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Case Report
Volume 2 Issue 1 - 2018
Carcinoma-in-situ of the Larynx in Canada and Nigeria
Wilson IB Onuigbo*
Department of Pathology, Medical Foundation & Clinic, 8 Nsukka Lane, Enugu 400001, Nigeria
*Corresponding Author: Wilson IB Onuigbo, Department of Pathology, Medical Foundation & Clinic, 8 Nsukka Lane, Enugu 400001, Nigeria.
Received: February 09, 2018; Published: February 20, 2018
Abstract
Internet search revealed two series of Canadian cases of carcinoma-in-situ. Therefore, this was compared with Nigerian cases with special reference to the Igbo Ethnic Group. In sum, whereas the Canadian median age was in the late 60s, the Nigerian was the late 50s. Incidentally, males preponderated in both series. Now, radiation therapy has been found to be effective and safe treatment modality in developed countries. It is yet to be common practice in this developing communities.
Keywords: Canada; Nigeria; Larynx; Carcinoma-in-situ; Comparison
Introduction
Internet search revealed 2 Canadian series concerning the carcinoma-in-situ of the larynx. One numbered 67 patients (52 men, 15 women; median age, 65 years). [1] The other consisted of 34 patients whose median age at diagnosis was 67 years while the male-female ratio was 6:1. [2] Therefore, comparison was made with a Nigerian series from the Igbo ethnic group, [3] especially as the result was expected to be noteworthy.
Investigation
A Birmingham (UK) group concluded that the establishment of a histopathology data pool was beneficial in epidemiological analysis. [4] Therefore, since such a Regional Pathology Laboratory was established by the Government of the Eastern Region of Nigeria with the author as the pioneer pathologist, the collection of data on the domiciled Igbo patients was deemed to be worthwhile in tabular form.
Results
No. Initials Age Sex Duration (yr/mt) Symptoms
1 EO 50 M 15 yr Hoarseness
2 MS 55 M 3 mt Hoarseness
3 NE 51 M 2 yr Hoarseness
4 NR 57 F 1 yr Hoarseness
5 AS 68 M 4 mt Loss of voice
6 ES 50 M 2 yr Loss of voice
7 EE 65 M 2 mt Hoarseness
8 OV 51 M 8 mt Hoarseness
9 EO 70 F 1 mt Breathless
10 OA 52 M 3 mt Hoarseness
Table 1: Epidemiological analysis of Nigerian patients.
The males and females in this cohort had the median age of 57 years and the male:female ratio of 4:1. Hoarseness was the major complaint. Most patients presented relatively early.
Discussion
In both countries, males preponderated. Clear also was the affection of younger elements in the Nigerian community. Thus, the median age was 65 in one Canadian group [1] and 67 years in the other group. [2] This contrasts with the local figure of 57 years.
Although not explored in Canada, it is of interest that the Nigerian patients tended to report for treatment within months rather than years. Interestingly, this is unlike the general pattern among African cancer patients. [5]
Incidentally, the Canadian cohorts were followed up for some years. [1,2] However, this does not apply to the Nigerian patients, in whom only the biopsy stage was reached.
Some authors concluded that “The first morphologically unequivocal recognizable step is represented by intraepithelial abnormalities, such as dysplasia and carcinoma in situ.” [6] “However,” as they went further, “adjacent apparently normal squamous epithelium may already harbor the initial genetic abnormalities leading to malignant transformation.”
From Greece, the recommendation centered on “long-term follow-up study,” [7] As for Norwegian associates, we learn from their 81 cases that “it thus appears that carcinoma in situ may comprise at least two different lesions with different biological behavior.” [8] Be that as it may, the favorable story was that, in 29 patients with a histological diagnosis of carcinoma in situ of the larynx, radiation therapy was an effective and safe treatment modality. [9] Of course, that this is not yet readily available in this developing community. 
References
  1. Spayne JA., et al. “Carcinoma-in-situ of the glottis larynx: Results of treatment with radiation therapy”. International Journal of Radiation Oncology, Biology, Physics 49.5 (2001): 1235-1238.
  2. Nguyen C., et al. “Carcinoma in situ of the glottis larynx: Excision or irradiation?” Head & Neck 18.3 (1996): 225-228.
  3. Basden GT. Niger Ibos. Lond: Cass, 1966.
  4. Macartney JC., et al. “Use of a histopathology data pool for epidemiological analysis”. Journal of Clinical Pathology 33.4 (1980): 351-353.
  5. Parkin DM., et al. “Cancer in Africa: Epidemiology and prevention”. International Agency for Research on Cancer World Health Organization, France: IARC Press Lyon 153 (2003): 1-414.
  6. Ferlito A., et al. “What is the earliest non-invasive malignant lesion of the larynx?” ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties 62.2 (2000): 57-59.
  7. Theodosiou MG., et al. “Laryngeal dysplasia: A long-term follow-up study”. JBUON 18.3 (2013): 683-688.
  8. Stenersen TC., et al. “Carcinoma in situ of the larynx: Results with different methods of treatment”. Acta Oto-Laryngologica 105.449 (1988): 131-133.
  9. Smitt MC and Goffinet DR. “Radiotherapy for carcinoma-in-situ of the glottis larynx”. International Journal of Radiation Oncology, Biology, Physics 28.1 (1994): 251-255.         
Citation: Wilson IB Onuigbo. “Carcinoma-in-situ of the Larynx in Canada and Nigeria”. Pulmonary Research and Respiratory Care 2.1 (2018): 125-127.
Copyright: © 2018 Wilson IB Onuigbo. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.