Spindle Cell Sarcoma kye ki? Ka tukyogereko mu ngeri ennyangu!

Wali weeraliikirira ekintu ekyewuunyisa, gamba ng’okulumwa oba okuzimba mu magumba go oba ebitundu ebigonvu ng’ebinywa byo? Oluusi bino biyinza okuba ebya bulijjo. Naye, si bulijjo, obubonero buno buyinza okuba akabonero k’ekintu eky’amaanyi. Kale, leero tugenda kwogera ku kika kya kookolo ekitali kya bulijjo katono, naye nga kikulu okumanyako. Ekyo kiyitibwa Spindle Cell Sarcoma.

Ddala Spindle Cell Sarcoma kye ki?

Mu ngeri ennyangu, Spindle Cell Sarcoma kika kya kookolo ekitali kya bulijjo ekikula mu magumba n’ebitundu ebigonvu eby’omubiri gwaffe. Obadde okimanyi nti ‘sarcoma’ kitegeeza obutoffaali obutali bwa bulijjo oba ebizimba ebikula mu magumba ago n’ebitundu ebigakwatagana?

Kati, ekintu eky’enjawulo ku Spindle Cell Sarcoma kiri nti bw’otunuulira obutoffaali obwo obutali bwa bulijjo wansi wa microscope, bufaanana ‘spindle’. Ekiwujjo kiringa omumuli, ng’enjuyi zaayo zigonvu ate wakati nga zigonvu katono. Eno y’ensonga lwaki yafuna erinnya.

Olw’okukeberebwa mu laabu okw’omulembe, abasawo basobodde okuzuula ebika bya sarcoma ebisoba mu 75. Spindle cell sarcoma kye kimu ku bika ebyo. Mu butuufu, ekigambo ‘spindle cell sarcoma’ kikozesebwa okutegeeza sarcomas ezitasobola kusengekebwa bulungi mu kukeberebwa okumu mu laabu, gamba ng’amabala oba engeri z’obuzaale. Kale, kigambo kigazi katono.

Ebizimba bino bisinga kubeera wa?

Spindle Cell Sarcoma esinga kubeera mu magumba amawanvu ag’omubiri gwaffe. Okugeza nga:

• Eggumba lyo ery'ekisambi (`femur`) .
• Eggumba ly’omugongo (`tibia`) .
• Eggumba ly’omukono ogwa waggulu (humerus) .

Kyokka, si bifo bino byokka. Abantu abamu balina obulwadde bwa spindle cell sarcomas mu kisambi, omutwe n’ensingo, n’ebitundu by’omubiri ebirala.

Bika ki ebikulu ebya Spindle Cell Sarcoma?

Kati, laba, sarcomas zonna zitandikira mu bitundu ebigonvu. Kwe kugamba, mu bintu ng’amasavu, ebinywa, emisuwa, obusimu, n’ebitundu ebyetoolodde amagumba. Abasawo bongera okugabanyaamu obutoffaali obuyitibwa spindle cell sarcomas okusinziira ku kika ky’obutoffaali kookolo mw’atandikira.

Bwe bategeera ekika ky’obutoffaali n’engeri zaabwo mu ngeri eno, abasawo basobola okwekenneenya engeri kookolo gy’ayinza okusaasaana. Kino era kibayamba okuzuula obujjanjabi obusinga obulungi.

Wadde nga ‘spindle cell sarcoma’ kigambo kigazi, waliwo ebika ebikulu ebiwerako:

• Obulwadde bwa Pleomorphic Sarcoma obutaawulwamu:Nga erinnya bwe liraga, obutoffaali mu kookolo ow’ekika kino ‘tebwawulwamu’. Kino kitegeeza nti tekinnategeerekeka kika kya katoffaali kookolo gye yatandikira. Obutoffaali obulwadde mu kizimba buba ‘pleomorphic’, ekitegeeza nti bujja mu ngeri n’obunene obw’enjawulo. Mu ngeri endala, ekizimba kwe kukuŋŋaanyizibwa kw’obutoffaali okuva mu bika eby’enjawulo.
• Fibrosarcoma: Zino zisibuka mu butoffaali obuyitibwa fibroblasts. Fibroblasts ze zisinga okuzimba ebitundu ebiyunga mu mibiri gyaffe.
• Leiomyosarcoma: Zino zitandikira mu butoffaali bw’ebinywa ebiseeneekerevu. Zino za njawulo ku butoffaali obuli mu bitundu by’ebinywa by’amagumba, bwe tukozesa okutambuza emibiri gyaffe n’okufuna amaanyi. Obutoffaali bw’ebinywa ebiseeneekerevu busangibwa mu bitundu byaffe eby’omunda, ebituli by’omubiri, n’amagumba agamu ng’ebitundu ebigonvu.

Embeera eno ya bulijjo etya?

Okufaananako n’ebika ebirala ebya sarcoma, spindle cell sarcoma tetera nnyo . Mu butuufu, ekola ebitundu ebitakka wansi wa 10% ku kookolo yenna ow’amagumba n’ebitundu ebigonvu. Kijjukire nti tekitera kubaawo nnyo nga omusawo wo ayinza obutasooka kuteebereza kookolo wa kika kino. Oyinza okugenda mu basawo abawerako, okulaba abakugu abawerako, n’okukeberebwa emirundi egiwerako nga tonnazuulibwa.

Spindle cell sarcoma esobola okukula mu muntu yenna. Wabula kisinga kubeera mu bantu abasukka mu myaka 40. Abantu abafuna obulwadde bwa undifferentiated pleomorphic sarcoma obwogeddwako emabegako batera okuba wakati w’emyaka 60 ne 70.

Bubonero ki obulaga kino?

Obubonero bw’obulwadde bwa spindle cell sarcoma buyinza okwawukana. Zisinziira ku bunene bw’ekizimba, omuwendo gw’ebizimba, n’amagumba (oba ebitundu ebirala eby’omubiri) obutoffaali bwa kookolo mwe buli.Bino bye bimu ku bubonero bw’osaanidde okwegendereza naddala :

• Obulumi bw’amagumba: Obulumi buno buyinza okuba nga buli kiseera oba okujja ne bugenda. Kiyinza okuwulira ng’omuntu akufumita okuva munda.
• Okumenya eggumba mu kifo ekinafuye kookolo: Kino kiyitibwa ‘okumenya kw’obulwadde.’ Eggumba liyinza okukutuka ne bwe ligudde katono.
• Okunyirira oba okuzimba ng’onyigiddwa ku kifo ekizimba we kiri: Wayinza n’okubaawo ekizimba ekinene ekimala okukwatibwa mu ngalo.
• Obutasobola kutambuza bulungi kiwanga okumpi n’ekizimba: Teebereza singa okugulu kuba kumpi, kyandibadde kizibu okufukamira oba okugaziya okugulu.
• Obukoowu: Buno si bukoowu bwa bulijjo bwokka. Buba bukoowu obuyitiridde obutagenda ne bw’ofuna otulo oba owummudde otya.
• Malaise: Okuwulira nga tolina bulungi , awatali nsonga yonna etegeerekeka, ng’omuntu atalina maanyi oba ky’ayagala ku kintu kyonna.

Kiki ekivaako obulwadde bwa spindle cell sarcoma?

Okufaananako ne kookolo omulala yenna, spindle cell sarcoma etandika ng’obutoffaali obulamu bufuuse obubi. Obutoffaali buno obubi bukula nga tebufugibwa, ne bukola ebizimba. Ebizimba bino bisobola okwonoona ebitundu ebiramu ebibyetoolodde. Ekisinga okuba eky’obulabe kwe kuba nti obutoffaali buno obwa kookolo busobola okwekutula ku kizimba ekyasooka ne busaasaana mu mubiri gwonna, ne bwonoona ebitundu ebirala n’ebitundu by’omubiri. Kino kye tuyita kookolo agenda mu bitundu ebirala oba kookolo agenda mu bitundu ebirala.

Naye, wuuno ekintu ky’olina okumanya. Mu budde obwabulijjo, obutoffaali bwa spindle (bwe bukula obulungi) mu butuufu kintu kirungi. Obutoffaali bwa spindle butondebwa awali ebitundu by’omubiri ebyonooneddwa. Kale, okubeera n’obutoffaali obuyitibwa spindle cells kabonero akalaga nti ekiwundu kyo kiwona. Obutoffaali buno bubula ng’ekiwundu kiwonye.

Naye mu sarcoma y’obutoffaali obuyitibwa spindle cell sarcoma, obutoffaali buno obuyitibwa spindle cells bweyongera okukula n’okweyongera. Bannasayansi tebannaba kuzuula nsonga ntuufu lwaki obutoffaali buno bufuuka bwa bulabe nnyo.

Kyokka abanoonyereza bakizudde nti enkyukakyuka ezimu ez’obuzaale zisobola okwongera ku bulabe bw’omuntu okufuna kookolo ono. ‘Enkyukakyuka’ nsobi eri mu buzaale bwaffe, enkola ebuulira obutoffaali bwaffe engeri gye bukola. Mu mbeera ya spindle cell sarcoma, enkyukakyuka zino zitera okuba ez’obuzaale, ekitegeeza nti zisobola okutambulira mu maka.

Biki ebiyinza okwongera ku bulabe bw’okufuna kookolo ono?

Waliwo ensonga eziwerako eziyinza okwongera ku bulabe bw’okulwala obulwadde bwa spindle cell sarcoma. Ka tulabe kiki kye bali:

• Obulwadde bw’amagumba: Kino kye kiseera ebitundu by’amagumba we bifa kubanga tebifuna musaayi gumala. Nga bw’omanyi, ebitundu by’amagumba byetaaga omusaayi okusobola okuwangaala, era nga kino oxygen ky’akola.
• Fibrous Dysplasia: Mu mbeera eno, ebitundu by’amagumba ebiramu bikyusibwa ne bifuuka ebitundu ebiringa amagumba ebirina ebiwuziwuzi. Kino kyongera ku bulabe bw’okumenya era (butera nnyo) kiyinza okuvaako okukula kw’obulwadde bwa fibrosarcomas.
• Osteomyelitis: Buno yinfekisoni ekosa ebitundu ebiringa sipongi munda mu magumba agamu, ebiyitibwa obusigo bw’amagumba. Kino kiyinza okubaawo singa obuwuka oba obuwuka obulala buva mu musaayi gwo okutuuka ku ggumba ne busiiga obutoffaali obuli eyo.
• Obulwadde bwa Paget obw’amagumba: Buno mbeera ya bbanga ddene (obutawona). Kivaako amagumba okunafuwa ne gamenya mangu. Kino kiyinza okwongera ku bulabe bw’okufuna kookolo w’amagumba omuli n’obulwadde bwa spindle cell sarcoma.
• Olw’okuba yali amaze okufuna obujjanjabi obw’amasannyalaze (radiation therapy) ku kookolo:Obujjanjabi bw’amasannyalaze bukozesa emisinde egy’amaanyi amangi (emirundi mingi X-rays egy’amaanyi amangi) okusaanyaawo obutoffaali bwa kookolo. Tekitera kubaawo, spindle cell sarcomas zizze zikula mu bitundu ebijjanjabiddwa n’obusannyalazo. Kino bwe kibaawo, sarcoma etera okukula emyaka egiwerako oluvannyuma lw’okujjanjabwa (emyaka musanvu okutuuka ku makumi abiri). Naye jjukira nti abantu abatakka wansi wa 1% abafuna obujjanjabi bw’amasannyalaze bafuna kookolo ow’ekika kino eyeekuusa ku masanyalaze.

Bizibu ki ebiva mu spindle cell sarcoma?

Kookolo ono ayamba amagumba go okumenya (okumenya) mu kifo ekizimba we kiri. Eggumba bwe limenyeka, obutoffaali bwa kookolo obuva mu kizimba busobola okugenda mu bitundu ebiriraanyewo.

Naye wakyaliwo okusika omuguwa oba ekika kino eky’okumenya amagumba kikola enjawulo mu kuteebereza okutwaliza awamu (kwe kugamba, ekiyinza okuvaamu) kwa kookolo, oba oba ebivaamu bikwatagana n’okusaasaana kwa kookolo okw’ewala kwokka (okusaasaana kw’amagumba mu bitundu ebirala).

Obulwadde bwa spindle cell sarcoma buzuulibwa butya?

Omusawo wo nga tannazuula kookolo wo n’okumuteeka ku mutendera, kirabika ojja kukeberebwa n’emitendera egiwerako. Okuteeka kookolo mu mitendera kisobozesa abasawo okugabanya obuzibu bwa kookolo okusinziira ku bunene bw’ekizimba, ekifo we kiri, n’okumanya oba nga kisaasaanidde. Bwe baba bateeka kookolo w’amagumba mu mitendera, era batunuulira oba ekizimba kya ‘high-grade’ oba ‘low-grade’. Ebizimba eby’omutindo ogwa waggulu biba n’obutoffaali obulabika obutali bwa bulijjo . Zitera okukula n’okusaasaana amangu.

Sarcomas ezisinga obungi eza spindle cell za mutindo gwa waggulu.

Ebigezo by’okukuba ebifaananyi

Wadde ng’okukebera ebifaananyi tekusobola kumanya kika kya kookolo, kusobola okulaga obunene n’ekifo ekizimba we kiri. Era zisobola okulaga oba kookolo asaasaanidde okusukka ekizimba ekisookerwako.

• X-rays: X-rays zisobola okulaga ebizimba oba ebitali bya bulijjo mu magumba go. X-ray y’ekifuba esobola okulaba oba kookolo asaasaanidde mu mawuggwe. Metastatic spindle cell sarcoma etera okusooka okusaasaana mu mawuggwe.
• MRI Scan: MRI ekozesa magineeti ennene, amayengo ga leediyo, ne kompyuta okukuba ebifaananyi by’ebintu ebiri munda mu mubiri. Obutafaananako X-ray, MRI esobola okulaga ebitundu ebigonvu mu bujjuvu. Kino kya mugaso nnyo eri abasawo okuzuula ebizimba by’ebitundu ebigonvu bye bateebereza nti biyinza okuba nga bya sarcomas.
• CT Scans: CT scans zikozesa X-ray ne kompyuta okukola ebifaananyi eby’ebitundu bisatu (3D) eby’amagumba n’ebitundu ebigonvu. Mu mbeera ya spindle cell sarcoma, CT scans zisobola okulaga oba kookolo asaasaanidde mu bitundu ebigonvu. Era zisinga kuzuula bikutuka oba ebitundu amagumba we ganafuye.
• PET Scans: PET scans zikozesa ekintu ekiyitibwa tracer okuzuula obutoffaali bwa kookolo mu mubiri gwonna. Ziyinza okuyamba okuzuula obulwadde bwa spindle cell sarcoma obusaasaana. Oyinza n’okukeberebwa PET scan okulaba engeri obujjanjabi bwo gye bukola. Wabula PET scans tezikozesebwa ku bika byonna ebya sarcoma. Omusawo wo y’ajja okusalawo oba PET scan ekusaanira.

Okukebera omusaayi

Tewali kukebera musaayi kwonna okusobola okuzuula obulwadde bwa spindle cell sarcoma. Kyokka, okukebera omusaayi kuwa amawulire amakulu agakwata ku bulamu bwo, era kikulu omusawo wo okumanya ebikwata ku bulamu bwo. Okutwalira awamu, okukebera omusaayi kuyinza okuwa amawulire agakwata ku bintu nga:

• Obutoffaali bwo obw’omusaayi
• Enkola y’ebitundu by’omubiri
• Emiwendo gya enzyme (enzymes kemiko eriyamba ebitundu by’omubiri okukola emirimu emikulu) .

Okukebera ebitundu by’omubiri (biopsy).

Engeri esinga okumanya obulungi oba ekizimba kirimu kookolo kwe kukeberebwa omubiri. Era y’engeri yokka ey’okumanya ekika kya kookolo n’ekigero kye. Mu kiseera ky’okukebera obutoffaali, omusawo aggya sampuli y’ebitundu by’omubiri okuva mu kizimba n’abisindika mu laabu okwekenneenya obutoffaali.

Abantu abasinga abalina obulwadde bwa spindle cell sarcoma balongoosebwa empiso. Abasawo baziba ebitundu ebyetoolodde ekizimba olwo ne bakozesa empiso entono eriko ekituli okutwala sampuli. Okusobola okuyamba omusawo okumanya ekifo ekituufu mu mubiri gwo w’ayinza okuyingiza empiso, oyinza n’okukwetaagisa okukeberebwa X-ray oba CT scan.

Obulwadde bwa spindle cell sarcoma bujjanjabwa butya?

Obujjanjabi bw’ofuna bujja kusinziira ku bulamu bwo, ekifo, obunene, ekigezo, n’ensonga endala. Era kisinziira ku oba ofuna obujjanjabi omulundi ogusoose oba kookolo akomyewo oluvannyuma lw’okujjanjabwa (okuddamu).

Okuloongoosa

Ekigendererwa ky’okulongoosa kwe kuggyawo ekizimba ate ng’okuuma eggumba lyo nga bwe kisoboka. Singa ebitundu byonna ebya kookolo mu kizimba ekisookerwako n’ebizimba eby’okubiri bisobola okuggyibwawo, kookolo asobola okuwona. Kyokka kookolo bw’amala okusaasaana okusukka ekizimba ekyasooka, kiba kizibu nnyo okukiggyawo ddala.

Obujjanjabi bw’eddagala

Chemotherapy bujjanjabi obukozesa eddagala okutta obutoffaali bwa kookolo mu mubiri gwonna. Oyinza okuweebwa eddagala eriweweeza ku bulwadde nga tonnalongoosebwa okukendeeza ku kizimba n’okukwanguyira okukiggyamu. Oba, oyinza okuweebwa eddagala eriweweeza ku bulwadde bwa kookolo okutta obutoffaali bwa kookolo bwonna obusigaddewo oluvannyuma lw’okulongoosebwa. Chemotherapy era ekozesebwa nga ‘palliative care’. Wadde nga tesobola kuwonya kookolo, eddagala eriweweeza ku bulwadde bwa kookolo liyinza okutta obutoffaali bwa kookolo okukendeeza ku bubonero ng’okulumwa amagumba.

Abantu bangi baweebwa eddagala erigatta eddagala eriweweeza ku bulwadde buno okusobola okukola obulungi. Okusinziira ku oba ofuna obujjanjabi omulundi ogusoose, toddamu bulungi ku ddagala erimu erya chemo, oba kookolo bw’aba akomyewo oluvannyuma lw’okugenda mu ``remission,'' oyinza okuweebwa eddagala lya chemo ery’enjawulo. ``Okusonyiyibwa'' kitegeeza nti kookolo ateredde oba agenze ddala oluvannyuma lw'okujjanjabwa.

Obujjanjabi bw’amasannyalaze (Radiation Therapy).

External Beam Radiation Therapy (EBRT) ekozesa ekyuma okulung’amya X-rays ku kizimba okutta obutoffaali bwa kookolo. Bw’oba ​​tosobola kulongoosebwa, oyinza okuweebwa obujjanjabi obw’amasannyalaze okusaanyaawo ekizimba. Oluusi, omusawo alongoosa ayinza obutasobola kutuuka ku kizimba ekyo ng’alongooseddwa. Kiyinza okuba nga kiri wansi nnyo mu bitundu by’omubiri oba nga kiri kumpi nnyo n’ebitundu ebikulu okusobola okuggyibwamu awatali bulabe. Mu mbeera ng’ezo, oyinza okuweebwa obujjanjabi obw’amasannyalaze mu kifo ky’ekyo.

Okufaananako n’obujjanjabi bw’eddagala, obujjanjabi obw’amasannyalaze (radiation therapy) nabwo busobola okukendeeza ku bubonero singa kookolo tasobola kuwona.

Bizibu ki oba ebizibu ebiva mu bujjanjabi buno?

Kitera okufuna ebizibu ebiva mu bujjanjabi bw’eddagala n’obusannyalazo ng’ojjanjabwa kookolo. Bino biyinza okuwangaala okumala ekiseera ng’obujjanjabi buwedde. Kikulu okubuuza omusawo wo ku biyinza okuvaamu, okusinziira ku bujjanjabi bw’ofuna.

Ddi lwe nnina okulaba omusawo wange?

Omusawo wo ajja kukubuulira emirundi gy’olina okuyingira okujjanjabibwa, oba okwekebejjebwa okulaba oba kookolo akyali mu ``kusonyiyibwa.`` Abantu bangi abalina kookolo abali mu kusonyiyibwa bajja kwetaaga okugenda ew’omusawo emirundi mingi mu ntandikwa. Bw’omala ebbanga eddene nga tolina kookolo, omuwendo gw’abantu abagenda okugoberera okukebera oba azzeemu okulwala gujja kukendeera.

Bujjanjabi bwa ngeri ki obw’okugoberera bwe nneetaaga?

Okusinziira ku ggumba omusawo lye yalina okuggyamu, oyinza okwetaaga okukola emirimu emirala. Enkola zino ziyamba okukuuma eggumba nga likola bulungi. Okugeza oyinza okwetaaga okusimbibwa amagumba. Okusimbibwa kw’amagumba kizingiramu okukyusa ekitundu ekiggiddwamu n’ossaamu ebitundu ebiva mu kitundu ekirala eky’omubiri gwo oba okuva mu muntu akuwadde. Oyinza n’okwetaaga ekitundu ky’omubiri eky’ekikugu. Oyinza okwetaaga obujjanjabi obulala okukuyamba okumanyiira enkyukakyuka zino.

Bibuuzo ki bye nnina okubuuza omusawo wange ku spindle cell sarcoma?

Bino bye bimu ku bibuuzo ebikulu by’olina okubuuza omusawo wo:

• Kookolo ali ludda wa?
• Omutendera/eddaala ki erya kookolo?
• Omutendera/ekigero ekyo kikwata kitya ku nteekateeka yange ey’obujjanjabi?
• Biki ebiva mu bujjanjabi bye nsaanidde okusuubira?
• Kookolo wange asobola okuwona?
• Biruubirirwa ki eby’obujjanjabi?
• Osobola okunyunga ku mpeereza y’obujjanjabi obw’okukkakkanya obulumi okunnyamba okugumira embeera gye nnazuulibwamu kookolo?

Obulwadde bwa spindle cell sarcoma busobola okuwona? Kiba kya maanyi kitya?

Singa obubonero bwonna obwa kookolo busobola okuggyibwawo, abasawo basobola okuwonya obulwadde bwa spindle cell sarcoma. Spindle cell sarcoma etasaasaana kusukka kifo we yasooka, nnyangu nnyo okuwona. Kyokka, okujjanjaba obulwadde bwa sarcomas obusaasaanye kizibu nnyo . Metastatic Spindle Cell Sarcomas tezitera kuwona.

Kookolo ow’ekika kino atera okuba ‘wa ddaala lya waggulu’. Kino kitegeeza nti kikula mangu ate ne kisaasaana mangu. Oluvannyuma lw’okusonyiyibwa, kitera okudda, oluusi mu kifo kye kimu ekizimba ekyasooka we kyali, oluusi mu kifo eky’enjawulo.

Naye jjukira nti buli muntu azuulibwa kookolo wa njawulo. Omusawo wo asobola okukubuulira ebiyinza okuva mu bujjanjabi (okuteebereza) okusinziira ku kika kya kookolo ekigere ky’olina, omutendera gwe, obulamu bwo okutwalira awamu, engeri gy’okwatamu obujjanjabi, n’ensonga endala ez’enjawulo. Omusawo wo y’asinga okukuwabula ku ngeri okuzuula kuno gye kunaakukwatamu.

Ebintu bye tusaanidde okujjukira okuva mu mboozi eno (Take-Home Message)

Okuzuulibwa nti olina obulwadde bwa Spindle Cell Sarcoma kiyinza okukuleetera okunyigirizibwa. Embeera eno esobola okukuleetera okuwulira ng’okooye era nga tolina mirembe. Obujjanjabi butera okuba obw’amaanyi, era oyinza okufuna okusoomoozebwa ng’okumanyiira okusimbibwa amagumba oba ekitundu ky’omubiri eky’ekikugu.

N’olwekyo, kikulu nnyo okuba n’emboozi ey’amazima era ey’olwatu n’omusawo wo okuva ku ntandikwa. Mu ngeri eno, osobola okutegeera obulwadde bw’ozudde, ekigero kookolo wo gy’asobola okuwona, ebigendererwa by’obujjanjabi bwo bye biruwa, n’enkyukakyuka mu bulamu bw’ogenda okwetaaga okukola ng’ojjanjabwa n’okuwona.

Spindle cell sarcoma kookolo wa maanyi era akula amangu. Kyokka waliwo obujjanjabi obusobola okufuga okukula kwayo ate mu mbeera ezimu ne buwonya ddala. Yogerako n’omusawo wo ku by’oyinza okusuubira. Toggwaamu ssuubi. Okugoberera amagezi amatuufu ag’abasawo n’okusigala nga oli mu mbeera nnungi kikulu nnyo mu lutalo luno.

Spindle Cell Sarcoma, Spindle Cell Sarcoma, Kookolo, Kookolo w’amagumba, Kookolo w’ebitundu ebigonvu, Ekizimba, Obubonero, Obujjanjabi