4%), were seen at a mean age 22.3-46.9years. Gestational trophoblastic disease 41(5.3%) with mean age of 21.7- 37.7 years. Adenomyosis and endometriosis, 34(4.4%) presented at a mean age range of 28- 50 years. Symptomatic endometrial hyperplasia was seen at an average age of 43years with 23(3%). Uterovaginal prolapse was seen at an average age of 61years with 5(0.6%). Secretory endometrium was seen in women of mean age 36years with 16(2.1%). Benign ovarian lesion were 32(4.2%) and included benign cystic teratoma 10, serous cyst adenoma 5, fibroma 6,corpus luteum cyst 10,Mullerian cyst 1. Tubal lesions were 34(4.5%); with Tuberculous salpingitis 3, ectopic gestation 25 and bacterial salpingitis 6 cases (.72%), was seen as a component of pelvic inflammatory disease . Vaginal lesions, only Bartolins cyst 2(0.3%). The malignant lesions are composed of 135 cases (17.4%). Cervical carcinoma was the most common malignancy with 110 cases (14.2%) and was predominantly of the invasive squamous cell type in 79 specimens (10.2%). The invasive squamous type presented with a mean age of 43.7-70.3 years, cervical adenocarcinomas was 19(2.45%) with a mean presentation age of 41-66 years. Cervical intraepithelial neoplasm 12(10.9%) was seen at an earlier average age range of 22.2-62.4 years. Malignant ovarian lesions 16 (2.1%) including ; ovarian clear cell carcinomas1, endodermal sinus tumor1 and transitional cell carcinomas1. Malignant Brenner 3, Granulosa cell tumour4, serous cyst adenocarcinomas 6. Leomyosarcomas of the uterus were 4(.5%). Finally only 5 choriocarcinomas were seen (0.6%). The most common gynaecological lesion in our environment remains leiomyomata uteri with 201(25.5%) and it occurred at a mean age range of 29.5-47.7years. The most common malignancy was cervical carcinoma representing 110 cases mainly the invasive squamous cell type. It also represents the second most common malignant female cancer second only to cancer of the breast. The mean age of cervical carcinoma in situ varied from 22.2-62.4 years. But invasive squamous cell carcinoma was seen from a mean age of 42.7years to 55years.