Background and Objective: Malignant melanoma is the most aggressive skin cancer because it has very strong metastatic power. Endobuccal localization is very rare. Its discovery is often made in the late stage, which l...Background and Objective: Malignant melanoma is the most aggressive skin cancer because it has very strong metastatic power. Endobuccal localization is very rare. Its discovery is often made in the late stage, which leads to a consistently pessimistic diagnostic. We report a case of palatal melanoma at the metastatic stage. Case Report: A 43-year-old woman presented left lateral cervical swelling associated with dyspnea for 5 months. She had regularly taken chewing tobacco for 4 years and had developed blackish gums. The endobuccal examination showed a blackish non-haemorrhagic swelling of 5 cm of the long axis, located at the level of the palatal vault, associated with pigmentation in teeth 21, 22, and 23. The anatomopathological examination confirmed the melanoma. The spreading assessment revealed pleural and hepatic metastasis. The proposed treatment was palliative treatment. The patient died 2 months later. Conclusion: Melanoma of the oral mucosa is a very aggressive tumor. The scarcities of dental care among the Malagasy people exacerbate the delay in diagnosis. Its management is still challenging in Madagascar.展开更多
A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She under...A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She underwent a right salpingo-oophorectomy in May 2022. The anatomical pathology result is in favor of a papillary carcinoma developed on stroma ovarii. No adjuvant treatment was necessary since the tumor was well limited, without capsular rupture, stage IA. The thyroid test was normal. The patient is currently being monitored. There is no sign of recurrence 20 months after surgery.展开更多
Chemotherapy with 5-fluorouracil (5 FU) has been widely used to treat advanced gastric cancer. Knowing the side effects is therefore important in order to better prevent them. Fluoropyrimidine-induced hyperammonemic e...Chemotherapy with 5-fluorouracil (5 FU) has been widely used to treat advanced gastric cancer. Knowing the side effects is therefore important in order to better prevent them. Fluoropyrimidine-induced hyperammonemic encephalopathy is a rare complication and characterized neurological status with elevated ammonia level without radiological abnormalities. We report the first case of 5 FU-induced hyperammonemic encephalopathy in women patients on induction chemotherapy for gastric cancer in Madagascar. His ammonia level (NH<sub>3</sub>) was 102 μmol/l. The patient recovered from his confusional state after two days of treatment with hyperhydration and vitamin therapy.展开更多
In Madagascar, a country with a tropical climate;skin cancers are often of epidermal or melanic origin. Adnexal tumors are not well known. We report the first case of an eccrine tumor in a 57-year-old woman with no pe...In Madagascar, a country with a tropical climate;skin cancers are often of epidermal or melanic origin. Adnexal tumors are not well known. We report the first case of an eccrine tumor in a 57-year-old woman with no personal or family history of cancer. She has no comorbidities. The patient presented with a 50 × 60 mm frontal swelling and an ulcerative lesion of the left half of the face that had been evolving for 5 months. The cerebral and cervical CT scan revealed bone lysis of the vault of the skull and left cervical lymphadenopathy. The CT chest-abdomen-pelvis showed no abnormal lesions. The mammogram was normal. The result of the pathological examination was in favor of a round-cell tumor. The AE1/AE3, CK7 and P63 markers were positive in the immunohistochemical study. The diagnosis of an advanced eccrine adenocarcinoma was retained after the exclusion of a visceral adenocarcinoma with cutaneous metastasis. The patient receives radiotherapy of 40 Gy in 20 fractions followed by 6 courses of Carboplatin-paclitaxel type chemotherapy. The lesion has decreased in size and dried up after these treatments. 3 months after stopping treatment for lack of financial means, the patient died at home. The diagnosis of an adnexal tumor requires more in-depth complementary examinations. Treatments should be multidisciplinary and adapted to each patient.展开更多
Introduction: Colorectal cancer is one of the most common causes of cancer morbidity. The epidemiological and therapeutic data available are very limited in Antananarivo. The aim of this study was to provide an update...Introduction: Colorectal cancer is one of the most common causes of cancer morbidity. The epidemiological and therapeutic data available are very limited in Antananarivo. The aim of this study was to provide an updated report on the management of colorectal cancer and know the survival of patients. Patients and Methods: A descriptive retrospective study during 2018 and 2019 carried out in the oncology department of Joseph Ravoahangy Andrianavalona Antananarivo Hospital. Newly diagnosed patients with histological evidence were included in the study. Results: Sixty-five cases of cancer were collected, including 39 colon cancers and 26 rectal cancers. The average age was 53 years with extremes of 18 and 83 years. In 41.53%, the patients were young people under 50 years old. The sex ratio was 0.95. Four patients (6.15%) had a family history of first degree cancer. The left colon was the most common location in 43.06% of cases. Only 39% of patients were diagnosed within 6 months of the first symptoms. The most common histological type was lieberkuhnian adenocarcinoma (87.69%). None of the patients underwent an immunohistochemistry examination. Stage IV and III accounted for 41.53% and 35.38% respectively. The majority (55.38%) of patients had benefited from surgery. Chemotherapy was performed in 56.89% of cases. One metastatic patient had received targeted therapy. Nine patients (34.61%) among the 26 with rectal cancers had benefited from concomitant radiochemotherapy. Survival at 30 months was 20%. Conclusion: The survival rate of patients at 30 months is very low. Improving the management of colorectal cancer requires awareness-raising and early detection.展开更多
Hepatoid adenocarcinoma of the lung is a rare tumor with a poor prognosis. There are no specific treatment-recommendations for this cancer. We report a 59-year-old man, a former smoker, with this condition. He present...Hepatoid adenocarcinoma of the lung is a rare tumor with a poor prognosis. There are no specific treatment-recommendations for this cancer. We report a 59-year-old man, a former smoker, with this condition. He presented with a cough and computed tomography revealed a pulmonary nodule (50 × 47 × 48 mm) with a right pleural effusion, together with a cerebral right temporal-lobe lesion and a right adrenal lesion. The serum alpha-fetoprotein value was normal. Histological examination via bronchoscopic biopsy revealed an adenocarcinoma. Positive CK7, AE1/AE2, and TTF1 with granular cytoplasmic staining on immunohistochemical study confirmed the diagnosis of hepatoid adenocarcinoma of the lung, stage IV-B. The patient had received chemotherapies (carboplatin-pemetrexed, gemcitabine) and cerebral radiotherapy, but he died at eight months of the treatment as a result of tumor progression.展开更多
Breast cancer in adolescents occurring in fibroadenomas is extremely rare. We report a case of right breast cancer in a 15-year-old female student diagnosed in 2020. This is the youngest reported case of breast cancer...Breast cancer in adolescents occurring in fibroadenomas is extremely rare. We report a case of right breast cancer in a 15-year-old female student diagnosed in 2020. This is the youngest reported case of breast cancer arising within fibroadenomas in the literature. The teenager has no personal or family history of cancer or known hereditary disease. Currently, there is no consensus on the management of breast cancer arising from adenofibromas in adolescents. Clinically, the tumor was inflammatory with axillary lymph node involvement (T4dN1M0). The fine-needle aspiration cytologic was suspicious of malignancy. The patient received four courses of neoadjuvant chemotherapy with 5-fluorouracil<sup>®</sup>, doxorubicin<sup>®</sup> and cyclosphosphamide<sup>®</sup>, followed by radical right mastectomy. The histological result of the surgical specimen is a non-specific carcinoma with a therapeutic effect greater than fifty percent. The patient received three courses of adjuvant chemotherapy with paclitaxel<sup>®</sup>. The adolescent underwent radiation therapy at her chest wall of 50 Gy and regional lymph node of 46 Gy. After radiotherapy, hormone therapy with Tamoxifene<sup>®</sup> at 20 mg per day was started. At 16 months from radiotherapy, there is no recurrence. The reconstruction of the right breast is planned in a few months.展开更多
Dermatofibrosarcoma is a rare, slow growing tumor with a tendency to local recurrence. The treatment is mainly surgical. In Madagascar there is no specialized center for the management of soft tissue sarcomas. It is i...Dermatofibrosarcoma is a rare, slow growing tumor with a tendency to local recurrence. The treatment is mainly surgical. In Madagascar there is no specialized center for the management of soft tissue sarcomas. It is in this context that we report a case of a 45-year-old man, driver, presenting with recurrent dermatofibrosarcoma of the left hand. The diagnosis was confirmed by the positivity of the CD34 marker. Extensive local excision surgery was performed with the patient’s consent. After free years of treatment, there is no tumor recurrence.展开更多
Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferatio<span><span><span style="font-family:;" "=""><span style="font-family:Verdana;&quo...Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferatio<span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">n of trophoblasts following fertilization. This includes complete and </span><span style="font-family:Verdana;">partial hydatidiform mole (HM) and gestational trophoblastic neoplasia (GTN).</span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">aim of this study was to report the epidemiological, clinical and thera</span><span style="font-family:Verdana;">peutic profile of gestational trophoblastic neoplasia (GTN) over period of ten years in the department of Oncology Radiotherapy at the University Hospital </span><span style="font-family:Verdana;">Joseph Ravoahangy Andrianavalona (HJRA) Antananarivo </span><span style="font-family:Verdana;">Madagascar. Medical records of women diagnosed with GTD in the department of Oncology Radiotherapy at HJRA from January 1st, 2007 to September 2017 were retrospectively reviewed. Only patients with the FIGO diagnosis GTN were in</span><span style="font-family:Verdana;">cluded, while those with the histological diagnosis of hydatidiform mole (HM)</span><span style="font-family:Verdana;">, also sometimes classified as GTD, were not included in this study. Also excluded</span><span style="font-family:Verdana;"> were all cases with incomplete or missing data. Twenty four pati</span><span style="font-family:Verdana;">ents were included. Median age of patients at the time of diagnosis was 37 years (range 18 - 60). Most patients developed GTN following molar pregnancy (75%), had disease duration from antecedent pregnancy of less than 6 months </span><span style="font-family:Verdana;">(58.20%), and had the pre-treatment hCG level more than 10,000 IU/L (58.27%).</span><span style="font-family:Verdana;"> At diagnosis, 14 patients (58.33%) had localized disease (M0). Most common metastatic sites at initial diagnosis were the liver and brain (20.83%). After a median follow-up from initial diagn展开更多
文摘Background and Objective: Malignant melanoma is the most aggressive skin cancer because it has very strong metastatic power. Endobuccal localization is very rare. Its discovery is often made in the late stage, which leads to a consistently pessimistic diagnostic. We report a case of palatal melanoma at the metastatic stage. Case Report: A 43-year-old woman presented left lateral cervical swelling associated with dyspnea for 5 months. She had regularly taken chewing tobacco for 4 years and had developed blackish gums. The endobuccal examination showed a blackish non-haemorrhagic swelling of 5 cm of the long axis, located at the level of the palatal vault, associated with pigmentation in teeth 21, 22, and 23. The anatomopathological examination confirmed the melanoma. The spreading assessment revealed pleural and hepatic metastasis. The proposed treatment was palliative treatment. The patient died 2 months later. Conclusion: Melanoma of the oral mucosa is a very aggressive tumor. The scarcities of dental care among the Malagasy people exacerbate the delay in diagnosis. Its management is still challenging in Madagascar.
文摘A 64-year-old woman with no particular history presented with chronic pelvic pain since November 2021. The ultrasound performed showed multiple right ovarian cystic ranging from 0.4 to 4 cm on the long axis. She underwent a right salpingo-oophorectomy in May 2022. The anatomical pathology result is in favor of a papillary carcinoma developed on stroma ovarii. No adjuvant treatment was necessary since the tumor was well limited, without capsular rupture, stage IA. The thyroid test was normal. The patient is currently being monitored. There is no sign of recurrence 20 months after surgery.
文摘Chemotherapy with 5-fluorouracil (5 FU) has been widely used to treat advanced gastric cancer. Knowing the side effects is therefore important in order to better prevent them. Fluoropyrimidine-induced hyperammonemic encephalopathy is a rare complication and characterized neurological status with elevated ammonia level without radiological abnormalities. We report the first case of 5 FU-induced hyperammonemic encephalopathy in women patients on induction chemotherapy for gastric cancer in Madagascar. His ammonia level (NH<sub>3</sub>) was 102 μmol/l. The patient recovered from his confusional state after two days of treatment with hyperhydration and vitamin therapy.
文摘In Madagascar, a country with a tropical climate;skin cancers are often of epidermal or melanic origin. Adnexal tumors are not well known. We report the first case of an eccrine tumor in a 57-year-old woman with no personal or family history of cancer. She has no comorbidities. The patient presented with a 50 × 60 mm frontal swelling and an ulcerative lesion of the left half of the face that had been evolving for 5 months. The cerebral and cervical CT scan revealed bone lysis of the vault of the skull and left cervical lymphadenopathy. The CT chest-abdomen-pelvis showed no abnormal lesions. The mammogram was normal. The result of the pathological examination was in favor of a round-cell tumor. The AE1/AE3, CK7 and P63 markers were positive in the immunohistochemical study. The diagnosis of an advanced eccrine adenocarcinoma was retained after the exclusion of a visceral adenocarcinoma with cutaneous metastasis. The patient receives radiotherapy of 40 Gy in 20 fractions followed by 6 courses of Carboplatin-paclitaxel type chemotherapy. The lesion has decreased in size and dried up after these treatments. 3 months after stopping treatment for lack of financial means, the patient died at home. The diagnosis of an adnexal tumor requires more in-depth complementary examinations. Treatments should be multidisciplinary and adapted to each patient.
文摘Introduction: Colorectal cancer is one of the most common causes of cancer morbidity. The epidemiological and therapeutic data available are very limited in Antananarivo. The aim of this study was to provide an updated report on the management of colorectal cancer and know the survival of patients. Patients and Methods: A descriptive retrospective study during 2018 and 2019 carried out in the oncology department of Joseph Ravoahangy Andrianavalona Antananarivo Hospital. Newly diagnosed patients with histological evidence were included in the study. Results: Sixty-five cases of cancer were collected, including 39 colon cancers and 26 rectal cancers. The average age was 53 years with extremes of 18 and 83 years. In 41.53%, the patients were young people under 50 years old. The sex ratio was 0.95. Four patients (6.15%) had a family history of first degree cancer. The left colon was the most common location in 43.06% of cases. Only 39% of patients were diagnosed within 6 months of the first symptoms. The most common histological type was lieberkuhnian adenocarcinoma (87.69%). None of the patients underwent an immunohistochemistry examination. Stage IV and III accounted for 41.53% and 35.38% respectively. The majority (55.38%) of patients had benefited from surgery. Chemotherapy was performed in 56.89% of cases. One metastatic patient had received targeted therapy. Nine patients (34.61%) among the 26 with rectal cancers had benefited from concomitant radiochemotherapy. Survival at 30 months was 20%. Conclusion: The survival rate of patients at 30 months is very low. Improving the management of colorectal cancer requires awareness-raising and early detection.
文摘Hepatoid adenocarcinoma of the lung is a rare tumor with a poor prognosis. There are no specific treatment-recommendations for this cancer. We report a 59-year-old man, a former smoker, with this condition. He presented with a cough and computed tomography revealed a pulmonary nodule (50 × 47 × 48 mm) with a right pleural effusion, together with a cerebral right temporal-lobe lesion and a right adrenal lesion. The serum alpha-fetoprotein value was normal. Histological examination via bronchoscopic biopsy revealed an adenocarcinoma. Positive CK7, AE1/AE2, and TTF1 with granular cytoplasmic staining on immunohistochemical study confirmed the diagnosis of hepatoid adenocarcinoma of the lung, stage IV-B. The patient had received chemotherapies (carboplatin-pemetrexed, gemcitabine) and cerebral radiotherapy, but he died at eight months of the treatment as a result of tumor progression.
文摘Breast cancer in adolescents occurring in fibroadenomas is extremely rare. We report a case of right breast cancer in a 15-year-old female student diagnosed in 2020. This is the youngest reported case of breast cancer arising within fibroadenomas in the literature. The teenager has no personal or family history of cancer or known hereditary disease. Currently, there is no consensus on the management of breast cancer arising from adenofibromas in adolescents. Clinically, the tumor was inflammatory with axillary lymph node involvement (T4dN1M0). The fine-needle aspiration cytologic was suspicious of malignancy. The patient received four courses of neoadjuvant chemotherapy with 5-fluorouracil<sup>®</sup>, doxorubicin<sup>®</sup> and cyclosphosphamide<sup>®</sup>, followed by radical right mastectomy. The histological result of the surgical specimen is a non-specific carcinoma with a therapeutic effect greater than fifty percent. The patient received three courses of adjuvant chemotherapy with paclitaxel<sup>®</sup>. The adolescent underwent radiation therapy at her chest wall of 50 Gy and regional lymph node of 46 Gy. After radiotherapy, hormone therapy with Tamoxifene<sup>®</sup> at 20 mg per day was started. At 16 months from radiotherapy, there is no recurrence. The reconstruction of the right breast is planned in a few months.
文摘Dermatofibrosarcoma is a rare, slow growing tumor with a tendency to local recurrence. The treatment is mainly surgical. In Madagascar there is no specialized center for the management of soft tissue sarcomas. It is in this context that we report a case of a 45-year-old man, driver, presenting with recurrent dermatofibrosarcoma of the left hand. The diagnosis was confirmed by the positivity of the CD34 marker. Extensive local excision surgery was performed with the patient’s consent. After free years of treatment, there is no tumor recurrence.
文摘Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferatio<span><span><span style="font-family:;" "=""><span style="font-family:Verdana;">n of trophoblasts following fertilization. This includes complete and </span><span style="font-family:Verdana;">partial hydatidiform mole (HM) and gestational trophoblastic neoplasia (GTN).</span><span style="font-family:Verdana;"> The </span><span style="font-family:Verdana;">aim of this study was to report the epidemiological, clinical and thera</span><span style="font-family:Verdana;">peutic profile of gestational trophoblastic neoplasia (GTN) over period of ten years in the department of Oncology Radiotherapy at the University Hospital </span><span style="font-family:Verdana;">Joseph Ravoahangy Andrianavalona (HJRA) Antananarivo </span><span style="font-family:Verdana;">Madagascar. Medical records of women diagnosed with GTD in the department of Oncology Radiotherapy at HJRA from January 1st, 2007 to September 2017 were retrospectively reviewed. Only patients with the FIGO diagnosis GTN were in</span><span style="font-family:Verdana;">cluded, while those with the histological diagnosis of hydatidiform mole (HM)</span><span style="font-family:Verdana;">, also sometimes classified as GTD, were not included in this study. Also excluded</span><span style="font-family:Verdana;"> were all cases with incomplete or missing data. Twenty four pati</span><span style="font-family:Verdana;">ents were included. Median age of patients at the time of diagnosis was 37 years (range 18 - 60). Most patients developed GTN following molar pregnancy (75%), had disease duration from antecedent pregnancy of less than 6 months </span><span style="font-family:Verdana;">(58.20%), and had the pre-treatment hCG level more than 10,000 IU/L (58.27%).</span><span style="font-family:Verdana;"> At diagnosis, 14 patients (58.33%) had localized disease (M0). Most common metastatic sites at initial diagnosis were the liver and brain (20.83%). After a median follow-up from initial diagn
