RESUMEN
In Madagascar, the epidemiological data actualized concerning the cancer of the collus of uterus are not available because of the absence of register of cancer. The objective of this study is to achieve a first assessment of the problem, to complete the epidemiological knowledge, to point out the tool of precoce detection of the precancerous lesions, to propose the measures aiming to improve the management of the patients and to contribute to the institution of a register of cancer. This is a retrospective survey on the frequency of the cancer of the cervix observed from 1992 to 2002 about 23,908 withdrawals addressed to the Institut Pasteur de Madagascar for anatomopathological exam and 12,605 cervical smears for cytological exam. In pathological anatomy, 2,621 (63.4%) of 4,136 cases of diagnosed cancer, have been observed in women. 687 cases (26.2%) of them were localized in the collus. The 3/4 of the cancers of the cervix is invasive and the mean age is 48.2 years old at the time of diagnosis. The cytology detects only 74 cases of invasive cancer of which most don't have an histological confirmation. 274 pre-lesions of cervix cancer were diagnosed for this period, the majority lesions are cytological diagnosis. In spite of a non representative recruitment of the general population, and by the number of withdrawals considered, these results may represent indicators of the epidemiological situation and justify the institution of program to detect the precancerous lesions in a national scale.
Asunto(s)
Neoplasias del Cuello Uterino/epidemiología , Centros Médicos Académicos , Academias e Institutos , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Incidencia , Madagascar/epidemiología , Tamizaje Masivo , Persona de Mediana Edad , Evaluación de Necesidades , Estadificación de Neoplasias , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/epidemiología , Vigilancia de la Población , Lesiones Precancerosas/complicaciones , Lesiones Precancerosas/diagnóstico , Lesiones Precancerosas/epidemiología , Sistema de Registros , Estudios Retrospectivos , Factores de Riesgo , Gestión de la Calidad Total , Neoplasias del Cuello Uterino/clasificación , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/etiología , Neoplasias del Cuello Uterino/prevención & control , Frotis VaginalRESUMEN
The authors reported the first case of leiomyomatosis peritonealis disseminata or diffuse peritonealis leiomyomatosis in a patient of 36 years old. The hyalin degeneration of leiomyomatosis with intra and extra peritonealis extension is an uncommon pathology. The right etiology of this complication of leiomyomatosis is unknown. Its detection is a fortuitous event during laparotomy. It is characterized by an extension to the serosa, a break-in of the tissues and unpredictable invasion of the contiguous organs, and it can touch the heart. Despite its rapid evolution, often accompanied by mechanical complications, it remains a benign tumour.
Asunto(s)
Leiomiomatosis/diagnóstico , Neoplasias Peritoneales/diagnóstico , Adulto , Anorexia/etiología , Estreñimiento/etiología , Progresión de la Enfermedad , Disnea/etiología , Femenino , Humanos , Histerectomía , Hallazgos Incidentales , Leiomiomatosis/complicaciones , Leiomiomatosis/cirugía , Madagascar , Menorragia/etiología , Neoplasias Peritoneales/complicaciones , Neoplasias Peritoneales/cirugía , Embarazo , Pronóstico , Factores de Riesgo , Resultado del Tratamiento , Incontinencia Urinaria/etiologíaRESUMEN
A retrospective survey of cases of cancer of the small intestine observed in the Institut Pasteur de Madagascar (IPM), in the Centre Hospitalier de Soavinandriana (CenHoSoa) and in the Centre Hospitalier Universitaire d'Antananarivo/Hôpital Joseph Ravoahangy Andrianavalona (CHUA/HJRA), has been undertaken with the goal to find out epidemiological and diagnostical particularities, as well as the therapeutic measures and their results. Only 25 cases have been found in 10 years (from 1992 to 2001). They represent 5.4% of the digestive cancers diagnosed by the Institut Pasteur de Madagascar. They concern 14 women and 11 men with a mean age of 36 years old at the time of diagnosis. The motive of hospitalization was an acute abdomen (peritonitis, perforation, occlusive syndrome, König's syndrome) in 64.3%, and a chronic abdominal pain often associated with abdominal mass in 35.7%. The duodenum is the predilection seat of the small bowel cancers (50%), followed by the ileum (25%) and the jejunum (10%). A diffuse shape has been observed in 15% of the cases. The most frequent histological type is the lymphoma (40%) followed by the adenocarcinoma (32%).
Asunto(s)
Neoplasias Intestinales/diagnóstico , Neoplasias Intestinales/epidemiología , Intestino Delgado , Centros Médicos Académicos , Academias e Institutos , Adenocarcinoma/diagnóstico , Adenocarcinoma/epidemiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Quimioterapia Adyuvante , Niño , Preescolar , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Neoplasias Intestinales/complicaciones , Neoplasias Intestinales/cirugía , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/epidemiología , Madagascar/epidemiología , Masculino , Persona de Mediana Edad , Selección de Paciente , Enfermedades Raras , Estudios Retrospectivos , Distribución por Sexo , Resultado del TratamientoRESUMEN
Breast cancer is a great problem of public health all over the world. In developed countries, breast cancer represents the most common cancer in females. Its incidence is also increasing in developing country. In Madagascar, no data is available to estimate the real incidence and prevalence rates of breast cancer. However, the data at the Institut Pasteur de Madagascar can confirm the extent of the problem even if it is not at a national scale. The authors report the results of a retrospective study from histological examination at the Laboratory of pathological anatomy of the IPM, during 7 years. Among 2,337 cases of cancer, 16% (373) were breast cancer. Most of them were a female breast cancer (356 cases). The average age is 48 years old. 30% of the tumors were more than 2 cm in size, corresponding at least to the T2 stade from the International Union Against Cancer anatomoclinical classification. The current histological type is the infiltrating ductal carcinoma (80%), about 2/3 belong to the grade 3 of the Scarff-Bloom-Richardson histopronostical classification. Early diagnosis of the cancer is difficult because of the insufficiency of the sanitary infrastructure, particularly for cervical and breast cancers. A national policy for screening must be set up in order to decrease the rate of these invasive carcinomas. In the meantime, informing women and training all the medical staff is a priority. Recording all the data in Madagascar would be desirable.
Asunto(s)
Neoplasias de la Mama , Adolescente , Adulto , Distribución por Edad , Anciano , Biopsia , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/epidemiología , Neoplasias de la Mama/terapia , Países en Desarrollo , Femenino , Educación en Salud , Política de Salud , Humanos , Incidencia , Madagascar/epidemiología , Masculino , Tamizaje Masivo , Persona de Mediana Edad , Programas Nacionales de Salud , Evaluación de Necesidades , Estadificación de Neoplasias , Prevención Primaria , Salud Pública , Estudios Retrospectivos , Factores de Riesgo , Distribución por SexoRESUMEN
Cervical and mediastinal cystic lymphangioma are rare and benign tumours. They looked like a lateral and cervical mass. Medical imaging allows to suspect the diagnosis but histology only may to assert it. The best therapy is surgery. Sclerosis by chemical drugs is only an alternative if surgery is not possible. A recovery is completely obtained if the whole tumour is removed.