Browsing by Author "Okecha, Tonny"

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Aids-Related Disseminated Kaposi Sarcoma with Renal Involvement: A Rare Non-Transplant Case Report
(2025-04-01) Omega, Phillip; Musoke Sharrif; Alele David; Okecha, Tonny; Mawanda Anatoli; Mwesigwa, Boaz; Adokorach, Gladys; Lukande Robert; Kalungi Sam
Kaposi’s sarcoma (KS) is a vascular malignancy associated with human herpesvirus 8 (HHV-8). In Africa, the commonest type is the AIDS-associated KS seen in immunocompromised individuals, infected with HIV. Although KS primarily affects the skin and mucosal surfaces, visceral involvement is also well-documented, with the lungs and gastrointestinal tract being the most frequently affected sites. Renal involvement in non-transplant patients remains exceptionally rare. We present a case of a 33-year-old HIV-positive woman with a history of non-adherence to highly active antiretroviral therapy (HAART), who developed disseminated KS involving the oral mucosa, lungs, gastrointestinal tract, liver, and the right kidney. She presented with respiratory distress, generalized lymphadenopathy, and a hyperpigmented sublingual mass. Histopathological examination of the oral lesion confirmed KS, and post-mortem findings revealed extensive tumor infiltration of multiple organs, including the right kidney. This case highlights the aggressive nature of disseminated KS in severely immunocompromised patients and underscores the critical importance of HAART adherence in preventing disease progression. Given the exceptional rarity of non-allograft renal KS, this report adds to the limited literature on its occurrence and emphasizes the need for heightened clinical awareness when evaluating advanced KS cases.
Bladder extra-gastrointestinal stromal tumor in an elderly patient in Uganda: a case report
(Edorium Journals, 2025-06-14) Okecha, Tonny; Bakenga, Alex; Waiswa, Ali; Mawanda, Anatoli; Nyakato, Veronica; Niyonzima, Nixon
Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract (GI). They arise from the interstitial cells of Cajal or similar cells. Gastrointestinal stromal tumors that occur primarily outside the GI tract are termed extra-gastrointestinal stromal tumor (EGIST). These tumors are extremely rare and very few cases have been reported to date. Case Report: We report a case of a 75-year-old male who presented with a bladder mass. The patient presented with hematuria and lower urinary tract symptoms of dribbling, straining and incomplete voiding of urine. Pelvic computed tomography scan showed a well-defined homogenous mass in the urinary bladder. The tumor was partially surgically resected, and histology revealed a spindle-shaped tumor that was initially reported as fibrosarcoma. However, a histology review was done and immunohistochemistry staining was positive for CKIT, CD34, and DOG-1. A diagnosis of EGIST was made. There has not been any case of EGIST reported in Uganda to the best of our knowledge. Conclusion: This case highlights the rarity of EGISTs, emphasizing the need for accurate diagnosis through immunohistochemistry and increased awareness for clinical management.
BRCA1 Protein Expression in Epithelial Ovarian Cancer and Associated Clinicopathological Factors in Uganda
(Wiley, 2024-10-21) Okecha, Tonny; Abila, Derrick B.; Nabbale, Dorothy L.; Katongole, Fauz; Yahaya, James Joseph; Lukande Robert; Kalungi, Sam; Nalwoga, Hawa
BRCA1 gene dysfunction seen in epithelial ovarian carcinomas often results from germline mutations, somatic mutations, and promoter methylation. Identi0cation of tumors with loss of BRCA1 protein expression has shown to have therapeutic and prognostic implications. *e aim of this study was to determine the expression of BRCA1 protein in epithelial ovarian cancer (EOC) and the associated clinicopathological characteristics. This was a cross-sectional laboratory-based study that used para5n-embedded tissue blocks of patients histologically diagnosed with EOC from January 2010 to August 2018. Tissue sections were stained with hematoxylin and eosin (H&E) for histological con0rmation and with immunohistochemistry (IHC) using a mouse-derived monoclonal antibody MS110 for BRCA1 protein expression. *e association between BRCA1 protein expression and independent variables was determined using Pearson’s Chi-square test. A total of 104 tissue blocks from patients with EOC were included in the study with a mean age of 48.7 ± 12.8 years. Serous tumors were the most common which comprised 74.0% (77/104) of all the tumors and majority of them 75.3% (58/77) were high grade. Loss of expression of BRCA1 protein expression was found in 33.7% (33/98) of all the cases. *ere was no statistically signi0cant association between BRCA1 expression and age of patients, tumor grade, and histological subtype. There is a high expression of altered BRCA1 expression in tissues of EOC. Although it has not shown association with age of patients, histology types, and tumor grade, further studies need to assess its inCuence of the survival of cancer patients with EOC.
Expression of Her-2 and Ki-67 in Gastric Cancer Formalin Fixed Paraffin Embedded Tissue Blocks and Their Correlation with Histological Grades at the Uganda Cancer Institute Pathology Laboratory
(Dovepress, 2025-12-15) Wasswa, Hassan; Birungi, Abraham; Amadile, Lawrence; Kasadha, Richard; Nabaasa, Saphurah; Ninsiima, Jolly Lydia; Okecha, Tonny; Ssedyabane, Frank; Atwine, Raymond; Tibenderana, Lauben
Background: Her-2/neu, the human epidermal growth factor receptor-2, is an oncogene reported to be excessively expressed in gastric cancer. This over-expression is a criteria for treatment with trastuzumab. An antigen linked to nuclear proliferation is Ki-67, and the level of gastric cancer aggression is reflected in its expression. Objective: To determine the expression of Her-2 and Ki-67 in gastric cancer formalin-fixed paraffin-embedded (FFPE) tissue blocks and their correlation with histological grades at the Uganda Cancer Institute pathology laboratory, with each block representing one gastric cancer case. Methods: A laboratory cross-sectional study was conducted among 75 endoscopic gastric cancer patient cases. Each case was assessed utilizing immunohistochemistry (IHC) for the expression of Her-2 and Ki-67. Spearman correlation coefficient was used to ascertain the expression and its correlation to histological grades. Results: The age range of gastric cancer cases was 26 to 80 years, with a mean age of 54. Poorly differentiated histology (43%) was the most profound. Her-2 over-expression was 20%. High Ki-67 expression was 56%, and the low Ki-67 expression was 7%. Her-2 overexpression correlated significantly with moderate differentiation (rs = 0.336, p = 0.003) and poor differentiation (rs = −0.229, p = 0.048). A significant correlation between moderate differentiation of gastric carcinoma with low intensity of Ki-67 staining was noted (rs = 0.255, p = 0.028). Conclusion: The aggressiveness of gastric cancer may be indicated by the over-expression of Her-2 and a high Ki-67. What This Study Adds: This study provides additional information on the relevance of Her-2 and a high Ki-67 over-expression in diagnosis, prognostic monitoring, and management of gastric cancer in Uganda.
Malignant Mixed Mullerian Tumor: A Case Report About a Uterine Tumor’s Case
(Elsevier, 2022-05-20) Morgan, Emanuel D; Okecha, Tonny; Yahaya, James J.; Othieno, Emmanuel
Introduction: Malignant mixed Mullerian tumor (MMMT) is an exceedingly rare and aggressive tumor which occurs predominantly in postmenopausal women though it has been reported rarely in premenopausal women. Case presentation: A 54-year old nulliparous postmenopausal female presented with a 3-month history of vaginal bleeding, mild lower abdominal pain and weight loss. Ultrasound revealed markedly enlarged uterus with a hyper-echoic solid and cystic mass and a right adnexal complex mass. Total abdominal hysterectomy and bilateral salpingioopherectomy were done. Histopathological features were consistent with MMMT. The patient is currently stable after 6 cycles of adjuvant chemotherapy which consisted of paclitaxel and carboplatin. Clinical discussion: MMMT of the uterus is rare, high-grade neoplasms comprising only 1–2% of uterine cancers and 3–5% of all uterine malignancies. This tumor may arise in the ovaries, fallopian tubes and vagina. Histologically, MMMT is a biphasic tumor composed of both epithelial (carcinoma) elements and mesenchymal (sarcoma) elements; though, which component is responsible for the tumor’s aggressive biological behavior remains undetermined. Conclusion: MMMT is a rare and aggressive tumor which is commonly seen in postmenopausal women with high rate of recurrence therefore, Radical surgery and close follow-up is mandatory since the role of chemoradiotherapy remains unclear in the management of patients with this tumor. Both stage of the tumor and myometrial invasion are considered as potential prognostic factors.
Prevalence and risk factors associated with hypopharyngo-esophageal foreign bodies impaction: a cross-sectional study
(Wiley, 2025-03-18) Kabazzi, Edrisa; Namwagala, Justine; Alunga, John R .; Byaruhanga, Richard; Okecha, Tonny; Yahaya, James Joseph
Ingestion of foreign bodies (FBs) is an emergency condition which may be associated with challenges for their removal. We aimed to assess the prevalence and factors associated with hypopharyngo-esophageal foreign bodies (HP-EFBs) impaction. A cross-sectional study was conducted at Mulago national referral hospital in Uganda from August 2018 to May 2019. The study consisted of 150 patients aged 6 months to 49 years with suspicion of HP-EFBs impaction. Binary logistic regression analysis was applied to determine factors associated with HP-EFBs. Statistical significance was set at P < 0.05. The median age of the patients was 7.1 (4.3–16.4) years, and males accounted for the majority (64%, n = 96) of the patients. Clinically, majority (62.0%, n = 93) of the patients had dysphagia. The prevalence of HP-EFBs was (33.3%, n = 50). Majority (76.0%, n = 38) of the FBs were coins. Being aged ≤5 years (aOR = 1.47, 95% CI = 2.18–3.39, P = 0.043), being a child attending school (aOR = 2.03, 95% CI = 1.56–4.92, P = 0.037), and being under caretakers aged ≤25 years (aOR = 6.83, 95% CI = 1.88–24.79), P = 0.003) were associated with increased risk of HP-EFBs impaction. This study has shown increased risk of HP-EFBs impaction particularly in male children and those attending school. Also, patients who were under younger caretakers had increased odds of HP-EFBs impaction. There is a need for caretakers and teachers at school to provide emphasis for children to always have precaution to avoid impaction of FBs.
Prognostic Factors for Overall Survival of Patients with Prostate Cancer in Kyadondo County, Uganda
(Hindawi, 2020-01-27) Yahaya, James Joseph; Okecha, Tonny; Odida, Michael; Wabinga, Henry
Prostate cancer is the second most common cancer among men globally. A few studies that have been done in Uganda on survival of patients with prostate cancer indicate that, the overall survival of patients with prostate cancer in Uganda is poor. The aim of this study was to determine the 3-year overall survival rate of a cohort of patients with prostate cancer residing in Kyadondo County who were diagnosed from 2012 to 2014. The secondary objective was to correlate the overall survival with the clinicopathological prognostic factors. Materials and Methods. This was a retrospective cohort study which involved 136 patients who were diagnosed histologically with prostate cancer at the department of pathology between 2012 and 2014. The cases were registered at the Kampala cancer registry and followed up to 31st December 2017. Data analysis was done using STATA version 12.0. The Kaplan-Meir curves were used for analysis of the 3-year overall survival rate. Hazard ratio (HR) and Log-rank test at 95% confidence interval under Cox-regression model were used to evaluate the effect of the covariates on the 3-year overall survival rate. < 0.05 was considered statistically significant. Results. More than half of the cases, 55.9% ( = 76) had Gleason score >8. Most of the patients, 67.7% ( = 92) had advanced disease at diagnosis. The 3-year overall survival rate was 67.6% with median survival of 36.5 months and range of 0–65 months. Clinical stage of the patients (HR = 1.65, = 0.039), Gleason score (HR = 1.88, = 0.008 ), and lymphovascular invasion (HR = 0.37, = 0.002) were the independent predictors of the 3-year overall survival rate in this study. Conclusion. The 3-year overall survival of prostate cancer patients in Uganda is poor. Most of the patients with are diagnosed with advanced clinical stages (stage III and IV). The Gleason score, clinical stage and lymphovascular invasion can powerfully predict independently the overall survival of patients with prostate cancer. This implies that the Gleason score, clinical stage and lymphovascular invasion may be used to predict the overall survival of patients with prostate cancer even prior prostatectomy.
Quantitative expression of estrogen, progesterone and human epidermal growth factor receptor-2 and their correlation with immunohistochemistry in breast cancer at Uganda Cancer Institute
(PLOS ONE, 2025-01-03) Wannume, Henry; Niyonzima, Nixon; Kalungi, Sam; Okuni, Julius Boniface; Okecha, Tonny; Kakungulu, Edward; Mpungu, Steven Kiwuwa; Waiswa, Geoffrey; Kadhumbula, Sylvester; Namayanja, Monica; Nabwana, Martin; Orem, Jackson
The detection of Estrogen Receptor (ER), Progesterone Receptor (PR), and Human epidermal growth factor receptor 2 (HER-2) is important for the stratification of breast cancer and the selection of therapeutic modalities. This study aimed to determine the quantitative expression of ER, PR and HER-2 using Immunohistochemistry and their correlation with quantitative baseline Ct values measured using Quantitative Polymerase Chain Reaction (PCR). This study also assessed the use of fresh breast tissue biopsies preserved in RNAlater solution in the quantitative detection of these receptors using PCR technique. The study evaluated 20 matched formalin fixed paraffin embedded and RNAlater preserved samples for ER, PR, and HER-2 using IHC and quantitative PCR technique. One portion of the breast tissue biopsy was fixed immediately in 10% neutral buffered formalin and another was preserved in RNAlater. After the histological confirmation of breast cancer by the H&E technique, formalin fixed paraffin embedded tissues (FFPE)—positive cases were matched with their corresponding RNAlater samples for IHC and qPCR. The extracted RNA was quantified using Nanodrop technology, resulting into complementary DNA. ER and PR using IHC were expressed in 60% (n = 12) of the study samples and were negative in 40% (n = 8) of samples. HER-2 was negative in 70% (n = 14) of study samples, 25% (n = 5) positive, and 5% (n = 1) equivocal. With the quantitative expression of ER, PR, and HER-2 being reported in the IHC triple—negative breast cancer cases. The mean Ct values for the hormonal receptors correlated with what has been previously studied with ER at 19.631, PR at 25.410 and HER-2 at 25.695. There was no statistically significant difference between the mean Ct values of RNAlater and FFPE with their P-values being 0.9919, 0.0896 and < 0.0001 for ER, PR, and HER-2 respectively. P-values; 0.9919 and 0.0896 for ER and PR respectively being greater than 0.05 it’s a borderline significance although HER-2 had a statistical significance. With a concordance in the detection of these breast cancer hormonal receptors, qPCR can be used in our setting considering the delays that may be associated in following the samples through IHC processing.