Primary squamous cell carcinoma of the kidney in southern Senegal (Ziguinchor): case report and review of the literature.

The kidney's primary squamous cell carcinoma is a rare tumor, representing 0.5-0.8% of malignant renal tumors and 4% of upper urinary tract tumors. This pathology often occurs after a long past history of renal lithiasis and repeated untreated or poorly treated urinary tract infections. The delay in diagnosis resulting from an insidious symptomatology, without specific signs, often leads to a pejorative development, especially in poor countries. A seventy-nine-year-old Senegalese woman, with no past history of lithiasis nor recurrent urinary tract infection and urinary schistosomiasis, was received for a recurrent total hematuria associated with left lumbar pain. Clinical examination revealed a mobile tender left lumbar mass, with lumbar contact and renal sloshing. The left renal tumor´s diagnosis was retained on clinical and scannographic arguments, justifying an enlarged left total nephrectomy, by laparotomy. The anatomopathological examination of the surgical sample made it possible to make the diagnosis of primary invasive squamous cell carcinoma of the left kidney and to find foci of carcinoma in-situ on squamous metaplasia in the calyxes. Unlike the typical case of primary squamous cell carcinoma of the kidney, our patient did not have a long past history of renal lithiasis nor untreated or poorly treated recurrent urinary tract infections and urinary schistosomiasis. Primary squamous cell carcinoma of the kidney may not be related to a past history of recurrent urinary tract infections and lithiasis, but to any other cause of squamous metaplasia of the urothelium. Surgery remains the best option for this entity.

[Atherosclerosis and coronary artery disease in Senegal: an autopsy series of 116 african patients at Aristide Le Dantec Hospital (Dakar-Senegal)]. / Athérosclérose aortique et coronarienne au Sénégal : à propos d'une série autopsique de 116 patients d'origine africaine au CHNU Aristide Le Dantec (Dakar-Sénégal).

OBJECTIVE: To study the prevalence of atherosclerosis (aortic and coronary lesions) in Senegalese people, to determine main risks factors and morphological patterns. METHODS: A prospective autopsy study was conducted in the pathology department of Aristide Le Dantec Hospital (Dakar-Senegal) where 116 specimens aged over 5 years old were studied. RESULTS: Autopsy study of 116 Senegalese specimens for atherosclerotic lesions revealed aortic lesions in 100 cases (86%), aortic and coronary lesions both in 48 cases. There were 88 men versus 12 women. The median age was 37.1 years comprised 5 to 77 years old. Hypertensive, smoking and abdominal obesity were detected respectively in 5 cases, 37 cases and 33 cases. In aortic vessel, the main lesions detected were severe fibrous plaques detected in 40 cases. In coronary arteries, fibrous plaques were detected in 18 cases, severe fibrous plaques in 17 cases. CONCLUSION: Our study in Senegalese population showed existence of atherosclerotic lesions. These lesions were more responsible for complications as myocardial infarction.

[Idiopathic nephrotic syndrome (INS) in children in Dakar: about 40 cases]. / Le syndrome néphrotique idiopathique (SNI) de l'enfant à Dakar: à propos de 40 cas.

INTRODUCTION: This study aimed to analyze the diagnostic, therapeutic, and evolutionary features of nephrosis in children in a pediatric department in Dakar. METHODS: The study was carried out in the Department of Pediatrics at the Aristide Le Dantec Hospital. We conducted a retrospective study over a period of 3 years from 1 January 2012 to 31 December 2014. All patients aged 2-12 years with idiopathic nephrotic syndrome were included in the study. RESULTS: Forty cases of nephrosis were collected, that is to say a prevalence of 23% among patients with kidney disease treated in the Department of Pediatrics. The average age was 7.11 ± 3.14 years. 72.5% (n=29) of patients suffered from pure nephrotic syndrome. Lower limb edema was present in 100% of patients, oliguria in 55% (n=22) and high blood pressure (HBP) in 5% (n=2) of cases. Median proteinuria was 145,05 ± 85,54 mg/kg/24 hours. Median protidemia was 46,42 ±7.88 g/L and median albumin was 17.90 ± 7.15 g/L. Thirty nine patients were treated with prednisone-based corticosteroid therapy. Corticosensitivity was retained in 77% (n=30) patients and corticoresistance in 13% (n=5) of cases. The factor of poor response after corticosteroid therapy was initial proteinuria greater than 150 mg/kg/day (p = 0.024). Renal biopsy was performed in 18% (n=7) of patients which showed focal and segmental hyalinosis in 57.2% (n=4). Cyclophosphamide and azathioprine were associated with corticosteroids in 10% (n=4) of cases respectively. The overall remission rate was 89.8%. The evolution toward chronic renal failure was observed in three patients. CONCLUSION: Nephrosis accounted for almost one quarter of all cases of kidney disease treated in our Department. It has high overall remission rate. The only factor contributing to poor response after corticosteroid therapy was high levels of initial proteinuria. Focal and segmental hyalinosis was the most frequently found lesion diagnosed by renal biopsy.