[Breast cancer: diagnostic and therapeutic problems at the Ougadougou University Hospital Center]. / Le cancer du sein: problèmes diagnostiques et thérapeutiques au CHU de Ouagadougou.

A retrospective study on a 4 years period (1991-1994) enabled the authors within the digestive and general surgery of the Ouagadougou Teaching Hospital Center in Burkina Faso to list 39 breast cancers. During the same period, 3788 patients were hospitalized within the service out of which, 120 for mammary tumoral pathology. Patients, most of the time come late and sometimes with very severe and progressive lesions. Mammography and extemporaneous biopsy were not possible. Fine-needle aspiration for cytologic diagnosis practiced in 17% cases revealed to be insufficient. PATEY's mastectomy was done on 59% of patients. As far as chemotherapy is concerned, it is too expensive and inaccessible, only 9 patients have benefitted from this practice. Te histological test on surgical parts retrieved ductal infiltrating carcinoma 61.5%, medullary infiltrating carcinoma 15.3%, comedo-carcinoma infiltrating 5.1%, lobular infiltrating carcinoma 5.1%, papillary carcinoma 5.1%, carcinoma with fibrous stroma 2.5%, undifferentiated carcinoma 2.5%, scirrhous carcinoma 2.5%.

[Salivary gland tumors. Apropos of 48 surgical cases]. / Les tumeurs des glandes salivaires. A propos de 48 cas opérés.

The interest of tumors of salivary gland has increased according to the nosology, diagnosis and therapeutic aspects. This study object to appreciate the frequency of this pathology at the ENT Department of the University Hospital Center of Ouagadougou and to report our experience in their diagnostic and therapeutic management. We have collected 48 cases, representing 2% of the department surgery activity and 7% of the tumors operated between 1985 and 1996. This report has concerned 32 parotid tumors (66.7%), 10 submaxillary tumors (20.8%), 6 minor gland tumors (12.5%). This series was composed of 28 women and 20 men with an average age of 41 years. Diagnosis management was based on clinical, radiologic and echographic examination. The correlation between preoperative and histological diagnosis was correct in 88.7% cases. Benign tumors represented 83.3% of the cases with essentially pleomorphic adenomas, and the malignant tumors 16.7% cases. Post operative evolution was simple in 85.4% cases. After 3 years, local recurrence occurred in 4 cases. The prognosis of malignant tumors has been unsatisfactory: the survival rate at 3 years has been 20%.

[Short- and long-term results of parotidectomy, apropos of 24 cases at the Ougadougou University Hospital Center]. / Résultats à court et moyen terme de la parotidectomie (a propos de 24 cas au CHU de Ouagadougou).

We reported the short and medium results of the 24 parodectomies performed at the ORL Department of the NHC of Ouagadougou between 1985 and 1993 in order to assess the frequency of the complications and to search for their causes. It is a retrospective study on 15 women and 9 men aging between 14 to 56 years. The research for the VII has been always done at the trunk. In the absence of an extemporan histological test, 3 exofacial parotidectomies have been performed for slight injuries of the superficial ear-lobe, 2 total parotidectomies in the other cases. All our sick persons have a 3-years recession. We registered: 1 case of post surgery haemorrhagia (4%) 2 cases of additional infection (8%) 3 cases of facial paralysis that are recessive or not (12.5%) 6 cases with Frei syndrome (25%). Multiple factors can explain the profile that follows surgery of our sick-persons. We insist on the fact that there is minimum specialist that are used to this kind of surgery and to the smallest of the technical board. Complications and after effects after-parotidectomy were in our view almost frequent in our conditions of work. It is true that it is a delicate surgery, but the after effects can be better improved by additional specialist in ORL and with an adequate equipment.

[Osteogenesis imperfecta diagnoses early, apropos of a case at the Yalgadou Ouédraogo National Hospital Center of Ouagadougou]. / Ostéogenèse imparfaite (O.I.) à révélation précoce (a propos d'un cas au Centre Hospitalier National Yalgadou Ouédraogo de Ouagadougou).

Osteogenesis imperfecta which represents a family tragedy for parents, a curiosity for physicians and radiologists, constitutes a real constitutional osteoporosis, usually rare with dominant autosomic transmission. Authors report a case of a 37 week amenorrhea living foetus, presenting an osteogenesis imperfecta. This affection, with early in utero manifestations, has a bad prognosis (baby deceased 72 hours after birth). Diagnosis was suspected at echography and conformed by x-rays investigations. The new born got also clinical and pathological examinations. Authors emphasize the unusualness and the gravity of these early clinical features. They insist on doing echography and radiography for the location of osseous and visceral lesions before and afterbirth.

[Human parasitoses in Burkina Faso. Histopathologic approach]. / Parasitoses humaines au Burkina Faso. Approche histopathologique.

The aim of this first study was to assess parasitic diseases encountered in histological practice in Burkina Faso. An examination of 3410 pathological specimens showed 138 cases of parasitic diseases which represented 4% of the results observed for 5 years in the laboratory of YALGADO OUEDRAOGO National Hospital. The parasitic diseases diagnosed were in decreasing order Schistosomiasis 53.6%, Cysticercosis 13.1%, Mycetoma 12.3%, Cutaneous Leishmaniasis 8%, Amebiasis 6.6%, Filariasis 4.3%, and Histoplasmosis 2.1%. We recommend better data collection for integration of these diseases into the health policy of Burkina.

[Gynecology-obstetrics at the Yalgado-Ouédraogo (Ouagadougou) National Hospital Center. Cancer of the cervix uteri: epidemio-clinical and anatomopathologic aspects]. / Gynécologie-obstétrique au centre hospitalier national Yalgado-Ouédraogo (Ouagadougou). Cancer du col utérin: aspects épidémio-cliniques et anatomopathologiques.

We report the findings of a 3-year retrospective study aimed at describing the epidemiological, clinical, anatomical and pathological profile of cervical cancers in an African country. We studied 46 cases of invasive cervical cancer. This type of cancer accounts for 31.7% of female genital cancers. The mean waiting time for a consultation was 7 +/- 2.4 months. The average age of the patients was 48 +/- 3.7 years. They were mostly women who had had several pregnancies without paid work. The main reasons for seeking medical help were metrorrhagia (95.6%), pelvic pain (58.7%) and purulent discharge (45.6%). In 89.1% of the cases, the cancer was inoperable. Pathology results were available in 37 cases. We found 36 cases (97.3%) of epidermoid carcinoma and a single case (2.7%) of adenocarcinoma. There were associated condylomatous lesions in 21.6% of cases. These results demonstrate the importance of making cervical smear tests a routine part of medical examination and of making the public aware of the importance of screening for cervical cancer.

[Male breast cancer in Africa, Apropos of 5 cases at the Ouagadougou University Teaching Hospital (Burkina Faso)]. / Cancer du sein de l'homme en milieu africain. A propos de 5 cas observés au centre hospitalo-universitaire de Ouagadougou (Burkina Faso).

A retrospective study of male breast cancer was undertaken at Ouagadougou University Teaching Hospital over a 3 year period (1993-1996). Authors report 5 cases representing 4.16% of all breast cancers. The patients' mean age was 61 years. The average duration of signs and symptoms before the diagnosis was 13 months. Clinically all the 5 cases presented advanced cancers (4 T4N2M0, 1 T4N2M1 according to UICC TNM System) with size ranging from 5.5, to 11.5 cm. Histology found: 2 medullary infiltrating carcinoma, 1 canalar infiltrating carcinoma, 1 colloid mucous carcinoma and 1 lobular infiltrating carcinoma. All patients had mastectomy associated with axillary clearance in 4 cases. Radiotherapy, chemotherapy and hormonotherapy were not associated because unavailable in Burkina Faso. Three patients died: the first, 10 days after surgical treatment and the 2 others respectively after 14 and 17 months. We have lost sight 1 patients. The last one is still alive. Authors find that to get better prognosis, it is important to improve medical and technical means, to increase information and to promote early detection.