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Eyelid Kaposi Sarcoma in HIV-Negative Patient

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Journal of Cancer Therapy 2024年第3期15卷 92-97页

作者： Malalaniaina Andrianarison Malala Razakanaivo Rindra Rafanomezantsoa Mendrika Fifaliana Rakotoarisaona Odilon Laza Fandresena Arilala Sendrasoa Irina Mamisoa Ranaivo Léa Raobela Lala Soavina Ramarozatovo Fahafahantsoa Rapelanoro Rabenja Unit of Dermatology University Hospital Center of Public Health and Care Analakely Antananarivo Madagascar Unit of Radiotherapy University Hospital Center Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Unit of Ophthalmology University Hospital Center Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Unit of Pathology University Hospital Center Tambohobe Fianarantsoa Madagascar Unit of Dermatology University Hospital Center of Joseph Raseta Befelatanana Antananarivo Madagascar Unit of Dermatology University Hospital Center Morafeno Toamasina Madagascar Unit of Dermatology and Internal Medicine University Hospital Center of Joseph Raseta Befelatanana Antananarivo Madagascar

Introduction: Kaposi sarcoma disease is a proliferative and multifocal disorder with dual components, vascular and fibroblastic cellular, cutaneous and visceral expression. Kaposi Sarcoma can affect the ocular surface and adnexa and can masquerade as other entities, delaying prompt diagnosis can lead to diagnostic wandering delaying treatment. Our aim is to describe a case of KS of the eyelid in an HIV seronegative patient. Case Presentation: A seventy-year-old man developed a bilateral growing tumoral reddish purple vascular mass on both the lower and upper eyelid involving rapidly for 6 months. Both feet and the two shanks show the presence of a brown-violet tumor-shaped formation. The patient was negative for HIV. Histology examination showed a nodular tumor-like mass with a fibro hemangioma-epitheliomatous. Polymerase chain reaction was positive for human herpes virus 8. Initial chemotherapy followed by surgery was proposed to the patient. Unfortunately, the patient rejected treatment and was lost to follow-up. Conclusion: This case reports the difficulty of managing KS in developing countries.

关键词： Eyelid HHV-8 Interferon Kaposi Sarcoma

Superficial Angiomyxoma of the Vulva: A Case Report

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Open Journal of Pathology 2024年第2期14卷 64-68页

作者： Zo Irène Raivoherivony Herilalao Elisabeth Razafindrafara Vahatra Joëlle Razafimahefa Romuald Randriamahavonjy Nantenaina Soa Randrianjafisamindrakotroka Department of Pathology Joseph Ravoahangy Andrianavalona University Hospital Antananarivo Madagascar Department of Pathology Soavinandriana University Hospital Antananarivo Madagascar Department of Pathology Andrainjato University Hospital Fianarantsoa Madagascar Gyneco-Obstetrics Department Soavinandriana University Hospital Antananarivo Madagascar

Superficial angiomyxoma is a rare benign mesenchymal tumor that mainly occurs in the genital region. We report the case of a 51-year-old woman with a painless vulvar mass, well circumscribed on ultrasound. On gross finding, it was a polypoid and bilobed mass, partially encapsulated. On histological examination, it was a proliferation of non-atypical spindle cells with an abundant, myxoid stroma and numerous medium-sized blood vessels. The diagnosis was superficial angiomyxoma. The clinical features do not often lead to the diagnosis of superficial vulvar angiomyxoma. It is based on histological examination and immunohistochemistry is helpful to differentiate it from other myxoid tumors.

关键词： Angiomyxoma Mesenchymal Tumor Myxoïd Stromal Tumor of Vulva

Digestive Tuberculosis in Madagascar: Histopathological Aspects

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Open Journal of Pathology 2023年第4期13卷 229-234页

作者： Nomenjanahary Lalaina Rabarison Manoahasina Ranaliarinosy Rakotonaivo Mamisoa Judicaël Randrianjafisamindrakotroka Nantenaina Soa Department of Pathology Joseph Ravoahangy Andrianavalona University Hospital Antananarivo Madagascar Department of Visceral Surgery Joseph Ravoahangy Andrianavalona University Hospital Antananarivo Madagascar

Tuberculosis is a contagious infectious disease caused by Mycobacterium tuberculosis complex. This illness is a major public health challenge in Madagascar and around the world. The disease can develop in the lungs and other organs. Digestive tuberculosis is rare, accounting for 10% of extrapulmonary forms. Symptoms are not specific. Diagnosis is based on anatomical pathology examination. The purpose of this study is to determine the epidemiological and anatomopathological characteristics of abdominal tuberculosis. Our study was a retrospective, descriptive study conducted at the Pathological Anatomy and Cytology Unit of the university hospital Center of joseph ravoahangy andrianavalona over a 10-year period from January 1, 2012 to December 31, 2021. Digestive localization accounted for 17 cases, which are 1.85% of extra-pulmonary localizations. The mean age of patients was 33 years with extremes of 9 and 66 years. The sex ratio was 4.67. Pain was the main symptom, accounting for 76.47% of cases. Histological aspects were caseo-follicular in 82.35% (n = 14) of cases, follicular in 11.76% (n = 2) and caseous in 5.89% (n = 1). Patients were treated with isoniazid, rifampicin, pyrazinamide, and ethambutol. Surgery has sometimes been required. Tuberculosis is a public health problem in Madagascar. Digestive localization of the disease is mainly observed in young adults especially among men. Clinical signs are not specific, and diagnosis is based on anatomopathology. Treatment is medical but sometimes surgery may be necessary.

关键词： Digestive Tuberculosis Anatomopathology Madagascar

Invasive Mole of the Uterus: A Case Report

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Open Journal of Pathology 2022年第4期12卷 177-182页

作者： Herilalao Elisabeth Razafindrafara Zo Irène Raivoherivony Joëlle Razafimahefa Vahatra Nomeharisoa Rodrigue Emile Hasiniatsy Romuald Randriamahavonjy Nantenaina Soa Randrianjafisamindrakotroka Department of Pathology Joseph Ravoahangy Andrianavalona University Hospital Antananarivo Madagascar

Invasive mole is a rare subgroup of gestational trophoblastic disease characterized by the invasion of molar tissue into the myometrium or uterine vasculature. In this paper, we report the third case of invasive mole described in the Malagasy literature. A 33-year-old woman was referred to the Soavinandriana hospital, her complaint was persistent vaginal bleeding during 2 months, occurring at 3 months of pregnancy with biological anemia without hemodynamic repercussions. The human chorionic gonadotropin (HCG) level was 385,931 mIU/ml. A haemostasis hysterectomy was performed. Histological examination showed an enlarged uterus and endometrial cavity containing edematous chorionic villi with trophoblastic proliferation invading the myometrium. The diagnosis was an invasive mole, stage I, FIGO score 6. Chemotherapy was prescribed but was not honored. After 45 days of follow-up, the serum βHCG level decreased to 1803 mIU/ml, without clinical symptoms. The patient then lost sight. Persistent vaginal bleeding after pregnancy may be the only clinical symptom of an invasive mole and should raise suspicion. Histological examination establishes the diagnosis. As this is an unusual cause of vaginal bleeding, our case should remind physicians that when faced with this symptom, the possibility of an invasive mole should be considered in order to make an early diagnosis for less aggressive treatment.

关键词： Hydatiform Mole Gestational Trophoblastic Disease Invasive Mole Madagascar

Gestational Trophoblastic Neoplasia: Clinical and Therapeutic Profile in Madagascar

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Open Journal of Obstetrics and Gynecology 2020年第7期10卷 946-956页

作者： Norosoa Randriamaroson Malala Razakanaivo Ny Ony Andrianandrasana Zo Ambinintsoa Solofonirina Florine Rafaramino Radiotherapy Department University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Medical Oncology Department University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Faculty of Medicine Antananarivo Madagascar

Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. This includes complete and partial hydatidiform mole (HM) and gestational trophoblastic neoplasia (GTN). The aim of this study was to report the epidemiological, clinical and therapeutic profile of gestational trophoblastic neoplasia (GTN) over period of ten years in the department of Oncology Radiotherapy at the University Hospital Joseph Ravoahangy Andrianavalona (HJRA) Antananarivo 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 included, while those with the histological diagnosis of hydatidiform mole (HM), also sometimes classified as GTD, were not included in this study. Also excluded were all cases with incomplete or missing data. Twenty four patients 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 (58.20%), and had the pre-treatment hCG level more than 10,000 IU/L (58.27%). At diagnosis, 14 patients (58.33%) had localized disease (M0). Most common metastatic sites at initial diagnosis were the liver and brain (20.8

关键词： Choriocarcinoma Gestational Trophoblastic Disease Gestational Trophoblastic Neoplasia Madagascar

Primary Bilateral Adenocarcinoma of the Fallopian Tube: A Case Report

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Open Journal of Pathology 2022年第4期12卷 140-145页

作者： Zo Irène Raivoherivony Lalaina Nomenjanahary Fenohery Nalisoa Rakotondrainibe Nantenaina Soa Randrianjafisamindrakotroka Department of Pathology Joseph Ravoahangy Andrianavalona University Hospital Antananarivo Madagascar

Primary fallopian tube carcinoma is an uncommon malignancy that accounts for 0.14% to 1.8% of gynecological cancers. The clinical symptom is not specific and preoperative diagnosis is easy to miss or delay because of a lack of specific symptoms. We reported a case of bilateral adenocarcinoma of the Fallopian tubes, was occurred in a 51-year-old postmenopausal woman and diagnosed with bilateral salpingectomy for suspicious of suppurative salpingitis. The diagnosis is not always suspected preoperatively. They are assimilated to salpingitis in the early stage, or to ovarian tumors in the advanced stage. The diagnosis is made postoperatively, after an anatomopathological examination. Its etiology is still poorly understood.

关键词： Adenocarcinoma Fallopian Tube Madagascar Tubal Carcinoma

Breast Carcinoma Arising in Fibroadenoma in a 15-Year-Old Girl;Diagnosis and Treatment Challenge

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Journal of Cancer Therapy 2022年第10期13卷 615-620页

作者： Malala Razakanaivo Toky Rakotoarivo Ny Ony Andrianandrasana Florine Rafaramino Department of Radiotherapy University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Department of Oncology University Hospital Tanambao Antsiranana Madagascar Department of Oncology University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar

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®, doxorubicin® and cyclosphosphamide®, 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®. 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® 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.

关键词： Adolescent Breast Carcinoma Fibroadenoma Mastectomy

Colorectal Cancer in the Oncology Department at the joseph ravoahangy andrianavalona, Antananarivo, Madagascar: Retrospective Study

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Journal of Cancer Therapy 2022年第8期13卷 531-538页

作者： Toky Rakotoarivo Malala Razakanaivo Mirana Christiana Ranaivoson Ny Ony Andrianandrasana Florine Rafaramino Department of Oncology University Hospital Tanambao Antsiranana Madagascar Department of Radiotherapy University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Department of Oncology University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar

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.

关键词： Colorectal Cancer Surgery Chemotherapy Radiotherapy Antananarivo

5-Fluorouracil-Induced Hyperammonemia Encephalopathy in a Patient with Gastric Cancer

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Journal of Cancer Therapy 2023年第2期14卷 102-106页

作者： Toky Rakotoarivo Vonjy Andrianarison Ny Ony Andrianandrasana Malala Razakanaivo Florine Rafaramino Department of Oncology University Hospital Tanambao Antsiranana Madagascar Department of Radiotherapy University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar Department of Oncology University Hospital Joseph Ravoahangy Andrianavalona Antananarivo Madagascar

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 (NH3) was 102 μmol/l. The patient recovered from his confusional state after two days of treatment with hyperhydration and vitamin therapy.

关键词： Encephalopathy Gastric Cancer Hyperammonemia 5-Fluororuracil