[Oncoplasty by the Thorek technique for lower quadrant cancers in a condition of gigantomastia]. / Oncoplastie selon la technique de Thorek pour cancers des quadrants inférieurs en situation de gigantomastie.

OBJECTIVE: Describe our experience of Oncoplasty according to Thorek in gigantomastia with hard and less plastic breasts and a major ptosis. METHODOLOGY: Thirteen cases of breast carcinoma on gigantomastia operated using the Thorek technique between 2014 and 2019 in Burkina Faso were analyzed retrospectively. The operative indications, technique and results were considered. Breast Q was used to assess patient satisfaction. RESULTS: The indication of oncoplasty by the Thorek's technique was breast lower quadrants carcinoma, associated with a major ptosis, gigantomastia. There was a consequence on the spine in 9 over 13 cases. The breasts were hard and less plastic, making the other breast reduction techniques difficult. This technique helped remove the carcinoma, reduce the volume of the breast and address the ptosis. The patients were satisfied with the volume of the remaining breasts and their aesthetic look. The resection margins were safe. Two cases of aerolar dyschromia were noticed. CONCLUSION: The Thorek technique remains an alternative concerning tumours on gigantomastia, with hard and less plastic breasts and a major ptosis. The results combine carcinological and aesthetic requirements.

Molecular Epidemiology of High-Risk Human Papillomavirus in High-Grade Cervical Intraepithelial Neoplasia and in Cervical Cancer in Parakou, Republic of Benin.

Human papilloma virus (HPV) infection remains a worldwide concern, especially in Sub-Saharan Africa where cervical cancer is the leading cause of cancer death in women. The aim of the study was to determine the prevalence and genotypic distribution of High-Risk HPV (HR-HPV) involved in Cervical Intraepithelial Neoplasia (CIN) II and III and in cervical cancer in Parakou. Out of a total of 149 samples of cervical tissues archived, fixed and paraffin-embedded, 78 samples with histological diagnosis of CIN-II, CIN-III and cervical cancer went through deparaffinization with xylene, followed by an extraction of HPV DNA and the detection of HR-HPV by real-time multiplex PCR. The average age of the women was 40.05±13.99 years. The samples were positive to at least one HR-HPV genotype in 76.92% (50/65) of cases. The HR-HPV genotypes which are most common in the cervical cancer and in CIN-II and III were, respectively HPV-39 (38 and 37.50%), HPV-18 (35 and 31.30%), HPV-45 (35 and 31.30%), HPV-35 (9 and 25%) and HPV-52 (9 and 12.50%). The HPV-16 was absent. This study helped to detect (in samples archived, fixed and paraffin-embedded tissues) HR-HPV involved in high-grade precancerous lesions and in cervical cancer in Parakou, some of which are not covered by currently available vaccines.

Les cancers broncho-pulmonaires primitifs à Ouagadougou

Le cancer bronchique primitif est la deuxieme cause de mortalite dans le monde apres les pathologies cardiovasculaires. En Afrique; l'introduction de l'endoscopie a entraine l'augmentation de son 'incidence. Pour avoir une recente idee sur cette affection; nous avons decide de mener une etude retrospective et descriptive a Ouagadougou du 1er janvier 2002 au 31 decembre 2011. Ainsi avons-nous observe une preponderance masculine et un age moyen de 58 ans. La consommation moyenne de tabac a ete evaluee a 15 paquets-annee. Il y avait une predominance de l'atteinte de l'arbre bronchique droit et du carcinome epidermoide. La place du tabagisme a encore ete confirmee comme facteur etiologique

[Epidermodysplasia verruciformis: clinicaland epidemiological features of 45 cases in the Department of Dermatology at the University Hospital Center of Yalgado Ouedraogo, Ouagadougou]. / Epidermodysplasie verruciforme: aspects epidémiologiques et cliniques de 45 cas dans le service de Dermatologie du Centre Hospitalier Universitaire Yalgado Ouédraogo, Ouagadougou.

INTRODUCTION: The epidermodysplasia verruciformis is a rare, autosomic, recessive, genodermatose characterized by a chronic, disseminated, cutaneous infection with human papillomavirus. The majority of these patients have a genetic or acquired immunodeficiency. PATIENTS AND METHODS: This retrospective study was conducted on the records of all patients who presented in our dermatology department with an epidermodysplasia verruciformis in a 13 years and 6 months period, from January 1st, 1992 to June 30th, 2005. RESULTS: We have collected 45 cases of epidermodysplasia verruciformis. They were aged from 3 to 57 years, with a mean of 24.6 years. The most concerned age bracket was that from zero to 9 years. They were 29 women (64.4%) and 16 men (35.6%). The eruption presented as papules of 2 to 3 mm size, associated with hypochromic, finely squamous macules with the same size. We noted three cases of itching. We found 37.7% of family cases. We observed 14 cases of HIV positive patients and one case of cancer. CONCLUSION: This study confirmed that the epidermodysplasia verruciformis was rare. Genetic factors or immunodeficiency would support the appearance of the disease.

Epidermodysplasie verruciforme : aspects epidemiologiques et cliniques de 45 cas dans le service de dermatologie du centre universitaire Yalgado Ouedraogo; Ouagadougou

Introduction : L'epidermodysplasie verruciforme est une genodermatose rare; autosomique recessive caracterisee par une infection cutanee a papillomavirus humains; disseminee; d'evolution chronique. La plupart de ces malades ont un deficit immunitaire. Patients et Methodes : Il s'agissait d'une etude retrospective a partir des dossiers des malades ayant consulte pour une epidermodysplasie verruciforme dans le service; du 1er janvier 1992 au 30 juin 2005; soit une periode de 13 ans et six mois. Resultats : Nous avons collige 45 cas d'epidermodysplasie verruciforme. L'age moyen etait de 24;6 ans avec des extremes de 3 a 57 ans. La tranche d'age la plus touchee etait celle de zero a 9 ans. Il s'agissait de 29 femmes (64;4) et de 16 hommes (35;6). L'eruption etait faite de papules de 2 a 3 mm associee a des macules identiques; hypochromiques; rosees; finement squameuses. Nous avons note trois cas de prurit. Nous avons retrouve 37;7de cas familiaux. Dans le cadre du deficit immunitaire acquis; nous avons observe un cas de cancer du sein et quatorze patients etaient seropositifs pour le VIH. Conclusion : Cette etude a confirme la rarete de cette affection et a montre que l'immunodepression cellulaire genetique ou acquise favoriserait l'apparition de la maladie

[Lupus tuberculosis: a cause of medio-facial mutilation not to be ignored]. / Le lupus tuberculeux: une cause de mutilation centrofaciale à ne pas méconnaître.

Medio-facial mutilations are a real problem from a diagnosis and prognosis point of view. Various etiologies may be in question, namely bacterial, parasitic, mycotic, viral infections or yet predisposing factors such as denutrition or a immunodepression. Among these etiologies, the lupus tuberculosis remains a major concern to be taken into account in poor socio-economic background. We report two cases of lupus tuberculosis in teen-agers whose diagnosis difficulty induced sequellae although limited by a further appropriate care management. The clinical spectrum of the cutaneous tuberculosis and the place of this affection featuring ahead of other medio-facial mutilations etiologies remain important in tropical area.

[Cutaneous leishmania in HIV patient in Ouagadougou: clinical and therapeutic aspects]. / Leishmaniose cutanée chez les malades infectés par le VIH. Aspects cliniques et thérapeutiques.

BACKGROUND: Immune suppression cause by HIV infection is a risk factor in the progression of leishmania diseases. In Burkina Faso atypical clinical presentations of leishmaniases have been observed among people living with HIV. The goal of this study was to describe clinical and evolutionary aspects of cutaneous leishmania and HIV co-infection among patients followed at Ouagadougou University Hospital. PATIENTS AND METHODS: This 16-month prospective study was carried out from January 2003 to April 2004 among HIV-seropositive patients with a diagnosed cutaneous leishmania infection. At baseline, infection and lesions were classified. Clinical diagnosis of cutaneous leishmania depended on finding parasites by microscopy in smears or tissue biopsies. Histological examinations were done if clinical and parasitological diagnosis were not concordant. Treatment consisted of three 21-day rounds of pentavalent antimonial, (Glucantime(R)). Clinical evolution was monitored at the end of each treatment round. RESULTS: Thirty-two HIV-1 positive patients (16 women and 16 men) were included. Mean age was 35.5 (10-67 years old). Leishmania lesions had been evolving, on average, for 12 weeks. Eleven patients were taking HAART and 21 patients were taking cotrimoxazole prophylaxis against opportunistic infections. Cutaneous lesions were found: in the face (15 cases), torso (18 cases), upperlimbs (26 cases) and lower-limbs (28 cases). Observed clinical forms were: papulo-nodular (9 cases), ulcerative (14 cases), infiltrative (12 cases), lepromatous and diffuse (15 cases), psoriasis-like (5 cases), cheloid, histioid or kaposi-like (1 case each). Some patients presented more than one clinical form. Prognosis was satisfactory in 24 patients after the first treatment. Twelve patients relapsed after the first treatment, among those 10 were only taking cotrimoxazole. At the end of the third treatment, 24 patients were cured, 3 died and 5 were lost to follow-up. CONCLUSION: Clinical polymorphism of cutaneous leishmania has been observed in HIV-patients, thereby increasing the risk of differential diagnosis.

[Solid and pseudopapillary tumor of the pancreas: immunohistochemical and ultrastructural study of 2 pediatric cases]. / Tumeur solide et pseudo-papillaire du pancréas : étude immunohistochimique et ultrastructurale de 2 observations pédiatriques.

We report 2 cases of solid and pseudopapillary tumors of the pancreas occurring in female children. Lesions were made of uniform small cells arranged in solid areas associated with pseudopapillary and cystic patterns. Immunohistochemistry study was positive for neuron-specific enolase, alpha-1 anti-trypsin and vimentin. Ultrastructural study showed an abundant cytoplasm, rich in mitochondria, containing a lot of granules of variable sizes, often disintegrated, and some lipid droplets. The differential diagnosis of this lesion included endocrine tumor, pancreatoblastoma and acinar cell carcinoma. It is a rare tumor of the pancreas with a favorable prognosis after complete resection.