[Cervical cancers diagnosed at the Pasteur Institute of Madagascar from 1992 to 2002]. / Bilan des cancers du col utérin diagnostiqués à l'Institut Pasteur de Madagascar de 1992 à 2002.

In Madagascar, the epidemiological data actualized concerning the cancer of the collus of uterus are not available because of the absence of register of cancer. The objective of this study is to achieve a first assessment of the problem, to complete the epidemiological knowledge, to point out the tool of precoce detection of the precancerous lesions, to propose the measures aiming to improve the management of the patients and to contribute to the institution of a register of cancer. This is a retrospective survey on the frequency of the cancer of the cervix observed from 1992 to 2002 about 23,908 withdrawals addressed to the Institut Pasteur de Madagascar for anatomopathological exam and 12,605 cervical smears for cytological exam. In pathological anatomy, 2,621 (63.4%) of 4,136 cases of diagnosed cancer, have been observed in women. 687 cases (26.2%) of them were localized in the collus. The 3/4 of the cancers of the cervix is invasive and the mean age is 48.2 years old at the time of diagnosis. The cytology detects only 74 cases of invasive cancer of which most don't have an histological confirmation. 274 pre-lesions of cervix cancer were diagnosed for this period, the majority lesions are cytological diagnosis. In spite of a non representative recruitment of the general population, and by the number of withdrawals considered, these results may represent indicators of the epidemiological situation and justify the institution of program to detect the precancerous lesions in a national scale.

[First description of a case of disseminated peritoneal leiomyomatosis in Madagascar]. / Première description de léiomyomatose péritonéale disséminée à Madagascar.

The authors reported the first case of leiomyomatosis peritonealis disseminata or diffuse peritonealis leiomyomatosis in a patient of 36 years old. The hyalin degeneration of leiomyomatosis with intra and extra peritonealis extension is an uncommon pathology. The right etiology of this complication of leiomyomatosis is unknown. Its detection is a fortuitous event during laparotomy. It is characterized by an extension to the serosa, a break-in of the tissues and unpredictable invasion of the contiguous organs, and it can touch the heart. Despite its rapid evolution, often accompanied by mechanical complications, it remains a benign tumour.

[A rare cancer: cancers of the small intestine. 25 cases diagnosed at the Institut Pasteur de Madagascar from 1992 to 2001]. / Un cancer peu fréquent: celui de i'intestin grêle. A propos de 25 cas diagnostiqués à l'Institut Pasteur de Madagascar de 1992 à 2001.

A retrospective survey of cases of cancer of the small intestine observed in the Institut Pasteur de Madagascar (IPM), in the Centre Hospitalier de Soavinandriana (CenHoSoa) and in the Centre Hospitalier Universitaire d'Antananarivo/Hôpital Joseph Ravoahangy Andrianavalona (CHUA/HJRA), has been undertaken with the goal to find out epidemiological and diagnostical particularities, as well as the therapeutic measures and their results. Only 25 cases have been found in 10 years (from 1992 to 2001). They represent 5.4% of the digestive cancers diagnosed by the Institut Pasteur de Madagascar. They concern 14 women and 11 men with a mean age of 36 years old at the time of diagnosis. The motive of hospitalization was an acute abdomen (peritonitis, perforation, occlusive syndrome, König's syndrome) in 64.3%, and a chronic abdominal pain often associated with abdominal mass in 35.7%. The duodenum is the predilection seat of the small bowel cancers (50%), followed by the ileum (25%) and the jejunum (10%). A diffuse shape has been observed in 15% of the cases. The most frequent histological type is the lymphoma (40%) followed by the adenocarcinoma (32%).

Bilan des cancers du sein diagnostiques a l'Institut Pasteur de Madagascar de 1995 a 2001

"Breast cancer diagnosed at the Pasteur Institute of Madagascar : outcomes from1995 to 2001"" : Breast cancer is a great problem of public health all over the world. In developed countries; breast cancer represents the most common cancer in females. Its incidence is also increasing in developing country. In Madagascar; no data is available to estimate the real incidence and prevalence rates of breast cancer. However; the data at the Institut Pasteur de Madagascar can confirm the extent of the problem even if it is not at a national scale. The authors report the results of a retrospective study from histological examination at the Laboratory of pathological anatomy of the IPM; during 7years. Among 2 337 cases of cancer; 16"

Un cancer peu frequent : celui de l'intestin grele. A propos de 25 cas diagnostiques a l'Institut Pasteur de Madagascar de 1992 a 2001

"Cancers of the small intestine diagnosed at the Institut Pasteur de Madagascar"":A retrospective survey of cases of cancer of the small intestine observed in the Institut Pasteur de Madagascar (IPM); in the Centre Hospitalier de Soavinandriana (CenHoSoa) and in the Centre Hospitalier Universitaire d'Antananarivo/Hopital Joseph avoahangy Andrianavalona (CHUA/HJRA); has been undertaken with the goal to find out epidemiological and diagnostical particularities; as well as the therapeutic measures and their results. Only 25 cases have been found in 10 years (from 1992 to 2001). They represent 5;4"

Premiere description de leiomyomatose peritoneale disseminee a Madagascar

"Leiomyomatosis peritonealis disseminata : first description of a case in Madagascar"" : The authors reported the first case of leiomyomatosis peritonealis disseminata or diffuse peritonealis leiomyomatosis in a patient of 36 years old. The hyalin degeneration of leiomyomatosis with intra and extra peritonealis extension is an uncommon pathology. Theright etiology of this complication of leiomyomatosis is unknown. Its detection is a fortuitous event during laparotomy. It is characterized by an extension to the serosa; a break-in of the tissues and unpredictable invasion of the contiguous organs; and it can touch the heart. Despite its rapid evolution; often accompanied by mechanical complications; it remains a benign tumour."

[Management of breast cancers diagnosed at the Pasteur Institute of Madagascar from 1995 to 2001]. / Bilan des cancers du sein diagnostiqués à l'Institut Pasteur de Madagascar de 1995 à 2001.

Breast cancer is a great problem of public health all over the world. In developed countries, breast cancer represents the most common cancer in females. Its incidence is also increasing in developing country. In Madagascar, no data is available to estimate the real incidence and prevalence rates of breast cancer. However, the data at the Institut Pasteur de Madagascar can confirm the extent of the problem even if it is not at a national scale. The authors report the results of a retrospective study from histological examination at the Laboratory of pathological anatomy of the IPM, during 7 years. Among 2,337 cases of cancer, 16% (373) were breast cancer. Most of them were a female breast cancer (356 cases). The average age is 48 years old. 30% of the tumors were more than 2 cm in size, corresponding at least to the T2 stade from the International Union Against Cancer anatomoclinical classification. The current histological type is the infiltrating ductal carcinoma (80%), about 2/3 belong to the grade 3 of the Scarff-Bloom-Richardson histopronostical classification. Early diagnosis of the cancer is difficult because of the insufficiency of the sanitary infrastructure, particularly for cervical and breast cancers. A national policy for screening must be set up in order to decrease the rate of these invasive carcinomas. In the meantime, informing women and training all the medical staff is a priority. Recording all the data in Madagascar would be desirable.

[Cystic cervical and mediastinal lymphangioma: a case report and review of the literature]. / Lymphangiome kystique cervico-médiastinal: à propos d'un cas et revue de la littérature.

Cervical and mediastinal cystic lymphangioma are rare and benign tumours. They looked like a lateral and cervical mass. Medical imaging allows to suspect the diagnosis but histology only may to assert it. The best therapy is surgery. Sclerosis by chemical drugs is only an alternative if surgery is not possible. A recovery is completely obtained if the whole tumour is removed.

[Cancer in Madagascar. Experience of the Institut Pasteur de Madagascar from September 1992 to June 1996]. / Le cancer à Madagascar. Expérience de l'Institut Pasteur de Madagascar de début septembre 1992 à fin juin 1996.

The Unit of the anatomo-pathology in the "Institut Pasteur de Madagascar" (IPM) examined in the period from September 1992 to June 1996 tissue specimens from 10,275 patients. Tumorous pathology presented 40% of the tissues and half of which were of malign etiology. 64% of the cancer diagnosed were in females. Cervical cancer was most frequently observed (17%), followed by breast cancer (16%). Cancer in the gastro-intestinal tract (15%) was most often located in the colon without sex difference. Stomach cancer occurring predominantly in males presented 25% of the total cases of cancer in the gastro-intestinal tract. Cancer of liver is rarely diagnosed despite the high prevalence of infection with hepatitis B virus. Skin cancer constituted 9% of the malign diagnosis and was mainly found in males. Children under 15 years old presented 7.4% of the total cases of malignancy with the haematopoietic tissues (30%) and the eyes (17%) as the most frequent topic locations. Due to a very low seroprevalence of the HIV in Madagascar, malign tumours associated to AIDS were only seen in a few rare cases. The review of cancer cases in the IPM may not be representative for the cancer epidemiology of Madagascar because of a general very low level of health care coverage, especially in the rural areas. Furthermore, a major part of the specimens originates from easily accessible organsystems, whereas other organs seem less investigated due to lack of appropriate available technique. Therefore, it is not feasible for the moment to establish a cancer register in Madagascar, although the Unit of Pathology in the IPM can offer a valid cancer diagnostical service.