Primary malignant skin tumours in Ghanaians: a prospective study of 31 cases

Abstract

Background: The incidence of malignant tumours of the skin is increasing worldwide. In Ghana the clinical picture is complicated by late presentation and traditional forms of treatment; data on these conditions are also scanty. Patients and Methods
A four year (2003 to 2007) prospective study of patients presenting at a Plastic and Reconstructive Surgical clinic in Ghana with malignant primary skin tumours was undertaken. The patients were examined clinically; the diagnosis was confirmed by biopsy. The patients had wide excision of their lesions with either direct closure of the defect or skin grafting as appropriate. Block dissection of palpably enlarged regional lymph nodes was
performed where indicated. Results: Thirty one patients with primary malignant skin tumours were seen. The ages of the patients range from 14 to 100 years, with a mean age of 61.5 years. Thirteen (42%) patients had malignant melanoma, 13 (42%), had
squamous cell carcinoma one (3%) had basal cell carcinoma and four (13%) had sarcomas comprising two cases of Kaposi sarcoma, one synovial sarcoma, and another of unknown origin. Patients with malignant melanoma had a mean age of 73.4 years while those with non-melanoma malignancies had a mean age of 53.0 years. Of the 13 patients with malignant melanoma only five (38.5%) were alive by the end of the study period;
eight (61.5%) had died of disseminated disease. The primary lesion was confined to the foot, especially the sole. All the 13 patients with squamous cell carcinoma were alive by the end of the study period and most lesions developed from chronic ulcers and scars.
Conclusions: Malignant melanoma and squamous cell carcinoma are the main primary skin cancers in Ghanaians. Most patients present late with advanced disease; most melanomas were inoperable, requiring only palliative surgery while most of the squamous cell carcinomas required extensive surgery.

Keywords: malignant skin tumours, squamous cell carcinoma, basal cell carcinoma, melanoma.

Nigerian Journal of Plastic Surgery Vol. 4 (1) 2008: pp. 7-13