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Rhabdomyosarcoma in Dakar: An Update on Pronostics Factors

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Open Journal of Pathology 2022年第1期12卷 37-45页

作者： Abdou Magib Gaye Marie Joseph Dieme-Haouidi Ibou Thiam Fabrice Senghor Gabriel Nougnignon Comlan Deguenonvo cherif mouhamed moustapha dial Anatomy and Pathological Cytology Laboratory of the Aristide Le Dantec Hospital Dakar Senegal Anatomy and Pathological Cytology Laboratory of the Fann Hospital Dakar Senegal Anatomy and Pathological Cytology Laboratory of the Idrissa Pouye General Hospital Dakar Senegal

Rhabdomyosarcoma (RMS) belongs to the soft tissue sarcomas that have striated muscle differentiation. It is most common in young children under 5 years of age and adolescents. The definite diagnosis of rhabdomyosarcoma is based on histology and the positivity of striated muscle markers in immunohistochemistry. Our objective was to describe the prognostic characteristics of RMS diagnosed in Dakar. MATERIAL AND METHODS: This was a retrospective and descriptive study spread over nine (09) years from 1 January 2011 to 31 December 2019. It was conducted from the histological report archives of the anatomy and pathology laboratories of Dakar. Paraffin blocks were reread and immunohistochemically studied by manual method. Antidesmin and antimyogenin antibodies were used. RESULTS: We collected 44 patients with rhabdomyosarcoma out of 228 cases of soft tissue cancers, i.e. 19.29% of all malignant soft tissue tumours. The mean age of the patients was 25.41 ± 23.95 (standard deviation) years with a median age of 16 years and extremes of 6 months and 81 years. Patients were less than or equal to 17 years of age in 61.4% of cases. A clear male predominance was observed with 29 men (65.9%) against 15 women (34.1%). Rhabdomyosarcomas were located in the limbs in 34.1% of cases, in the head and neck in 29.5% of cases and in the genitourinary tract in 25% of cases. The average tumour size was 7.45 cm ± 4.64 (standard deviation) with a minimum of 2 cm and a maximum of 17 cm. It was greater than or equal to 5 cm in 15 patients (68.2%). Embryonal rhabdomyosarcoma (ERMS) was the most frequent histological type with 34 cases (77.3%), followed by pleomorphic rhabdomyosarcoma 7 cases (15.9%) and alveolar rhabdomyosarcoma 3 cases (6.8%). The histological subtypes of ERMS consisted of conventional ERMS (91.18%);botryoid RMS (5.88%) and spindle cell RMS (2.94%). The correlation between histological type and age was statistically significant (p = 0.039). A relationship was also observ

关键词： Rhabdomyosarcoma Prognosis Histology Dakar

Laryngeal Cancers at the Pathological Anatomical Laboratory (ACP) in Dakar about 215 Cases

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Open Journal of Pathology 2023年第2期13卷 79-86页

作者： Marie Joseph Dieme Ahouidi Adama Diedhiou Abdou Magib Gaye Dibor Niang Falilatou Seidou Ibou Thiam cherif mouhamed moustapha dial Anatomy and Pathological Cytology Laboratory Fann Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Aristide Le Dantec Hospital Dakar Sénégal Anatomy and Pathological Cytology Laboratory Gaston Berger University St Louis Sénégal Anatomy and Pathological Cytology Laboratory Idrissa Pouye Hospital Dakar Sénégal

Introduction: Laryngeal cancer is the first cancer of upper aerodigestive tract. Dysphonia, dyspnea and dysphagia are evocative signs. Diagnosis is histological and squamous cell carcinoma is the most common type. The objective of our study was to discuss epidemiological and anatomo-pathological characteristics of laryngeal cancers diagnosed in different pathological anatomy and cytology (ACP) laboratories of Dakar hospitals. Material and method: This was a retrospective study spanning from January 2013 to December 2018 at the pathological anatomy laboratories of Fann, Aristide Le Dantec and Idrissa Pouye hospitals. All patients with laryngeal cancer confirmed at histology were included. Data collection was based on clinical records of the patients and archives of histological reports of the pathological laboratories. Data analysis was performed under the Excel software. Results: We collected 215 cases of laryngeal cancer. The average age was 58.01 years with extremes of 07 and 94 years. The male sex was predominant with 183 patients (85.12%) against 32 women (14.88%). The most noted risk factor was tobacco which affected 14 patients, or 60.87%. Three patients (13.04%) did not present any alcohol-smoking impregnation. Clinically, dysphonia was noted in 22 patients (26.51%). It was associated with dyspnea in 0.48% of cases and dysphagia in 3.61%. Laryngoscopy was performed in 62 patients or 28.83% of cases, nasofibroscopy in 6.45% of cases. Cord arythenoid fixity was noted in two patients (3.23%) and hypo-mobility in 1 patient (1.61%). The most frequent local extension was involvement of the piriform sinus with 11.29% of cases. Palpable lymphadenopathy reported in 17 patients (20.48%). Pathological examination was performed in all patients after post endoscopic biopsy in 92 patients (42.79%), and after obtaining the operative specimen in 123 cases (57.21%). The three floors affected 76 patients (35.35%). The ulcerative budding aspect most noted concerned 108 patients

关键词： Laryngeal Cancer Carcinoma Dakar

Epidermal Inclusion Cyst: A Rare Benign Breast Lesion

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Open Journal of Pathology 2022年第2期12卷 64-69页

作者： Abdou Magib Gaye Modukpè Colette Nadine Odah Moussa Guira Fabrice Senghor Gabriel Nougnignon Comlan Deguenonvo Amadou Ndiade Ibou Thiam Marie Joseph Dieme-Ahouidi cherif mouhamed moustapha dial Anatomy and Pathological Cytology Laboratory Aristide Le Dantec Hospital Dakar Senegal Public Care Center of Richard Toll Saint-Louis Senegal Anatomy and Pathological Cytology Laboratory Idrissa Pouye General Hospital Dakar Senegal Anatomy and Pathological Cytology Laboratory Fann Hospital Dakar Senegal

Epidermal inclusion cyst in the breast is an uncommon condition. It may be congenital, originating from hair follicles or occurring after trauma (breast reduction or breast cytology puncture) or consists of squamous metaplasia of the regular columnar epithelium within an ectatic ductus galactophorus. We report the case of a 22-year-old woman, with two pregnancies and with no particular pathological history, who presented with a 3 cm nodule of the right breast at the union of the upper quadrants, firm, mobile and painless. The skin, areola and nipple were unaffected. The axillary areas and the contralateral breast were unremarkable. The breast ultrasound showed a heterogeneous and well circumscribed hypoechoic mass classified as ACR3. Macroscopic examination revealed a unilocular cyst with a discretely thickened wall, abundant yellowish contents and measuring 2 cm on a long axis. Histologically, it was a cystic cavity whose wall was lined with a pseudo stratified keratinized squamous epithelium with a granular layer and whose lumen contained keratin lamellae. This cyst is surrounded by a more or less fibrous pallial tissue containing regular, sometimes dilated or even cystic milk ducts. The diagnosis of epidermal inclusion cyst of the breast on a background of fibrocystic mastopathy was thus concluded. The importance of this benign lesion lies in the differentiation between other non-neoplastic and neoplastic breast lesions.

关键词： Epidermal Inclusion Cyst Breast Fibrocystic Mastopathy Dakar Senegal

Superior Mesenteric Artery Syndrome, a Rare Complication of Severe Malnutrition: Two Cases from a Subsaharian Endocrinology Department

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Open Journal of Endocrine and Metabolic Diseases 2024年第4期14卷 87-93页

作者： Nafy Ndiaye Ngone Diaba Diack Yakham Mohamed Leye Sokhna Awa Balla Sall Moussa Gueye mouhamed Fawaz Mouhamadou moustapha Ndong Abdoulaye Leye Department of Internal Medecine and Endocrinology Teaching Hospital of Pikine Dakar Senegal

Introduction: Superior mesenteric artery syndrome (SMAS), a rare diagnosis due to compression of the third duodenum between the superior mesenteric artery (SMA) and the aorta resulting in bowel obstruction, may lead to severe malnutrition. We report two cases of patients hospitalised in the Internal Medicine, Endocrinology, Diabetology, and Nutrition Department of the National Hospital Center (NHC) of Pikine. Observations: Patient 1: A 35-year-old female was referred for an aetiological diagnosis due to a rapid weight loss of 15 kilograms in one month, accompanied by persistent vomiting, following an appendectomy performed a month before admission. Upon clinical examination, she presented severe malnutrition (Buzby index of 76%), early post-prandial chronic vomiting, and a poor general condition. An abdominal CT scan revealed aortomesenteric clamp syndrome (AMCS) with an angulation between the aorta and the SMA of 13˚. The underlying cause in this patient was severe malnutrition. Fortunately, her condition improved with medical treatment. Patient 2: We report the case of a 30-year-old female hospitalized due to unusual weight-bearing post-prandial epigastric pain and intermittent vomiting over the past six months. Upon physical examination at admission, she exhibited severe malnutrition with a body mass index (BMI) of 14 kg/m2, a Buzby index of 71%, trophic disorders, and a stage IV general condition assessment according to the World Health Organization (WHO). An abdominal CT scan revealed AMCS with an angle between the aorta and the SMA of 22˚ and an aortomesenteric space of 4 mm. The outcome was poor with medical treatment failure and, unfortunately, the patient died before surgery. Conclusion: SMAS is rarely evoked in clinical practice despite the presence of contributing factors and suggestive clinical signs. The prognosis depends on management time.

关键词： Superior Mesenteric Artery Syndrome Malnutrition Pikine

Renal Disease among HIV Positive Patients in Senegal

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Open Journal of Nephrology 2017年第4期7卷 101-106页

作者： Khodia Fall Mouhamadou moustapha Cissé Ahmed Tall Lemrabott Maria Faye mouhamed cherif dial Atoumane Faye Seynabou Fall moustapha Faye Alex Keita Mansour Mbengue Seynabou Diagne Niakhaleen Keita Bacary Ba Abdou Niang Boucar Diouf El Hadji Fary Ka Nephrology and Hemodialysis Department CHU Aristide Le Dantec Dakar Senegal Cytology and Histopathology Department Grand-Yoff General Hospital Dakar Senegal Internal Medicine Department CHU Aristide Le Dantec Dakar Sénégal

Introduction: Renal disease (RD) in human immunodeficiency virus (HIV) infection is a decisive turning point in the development and prognosis of this disease. In Africa, the prevalence varies between 2.5% and 48.6%. In Senegal, little data are available in the literature. The objective of our study was to describe the epidemiological, clinical, paraclinical, therapeutic and progressional aspects in patients living with HIV (PLWHIV). Patients and methods: This was a retrospective, descriptive and analytical study carried out over a 10-year period in the Department of Internal Medicine and Nephrology at the Aristide Le Dantec Hospital in Dakar, Senegal. We included all 15-year old and above PLHIV with available CD4 count and viral load. Results: Out of 248 PLHIV, 32 had kidney disease (KD), which means a hospital prevalence of 12.9%. The mean age was 51.22 ± 10 years (extremes of 36 and 77 years) with a sex ratio (male/female) of 1.28. Renal signs were dominated by glomerular nephropathy syndrome. It was present at 80%. Tubulo-interstitial nephropathy syndrome and chronic uremic syndrome accounted for 6.25% and 3.1% of cases, respectively. Renal function Impairment was present in 21 patients with 18 cases of acute kidney injury (85.7%) and 3 cases of chronic renal failure (14.3%), including 2 in stage 5 of chronic kidney disease. Renal biopsy (RB) was indicated and performed in 20 (62.5%) patients with glomerular signs in 12 patients (60%). Glomerular lesions were dominated by focal and segmental glomerulosclerosis (FSGS) in 6 cases, membraneous nephropathy (MN) in 4 cases and minimal change disease (MCD) in 2 cases. Tubulo-interstitial and vascular lesions were present in 45% and 12.5% of cases, respectively. In highly active antiretroviral therapy (HAART), 12 (37.5%) patients had total remission, 9 (28.12%) had partial remission. One (3.12%) death from severe metabolic acidosis on chronic renal failure was deplored. Conclusion: This study illustrates the high preval

关键词： Kidney Disease HIV HIVAN Senegal

Idiopathic Adult Nephrotic Syndrome: A Clinicopathological Study and Response to Steroid in a Sub-Saharan African Country

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Open Journal of Nephrology 2016年第2期6卷 61-65页

作者： Maria Faye Ahmed Tall Lemrabott Mouhamadou moustapha Cisse Jean De Dieu Nzambaza cherif mouhamed Dia Sidy Mohamed Seck Khodia Fall moustapha Faye Elhadji Fary Ka Abdou Niang Boucar Diouf Department of Nephrology Aristide Le Dantec University Hospital Dakar Senegal Anatomo-Pathology Laboratory Grand-Yoff General Hospital Dakar Senegal Faculty of Medicine Gaston Berger University Saint-Louis Senegal

Introduction: Idiopathic nephrotic syndrome represents 25% to 30% of glomerulonephritis in adults. These glomerulonephritides are responsible of about the half of chronic kidney failure examined as well in United States as in Europe or Africa. The aim of this study was to determine the anatomoclinic, therapeutic and progression patterns of idiopathic nephritic syndrome in Dakar. Patients and Methods: It is a retrospective ten-year study in the nephrology department of Aristide Le Dantec Hospital. Patients with idiopathic nephrotic syndrome were included. We analyzed anatomoclinic, therapeutic and progression data of idiopathic nephrotic syndrome. Results: On 202 patients with nephrotic syndrome, 156 (77%) were primitive. The mean age was 29.7 ± 12 years with a sex ratio of 2.4. Edema was found in 98 patients (62.8%) and hypertension in 63 patients (40%). The mean proteinuria was 6.8 ± 4.8 g/24h. Histologic lesions found at renal biopsy were focal segmental glomerulosclerosis in 71 patients (45.5%), minimal change disease in 68 patients (43.5%) and membranous nephropathy in 8 patients (5%). 134 patients (85.8%) received steroids alone, 12 patients (7.6%) received cyclophosphamide and 4 patients (2.5%) azathioprine in association with steroids. 44 patients (28.2%) reached remission. The factors of poor prognosis were: age, above 40 years, proteinuria above 10 g/24h, existence of renal failure at admission, absence of use of steroids therapy. Conclusion: This study shows that idiopathic nephrotic syndrome is frequent in our country with a prevalence of 77%. The most common lesion found at the renal biopsy is the focal segmental glomerulosclerosis. Remission is found only in 28% which is very low. 33% of patients progress towards chronic kidney disease due to the lack of early diagnosis and the use of traditional medicine.

关键词： Idiopathic Nephrotic Syndrome Focal Segmental Glomerulosclerosis Minimal Change Disease Membranous Glomerulonephritis

Profile of Female Hyperandrogenism at the Medical Clinic II: About 19 Cases

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Open Journal of Endocrine and Metabolic Diseases 2023年第5期13卷 63-74页

作者： Michel Assane Ndour Demba Diédhiou Djiby Sow Ibrahima Mané diallo mouhamed Dieng Fatou Gueye Astou Mbodj Julie Borges Preira Fatou Kiné Gadji Muriel Diembou Fama Ndiaye El Hadj Mouhamadou moustapha Thioye Charles Halim Anna Sarr Maïmouna Ndour Mbaye Internal Medicine Department Abass Ndao Hospital Cheikh Anta Diop University of Dakar Dakar Senegal

Introduction: Female hyperandrogenism is essentially manifested by hirsutism. It is present in Senegal but not yet elucidated for lack of data. This is why we proposed to study the profile of hyperandrogenism in our context. Patients and Methods: This was an observational, cross-sectional cohort study of 19 patients of reproductive age followed for hyperandrogenism at the Medical Clinic II of Abass Ndao Hospital, from November 1st, 2019 to August 31st, 2021. Results: Our cohort consisted of women with an average age of 25.3 years, single (73.7%), with a low socioeconomic level (42.1%). A family history of hirsutism was found in 31.6% of cases. The main reasons for consultation were a menstrual cycle disorder in 94.7% of cases, and hirsutism in 78.9% of cases. The latter was post-pubertal (66.7%), with a slow or progressive evolution. The physical examination revealed: hirsutism (100%) with an average modified Ferriman Gallwey score (mFG) of 8.9 ± 5.8, acne (36.8%), hyperseborrhea (57.9%), major signs of virilization (10.5%), acanthosis nigricans (47.4%) and galactorrhea (5.3%). Hormonal explorations revealed an elevation of: testosterone (31.6%), 17-hydroxyprogesterone (5.3%), dihydrotestosterone (31.6%), and prolactin (10.5%). The ovarian morphology was micropolycystic (84.2%). The etiological profile corresponded to polycystic ovarian syndrome or PCOS (68.4%), ovarian hyperthecosis (10.5%), hyperprolactinemia (10.5%), congenital adrenal hyperplasia or CAH (5.3%). Idiopathic hirsutism was found in 5.3% of cases. Conclusion: Female hyperandrogenism is a less frequent reason for consultation in endocrinology. It deserves to be further evaluated in a large-scale study focused on epidemiological, clinico-biological and etiological investigation, in order to assess its prevalence and better define its profile in our context.

关键词： Female Hyperandrogenism Hirsutism Senegal

Prolactin Adenomas in Senegal: Epidemiological, Diagnostic and Therapeutic Aspects of 89 Cases

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Open Journal of Internal Medicine 2023年第3期13卷 209-217页

作者： Michel Assane Ndour Demba Diédhiou Djiby Sow Boundia Djiba mouhamed Dieng Ibrahima Mané diallo Fatou Kiné Gadji Julie Borges Muriel Diembou Fama Mody Ndiaye El Hadj Mouhamadou moustapha Thioye Charles Halim Philippe Moreira Anna Sarr Maïmouna Ndour Mbaye Medical Clinic II Abass Ndao Hospital Center Cheikh Anta Diop University Dakar Senegal

Introduction: In Senegal, there is very little data on prolactinomas despite their negative impact on couples fertility. Patients and methods: This was a multicentre, retrospective, descriptive, analytical study conducted from 1 January 2008 to 31 December 2022 in the neurosurgery departments of the Fann and Principal hospitals and the endocrinology department of the Abass Ndao Hospital. Results: We included 89 patients, representing a prevalence of 36.7% among all cases of pituitary adenoma. The mean age was 35.6 ± 10 years and the sex ratio was 0.34. The mean time to consultation was 27.1 ± 29 months. Clinical symptoms were dominated by gonadotropic disorders represented by galactorrhoea (71 cases, 79.8%), amenorrhoea (61 cases, 68.5%), and infertility in the couple (31 cases, 34.8%). Fifty-seven (58) patients presented with a tumour syndrome (65.2%, including 57 cases of headache (64%), 34 cases of visual disorders (38.2%) and 8 patients with a dysmorphic syndrome (8.9%). Imaging revealed a macroadenoma in 68.5% (61 cases) and extension of the adenoma in 11 patients (12.4%). The hormonal profile was isolated lactotropic hypersecretion (80 cases, 89.9%) and mixed in 9 cases (including concomitant secretion of GH in 8 cases and ACTH in 1 case). All patients had initially benefited? from dopaminergic agonist-based medical treatment. Pituitary surgery was effective in 45 patients (50.6%), including 44 cases by transsphenoidal approach. Postoperative incidents included transient diabetes insipidus (77.7%) and cerebrospinal fluid leakage (20%). We noted 7 cases (7.9%) of death presenting with a tumour syndrome (100%), a macro-adenoma (85.7%), having undergone pituitary surgery (42.9%). The factors significantly associated with prolactinoma were young age (p Conclusion: This series also demonstrates the impact of prolactin adenomas on reproductive function. Delayed diagnosis explains the predominance of macroadenomas, which are a source of pre- and post-operative compli

关键词： Prolactinoma Fertility Disorders Tumour Syndrome Pituitary Adenomas

Epidemiological, Diagnosis, Therapeutic and Evolving Profile of Triple Negative Breast Cancer in Senegal

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Advances in Breast Cancer Research 2021年第3期10卷 100-109页

作者： Papa Macoumba Gaye mouhamed Diouf Mouhamadou Bachir Ba Doudou Diouf Fatimatou Néné Sarr Maimouna Mané Mamadou Sarr Mamadou moustapha Dieng Sidy Ka Ahmadou Dem Radiotherapy Department of Dalal Jamm Hospital Dakar Senegal Cheikh Anta Diop University of Dakar Dakar Senegal Oncological Surgery Department of Dalal Jamm Hospital Dakar Senegal Joliot Curie Institute in Dakar Aristide Ledantec Hospital Dakar Senegal

Objective: Describe the epidemiological, diagnostic, therapeutic and evolutionary profile of triple negative breast cancer at the Dakar Cancer Institute in Senegal. Patients and Methods: This was a retrospective study between January 1, 2011 and December 31, 2014. All patients with a triple negative molecular profile were included. The data were collected from the medical records of the patients. The data were entered and analyzed with SPSS edition 16 software under Windows 7. Results: Two hundred and twenty-five patients were selected. The mean age was 47.9 ± 12.5 years with extremes of 25 and 90 years. The main reason for consultation was dominated by the finding of a breast lump. The mean clinical tumor size was 8, 54 cm with a large majority of T3-T4 tumors 26% and 63% respectively, lymph node involvement in one hundred and seventy-two cases (76.4%);twenty eight patients (12.4%) were metastatic from the outset. Non-specific invasive carcinoma was the most common histologic type (78.2%), and more than half of the patients (53.3%) had an aggressive tumor (Scarff-Bloom-Richardson grading III). Neoadjuvant chemotherapy was performed in 65.78% of cases. We noted 27.7% total response and 41.7% partial response in patients who have received this neoadjuvant chemotherapy. The surgery was radic

关键词： Breast Cancer Triple Negative Senegal