[Precancerous lesions of the uterine cervix in cameroonian women. Cytological and epidemiological aspects of 946 cases]. / Lésions précancéreuses du col utérin chez la femme camerounaise. Aspects cytologiques et épidémiologiques de 946 cas.

OBJECTIVE: The aim of this study was to present the cytological and epidemiological aspects of precancerous lesions of the uterine cervix of women living in the two first cameroonian cities (Yaounde and Doubla). MATERIAL AND METHODS: The material was made of pap smears registrar of the Yaounde Central Hospital pathological laboratory and the reports of cervical cancer screening from Douala and Yaounde within a period of five years (1st January 1994 to 31st December 1998). We recruited all cases showing a precancerous lesion of the uterine cervix. For each case, we noted: the type of lesion, the age of the patient, the age at the first sexual intercourse, the age at the first delivery, the number of pregnancies, the parity, the marital status, the socioeconomical class. RESULTS: From a total of 13524 pap smears done, 946 (7%) have shown precancerous lesions. 70% of these were high grade while 30% were low grade. These lesions were observed at all age from the range of 11 to 15 years. All women showing these lesions had had sexual intercourse. 30% of these lesions were noted among women who have had their first sexual intercourses between 10 and 15 years. 40% were observed among women who have had their first sexual intercourses between 16 and 18 years. 66% among women who have had their first delivery between 13 and 21 years. 92% are observed among women who have had more than five pregnancies, more than five parities; 54% among women who are married and 76% among bachelors and widows; 64% among women with low socioeconomical status; 9% among women with high socioeconomical status. CONCLUSION: Many cameroonian women are prone to cervical cancer.

[Lymphoid nodules of the breast. Report of 10 cases observed in Cameroon]. / Les nodules lymphoïdes du sein. A propos de 10 cas observés en milieu camerounais.

The aim of this study was to present clinico-pathological aspects of breast lymphoid nodules in Cameroon. From the collection of the pathology laboratory of the Yaounde Central Hospital, all the cases of breast lymphoid nodules diagnosed between 1st January 1993 and 30th June 1998 were recorded. For each case, the following data were noted: age of the patient, clinical informations (signs and symptoms), microscopical aspects and histological description. 10 cases of breast lymphoid nodules were recorded. These were observed in women aged 19 to 50 and most of them were painless. All were mobile and felt by the patients before excision-biopsy. They were mostly found on the right and were less than 1 cm in diameter. Histologically, they presented as diffuse lymph node hyperplasia.

[Extramembranous glomerulonephritis: clinicopathologic finding in a group of 45 Cameroonians]. / Glomérulonéphrites extramembraneuses: constatations clinicopathologiques dans un Groupe de 45 Camerounais.

Forty five Cameroonian patients in West Africa who were diagnosed as having membranous glomerulonephritis (MGN) were studied and followed up over a five year period. The mean age of these patients was 32.3 years with a female to male ratio of 5/4. Proteinuria (93.3%) and nephrotic syndrome (89%) were the two most important clinical manifestations at the time of diagnosis. Seventeen cases (37.8%) of the MGN were considered idiopathic while 62.2% were associated with known aetiological factors. Histologically, the majority of patients were at stage I (35.55%) or stage II (37.8%) of the World Health Organisation (WHO) classification. Except of the patients in stage I, most patients in stage II and all those in stages III and IV, showed associated important, tubular interstitial and vascular lesions. Immunofluorescence studies showed deposits to be mainly IgG (80%) and C3 (71.1%) while electron microscopy showed varied dense deposits in all cases. Seventeen patients with idiopathic MGN and 10 MGN patients whose only associates aetiological factor was a positive hepatis B antigen were followed up over 5 years. During this period, eight patients (29.6%) had a complete clinical remission, eleven patients (40.7%) improved their renal function and decreased their 24 hour proteinuria, while eight (29.6%) patients deteriorated into end stage renal failure and had to be commenced on dialysis; three of them died during this procedure.

[Treatment of early T1 small T2N breast cancers. Our experience at the Yaounde General Hospital. 21 cases]. / Traitement des cancers du sein aux stades précoces T1 petit T2 N-notre experience a l'Hôpital Général de Yaoundé. A propose de 21 cas.

From February 1989 through February 1993, a group of 23 patients suffering from T1 mammary carcinoma small T2 N-MO was treated in the radiotherapy department of the Yaoundé General Hospital, according to a simplified procedure. A first conservative surgery of tumorectomy type (3 cases) and quandrantectomy type (4 cases) was carried out, followed by a postoperative irradiation. In 14 cases, a Patey type radical surgery preceded a local/regional radiotherapy. The general treatment was made up of only a hormonotherapy without chemotherapy. After a 4-year decline, there were 5 cases--i.e. 23.8%--of ganglionic and/or metastatic relapse. In the light of research data, we are analysing the reasons for these unexpected therapeutic failures in this group of tumor considered as favorable prognosis. We raised the problem of the inability of the prognosis factors, presently defined by means of histological and biological factors, to detect all the especially aggressive cancers. We carried out a general review of the new factors defined essentially from molecular and genic bases. We offered an approximative solution which makes it possible to by-pass the technological difficulties in having access to the new factors.

[Burkitt lymphoma in Cameroon children: descriptive and clinico-anatomical aspects]. / Lymphome de Burkitt chez l'enfant au Cameroun: aspects descriptifs et anatomocliniques.

This retrospective study is armed to indicate the descriptive and pathological aspects of children Burkitt lymphoma in Cameroon. It was performed on a 4 year period between July 1988 and July 1992. Children from 0 to 15-year-old who were hospitalized and who had histologically provern Burkitt lymphoma were included. There were 39 patients, that is 27% of all malignant tumors in children during this period. Twenty-four were boys and 15 were girls; the median age was 90 months (+/-46) (range from 3 to 180 months). All children had Plasmodium falciparum infection. EBV serology was positive in 18 patients out of 25 (72%), 14 (36%) had a good nutritional status, the 25 other patients suffered malnutrition. Tumor localizations were: maxillary in 29 (74%) patients, abdominal in 7 (18%), other in 3 patients. Clinical stages according to Murphy classification were: stage I in 6 (15%) patients, II in 3 (8%), III in 20 (51%) and IV in 10 (26%). It is concluded from this series that clinical aspects and histological pattern in children Burkitt lymphoma in Cameroon are not different from what is observed in other endemic areas.

Superior vena cava tumoral thrombosis revealing a Burkitt's lymphoma and a lymphoblastic non-Hodgkin's lymphoma. A case report.

Superior vena cava thrombosis (SVCT) is a rare pathology, though of great significance since it implies the development of a malignant process. The most common etiologies are basically bronchopulmonary and mediastinal tumors. Observations involving 2 patients presenting with superior vena cava syndrome (SVCS) are reported in this study, in which radiologic investigations (chest roentgenogram, computed tomography scan of the thorax, and superior vena cavography) revealed thrombosis of the SVC disclosing in both cases a non-Hodgkin's lymphoma. The first case was a mediastinal Burkitt's lymphoma in a thirty-eight-year-old man (exceptional form) and in the second case a lymphoblastic non-Hodgkin's lymphoma in a nine-year-old girl. In the patient with Burkitt's lymphoma healing was satisfactory twenty-four months after treatment by surgery, chemotherapy, and radiotherapy. The second patient died suddenly. In both cases the SVCT revealed the tumor. The causes of SVCT are reviewed and discussed.

[Cancer localisation in men and women aged over 50 in Cameroon]. / Localisations des cancers chez les hommes et les femmes âgés de plus de 50 ans au Cameroun.

The aim of this study was to present the sites of cancers diagnosed in men and women aged 50 years and above in Cameroon. From the registries of the pathology laboratory of the Yaoundé Central Hospital which at the national level receives the majority of samples sent for histopathology analysis, we recorded all cases of cancers diagnosed in people aged 50 years and above, during the period from 1st January 1987 to 31st August 1996 (9 years 8 months). 1,925 cancers were recorded: -1,005 of these (52.2%) were issued from men aged fifty years and above. These 1,005 cancers came from seventeen sites, the most common being: liver (226 cases = 22.49%), prostate (222 cases = 22.09%), skin (195 cases = 19.40%) and ENT (100 cases = 9.95%); that made 73.93% (above 3/4) of cancers observed in men aged fifty years and above from this study. -920 of these (47.8%) were diagnosed from women aged fifty years and above. These 920 cancers came from twenty-two sites, the most common being: uterine cervix (292 cases = 31.74%), breast (170 cases = 18.48%), skin (111 cases = 12.07%) and liver (90 cases = 9.78%); that made 72.07% (about 3/4) of cancers observed in women aged fifty years and above, from this study.

Testes tumors in a Sub-Saharan African city (Yaounde). Incident cases and histopathology.

OBJECTIVES: To determine the histologic types of testicular tumors and identify associated risk factors. METHODS: Data on clinical presentation, age, race, history of cryptorchidism or testicular trauma and histologic types, on each patient with testis tumor, were abstracted from medical records and the pathology register. RESULTS: Of 14 tumors, 11 were malignant. Five were Burkitt's and 2 non-Burkitt's lymphomas, 1 plasmocytoma and 3 seminomas. None of the seminomas occurred in black Africans. CONCLUSION: The epidemiology and histology of testis tumors in Yaounde differs considerably from other reported series. Burkitt's lymphoma is the commonest tumor. This alters the approach to the management of testicular masses. Race and geography seem to be important in the occurrence of testes tumors.

[Cytologic aspects of cervical smears in optic microscopy in HIV seropositive women in Yaounde-Cameroon (Central Africa)]. / Aspects cytologiques du frottis cervical en microscopie optique chez les femmes VIH séropositives à Yaoundé-Cameroun (Afrique Centrale).

Cytologic aspects of cervical smears in HIV seropositive women in Yaounde-Cameroon (Central Africa). The aim of this study was to present the cytologic aspects of cervical smears performed on HIV seropositive Cameroonian women and analysed by light microscope. Seropositive women (case group) and seronegative women (control group) had cervical smears which were stained by the Papanicolaou Method and analysed by light microscope. For the 65 seropositive women, there were: 62 inflammatory smears (95.5%), 2 normal (3%) and 1 low grade squamous intra-epithelial lesion (1.5%). The 50 seronegative women had: 35 inflammatory smears (70%), 13 normal (26%) and 2 low grade squamous intra-epithelial lesion (4%). In both groups, inflammatory smears were predominant. They were more frequent in seropositive women. There was no significant difference between the percentage of squamous intra-epithelial lesions in seropositive women (1.5%) and seronegative women (4%). We were unable to detect, in Cameroonian seropositive women, any specific lesions on cervical smears predictive of HIV infection without serology.

[Rare association of a non-functional retroperitoneal paraganglioma and nephrotic syndrome]. / Association rare d'un paragangliome rétropéritonéal non fonctionnel et d'un syndrome néphrotique.

Non functional retroperitoneal paragangliomas are rare: less than 50 cases in literature. They are usually asymptomatic and can attain reasonable dimensions. The association with nephrotic syndrome is exceptional. The authors report a clinical observation of non-functional paraganglioma in a 45 year old woman, with repeated surgical abstention. Literature was reviewed and therapeutic indications discussed.

[Problematic management of tumors with a very high proliferation coefficient: a case of an embryonal rhabdomyosarcoma of the right orbit in an eleven-year-old child]. / Problèmatique de l'approche thérapeutique des tumeurs à coefficient de prolifération très élevé: a propos d'un cas de rhabdomyosarcome embryonnaire de l'orbite droit chez un enfant de 11 ans.

We propose through the retrospective analysis of this document, to explain the inefficiency of the action of chemo and radiotherapy on tumours with a high proliferation coefficient but which are however known to be highly sensitive as well as curable with chemo and radiotherapy. This study shows the technical conditions and dispositions for a better therapeutic approach in these tumours with a rapid growth.

[Prostatic tumors (adenoma, adenocarcinoma) and obesity in Cameroon]. / Tumeurs de la prostate (adénomes, adénocarcinomes) et obésité en milieu camerounais.

The aim of this study was to look for an association between obesity and prostatic tumors in general in Cameroon. During a sixteen month period (1 September 1991 to 31 December 1992), we recruited 50 symptomatic patients with histologically confirmed prostatic tumors who were matched with a control of the same age. Of these patients, 36 had adenomas, 12 had carcinomas, two had both tumors. Patients' age ranged from 49 to 91 years. The difference in body weight and height between the patients and the controls was not significant. According to the Lorentz formula, there were as many obese patients as controls. Obesity was five times more frequent in the patients than the controls following the body mass index, but this difference was not significant. We conclude that in our area, there might be an association between obesity and prostatic tumors in general but our study is too small to reach a conclusion.

[Benign giant epignathic teratoma in the newborn. Apropos of an unusual clinical case]. / Tératome épignathe géant bénin chez le nouveau-né. A propos d'une observation clinique exceptionnelle.

A rare case of giant epignathus teratoma with intracranial extension is reported in a male newborn. Pre-operative diagnosis of teratoma was made or suspected on radiological evidence of calcification within the tumor and increased level of alpha-foetoprotein. Optimal treatment consisted in complete surgical resection. The literature is revisited and surgical indications are discussed.

[A rare complication of inguinal hernia. Evisceration by rupture of the scrotum secondary to blunt trauma of the abdomen]. / Une complication rare de hernie inguinale. Eviscération par rupture scrotale secondaire à un traumatisme appuyé de l'abdomen.

The authors present a case report of scrotal rupture with evisceration from abdominal contusion in a patient with a voluminous inguino-scrotal hernia. The mechanism and treatment of lesions are discussed.

[Kidney tumors in Africa. Incidence and anatomo-clinical aspects. Apropos of 123 observed cases at the Central Hospital and at the University Hospital Center in Cameroon]. / Les tumeurs du rein en milieu africain. Incidence et aspects anatomo-cliniques. A propos de 123 cas observés à l'Hôpital Central et au C.H.U. de Yaoundé (Cameroun).

123 renal tumours, among which 4 benign, were observed in 13 years. Renal tumours have a low incidence in Africa and are mostly seen in young patients. Nephroblastoma is the most frequent of these tumours. The clinical and paraclinical aspects of these tumours have nothing particular but the diagnosis is usually late.

Is cancer of the prostate rare in tropical (black) Africa? Case series from the Centre Hospitalier et Universitaire and the Hospital General de Yaounde from 1986 to 1990.

The objective of this study was to determine the crude incidence of cancer of the prostate in a hospital-based population. Patients presenting at urological clinics were studied using a standard proforma. The settings included the urological outpatient clinics and hospital wards of the University Hospital Center (CHU) and the Yaounde General Hospital (HGY)--Institutions of the University of Yaounde I, Faculty of medicine and biological sciences, Centre Pasteur de Yaounde. Included were 447 new male patients over age 40, observed over a five-year period. All patients underwent standard clinical evaluation, laboratory and radiological studies. Patients with abnormal prostates, enlarged lymph nodes, metastatic bony lesions had tissue removed for histology. Seventy-two patients with abnormal prostates had them biopsied. Five had excisional biopsy of enlarged supraclavicular lymph nodes in addition to abnormal prostates. Six patients with bony lesions, elevated prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) did not have tissue diagnosis. Thirty-three patients were treated with orchidectomy and fefosterol (ST-52) and 12 with ST-52 only. Seventy-eight out of 447 patients had abnormal clinical findings. 39 of these had a tissue diagnosis of adenocarcinoma of the prostate. Six others with probable cancer of the prostate did not have a tissue diagnosis. All but one patient with stage C disease had stage D disease. The calculated age-adjusted incidence of cancer of the prostate is 93.8 cases per 100,000. Cancer of the prostate is common in the blacks of Cameroon and its incidence is increasing annually.

Value of whole-cell antigen extracts for serologic detection of Helicobacter pylori.

Whole-cell protein extracts of Helicobacter pylori strains were evaluated by enzyme-linked immunosorbent assay to detect immunoglobulin G antibody against H. pylori in 113 patients with upper gastrointestinal complaints. These antigen preparations were of value for detecting infection by H. pylori in patients with high antibody titers (> or = 12,800), whereas for patients with lower titers, the results were inconclusive.

[Solitary extra-osseous ovarian plasmacytoma. Apropos of an unusual case in a 12 year old child]. / Le plasmocytome solitaire extraosseux ovarien. A propos d'un cas exceptionnel chez une enfant de 12 ans.

A rare case of extramedullary or solitary ovarian plasmocytoma in a 12 years old patient is reported. Surgery consisted of left adnexectomy associated with omentectomy. Chemotherapy with abdomino-pelvic iradiation were effectuated afterwards. Review of literature and therapeutic indications are discussed.

[Diagnosis of hepatocellular carcinoma by needle puncture--aspiration and cytological test. The experience in Cameroon]. / Diagnostic du carcinome hépato-cellulaire par ponction-aspiration à l'aiguille et examen cytologique. L'expérience du Cameroun.

The authors report their experience of the diagnosis of hepatocellular carcinoma using needle aspiration cytology over a four year period (1989-1992). In 116 of the 119 patients presenting with histologically proven hepatocellular carcinoma, the diagnosis was previously established by cytology. This method has a 97% sensitivity. Also, in forty patients without hepatocellular carcinoma, previous cytology did not detect any carcinomatous cells and therefore recorded a 100% specificity. Thus, cytologic diagnosis of hepatocellular carcinoma is possible. In countries with limited resources in which this carcinoma is widespread, needle aspiration cytology needs to be well known and used.