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.
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.
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.