[Adequacy of histopathology request forms and pathological reports of breast cancer surgical specimens in Benin]. / Conformité des formulaires de demande et des comptes rendus anatomopathologiques de pièces opératoires de cancer du sein au Bénin.

Introduction: Breast cancer requires multidisciplinary management. Pathologists and physicians communicate using the histopathology request form and the pathology report. There are some minimal criteria that both should respect. Objective: We assessed the adequacy of histopathology request forms and pathology reports in the management of female breast cancer specimens in Southern Benin. Method: This was a cross-sectional, descriptive and analytical study, with retrospective data collection over 57 months (4 years and 9 months). The adequacy of the histopathology request forms and pathology reports was assessed on the basis of the recommendations of the Haute Autorité de Santé (HAS) of France. Data processing was done using SPSS software. We checked frequencies with the Chi2 test, with a significance level set at 5%. Results: 31.3% of histopathology request forms complied with HAS recommendations. Pathology reports were presented in a narrative way in 92.7% of cases and 68.8% met the minimal criteria. The presence of vascular embolus, of hormone receptors and the HER2 status were all reported in only 29.2% of the reports. Discussion: The draft of histopathology request forms and pathology reports did not comply to the required minimal criteria. This situation could mainly be explained by the inexistence of consensus between physicians and pathologists and by the lack of immunohistochemistry. Editing national referentials and using synoptic reports would give better results.

Challenge of gastro-intestinal stromal tumor management in low-income countries: example of Benin.

BACKGROUND: GISTs are rare tumors but the most frequent mesenchymal tumors of the digestive tract. Diagnosis and treatment are challenging in low-income countries due to relatively poor access to immunohistochemistry and targeted therapy. In Africa, there are few studies about it. Imatinib, an oral targeted therapy, has been available in Benin since 2010 and free since 2016. This study describes the diagnosis and therapeutic management of GIST in Cotonou, Benin. METHODS: This is a descriptive cross-sectional study, with retrospective data collection over a 10-year period from 2010 to 2020, focused on patients with histological confirmed gastro-intestinal stromal tumor (GIST). Cases were identified using the registry database and the archival files of the Hubert Koutoukou Maga National University Hospital of Cotonou (CNHU-HKM). RESULTS: Fifteen GISTs were identified during the study period. The median age was 52 and the sex ratio was 2:1 (10 males and 5 females). The most frequent symptom was abdominal pain (n = 12). Delay in care seeking after onset of symptoms ranged from 24 h to 15 years. The most common site for GISTs was the stomach (n = 8). The median tumor size was 11 cm and the majority (n=10) was metastatic or locally advanced at the time of diagnosis. The tumors were often spindle-shaped at histology (n = 13) and the majority expressed KIT (n = 14). Most of the tumors (n = 12) were at high risk of recurrence according to the Joensuu scoring system. The availability of imatinib has improved the outcome of GIST with response in all cases it was used in neoadjuvant setting (n = 7). CONCLUSION: GISTs are rare tumors and preferentially affect the stomach in Cotonou). Most of the tumors were large, unresectable at the time of diagnosis and at high risk of recurrence. Access to imatinib has revolutionized the management of those tumors in our country.

[Epidemiological and histopathological aspects of sarcomas in Cotonou (Benin) from 2010 to 2020]. / Aspects épidémiologiques et histopathologiques des sarcomes à Cotonou (Bénin) de 2010 à 2020.

Aims: To study the epidemiological and histopathological characteristics of sarcomas. Procedure: This was a multi-center, descriptive, retrospective study realized over a 10-year period. We systematically recruited all medical reports of patients with histologically confirmed sarcoma. Results: 159 reports of sarcoma were retained. The average age was 38.9 years. There was a female predominance with a 0.9 estimated sex ratio. Soft tissue sarcomas were the most common (65.4%). The most frequent location was the lower limbs (30.2%). Conclusion: Better access to diagnosis would contribute to a better assessment of the burden of this pathology in Benin.

[Paraganglioma of the cauda equina region: Report of 9 cases]. / Paragangliome de la queue de cheval : à propos d'une série de 9 cas.

INTRODUCTION: The paraganglioma of the cauda equina is a rare tumor, the diagnosis is morphological and the immunohistochemistry provides a definite diagnosis. The objective of our study is to specify the clinical signs, radiological and associated pathological criteria and to compare our data with those of the literature. PATIENTS AND METHOD: This is a retrospective study of nine cases of paragangliomas of the cauda equina diagnosed in our department from 2003 to 2018. The median age of the patients was 50 years-old with a male predominance (sex ratio: 3,5/1). All patients had preoperative magnetic resonance imaging (MRI) and surgery to remove the tumor. The diagnosis was performed after HES (Hematoxylin Eosin Saffron) and immunohistochemical sections examination. RESULTS: Radiculalgia was the chief symptom of these tumors. MRI showed an oval lesion uniformly enhanced by Gadolinium in the eight patients whose records were available. Histologically, the tumors had a lobular and trabecular pattern with neuroendocrine-like cells and a rich vascularization. By immunohistochemistry, the cells expressed chromogranin, synaptophysin and CD56. DISCUSSION AND CONCLUSION: Paragangliomas of the cauda equina are rare, benign tumors. Except for cases of secreting tumors, the preoperative diagnosis is difficult. MRI is useful and may reveal radiological features suggestive of these tumors. However, it is rare for the diagnosis to be made before surgery. The diagnosis is established by histological examination and immunohistochemical techniques must be used to confirm the diagnosis. The paragangliomas of the cauda equina are well encapsulated tumors whose complete excision is curative. When the excision is incomplete, treatment with radiotherapy is recommended. Long-term clinical and radiological monitoring is recommended because of the slow evolution of the tumor and the potential for recurrence.

[Erosive adenomatosis of the nipple in an adolescent girl: A case report]. / Adénomatose érosive du mamelon chez une adolescente : à propos d'un cas.

Erosive adenomatosis of the nipple is a rare benign lesion arising from the lactiferous sinuses. A 14-year-old girl with a nipple-pricked, left nipple lesion that had been evolving for 15 days with purulent discharge was referred to breast consultation. An oozing eczema-like nipple lesion with a yellowish discharge which secondarily took on the appearance of an ulcerated tumor was observed. Breast ultrasound found no abnormality. An excision of the lesion was performed. The diagnosis of erosive adenomatosis of the nipple was given on histological examination. This rare benign proliferative lesion has an excellent prognosis and is important to recognize as its care differs from that of differential diagnostic entities.