[Breast angiosarcomas: three case reports]. / Les angiosarcomes du sein: à propos de 3 observations.

Angiosarcoma is a rare type of breast cancer, it has the worst prognosis of all breast malignancies. We report three cases of breast angiosarcoma observed at the National Oncology Institute and the Maternity of Orangers. A preoperative diagnosis was evoked in one case only, after a local recurrence in the second one and histological in the last one. Mastectomy is the reference treatment. The development is distinguished by general metastasis. Based on review of literature, we analysed the different aspects of this disease.

[Cancer of the liver in pregnancy. Reflections apropos of a case]. / Cancer du foie associé à la grossesse. Réflexion à propos d'un cas.

Primary cancer of the liver is rare in western countries. Men of a mean age of 60 tend to be more subject to it than women. In Africa, however, younger people of a mean age of 36 and more women become subject to it. 13.5% of malignant tumours of the liver are found in African women with a mean age of 34 years. Thus, the association of liver cancer with pregnancy is rare. The case which has been studied concerns a woman of 34 years of age, a para. 2 in her 4th pregnancy. There were no known pathogenic factors such as the taking of androgens or of oral contraceptives. The main symptoms were pain in the right side and in the centre of the abdomen. A tumour increasing in size was found. The alpha fetoprotein ratio was high and increased as pregnancy progressed. Ultrasound and scintography were positive. Liver cytology testing failed. The patient died soon because the disease progressed rapidly after a stillborn baby had been born prematurely and laparatomy had been undertaken. Laparatomy is the last possible method of diagnosis and treatment. Pregnancy seems to accelerate the development of liver tumours and makes them a very high risk. Since chemotherapy has not yet been demonstrated to be effective, only surgery can be considered as a possible therapy. The association of primary cancer of the liver with pregnancy is rare and of poor prognosis.

[Endometriosis of the cervix, colposcopic aspects: a case report and review of the literature]. / Aspects colposcopiques de l'endométriose du col utérin: une observation ave revue de la littérature.

We present a review of endometriosis of the uterine cervix focusing on colposcopic features, prognosis, and therapeutic strategies. Colposcopic images are provided from a case report.

[Severe sickle cell disease and pregnancy. Systematic prophylactic transfusions in 16 cases]. / Drépanocytose majeure et grossesse. Transfusions prophylactiques systématiques, à propos de 16 cas.

Sickle cell disease is a major cause of maternal and neonatal mortality in tropical regions. Treatment consists of regular blood transfusion during pregnancy and delivery. Transfusion may be performed selectively (in function of the clinical status of the mother, fetus, and pregnancy) or prophylactically. Both management strategies result in a significant improvement in the obstetric outcome. However systematic prophylactic transfusion has been shunned due to the risk of transmitting infections and allo-immunization. The16-case series reported here demonstrates a real benefit for prophylactic blood transfusion during pregnancy complicated by sickle cell disease in tropical zones. Improvements in our transfusion curves resulting from better donor selection, follow-up, and phenotyping support arguments previously made over one decade ago in favor of the prophylactic approach especially in countries with high transfusional risks. In our experience the risks associated with more transfusions was offset by the greater safety margin and better efficacy of the prophylactic approach.