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Background and objectives Tumors of the abdominal wall are uncommon but diverse. The surgical challenge is double. The tumor must be completely removed and the abdominal wall repaired. Our aim was to describe the indications, techniques, and results of surgery on these tumors in an African context. Methods Retrospective, multicentric and descriptive study conducted in three West African surgical oncology units. We included all abdominal wall tumors followed up between January 2010 and October 2022. Histological type, size, surgical procedure, and method of abdominal wall repair were considered. Survival was calculated using the Kaplan–Meier method and comparisons of proportions were made using the Student t test. Results We registered 62 tumors of the abdominal wall and we operated on 41 (66.1%). The mean size of the tumors was 14.3 ± 26 cm. Dermatofibrosarcoma and desmoid tumor were present in 33 and 3 cases respectively. In 31.7% of cases in addition to the tumour, the resections carried away the muscular aponeurotic plane. Parietal resections required the use of a two-sided prosthesis in 6 cases. In 13 cases, we used skin flaps. The resections margins were invaded in 5 cases and revision surgery was performed in all of them. Incisional hernia was noticed in 2 cases. The tumor recurrence rate was 12.2% with an average time of 13 months until occurrence. Overall survival at 3 years was 80%. Conclusions Surgery is the mainstay of treatment for abdominal wall tumors. It must combine tumor resections and parietal repair. Cancer surgeons need to be trained in abdominal wall repair.

Background and objectives Skin cancers in albinos are frequent in sunny countries. The surgeon plays a crucial role in their treatment. The objective was to describe the challenges of surgical management of skin cancer in albinos. Methods Retrospective, descriptive, and multicenter study on skin cancer surgery in albinos performed over the past 14 years in Ouagadougou. We were interested in surgery indications, techniques, and results. Survival was assessed using the Kaplan–Meier method. Comparisons of proportions were made by Student’s t -test. Results The cancers were multiple synchronous in 41.3%. We identified 46 albinos with 71 skin cancers. Surgery was performed in 93%. Lesions were located on the back, upper limbs, and head and face in 40.9%, 30.3%, and 16.7%, respectively. Precancerous lesions were treated concomitantly in 23.6%. The surgery consisted of a lumpectomy. Direct suturing and mobilization of flaps allowed skin coverage in 17.9% and 34.3%, respectively. Lymph node dissection was associated with the limbs in 73.1% of localizations. The average number of lymph nodes removed was 11, with extremes of 7 and 14. Node invasion was noted in 16 out of 19 cases. The resection margins were invaded in 7.5% and required surgical revision. Recurrences were noted in 8.9% of cases. Overall 2-year survival rate was 55.8%. Conclusions Surgery must meet the triple challenge of treating single or multiple synchronous cancers, precancerous lesions, and allowing good healing. Early diagnosis would reduce the rate of secondary healing and improve survival. The absence of extemporaneous histology and the large size of the tumors associated with the delay in diagnosis meant that surgery, whenever possible, was limited to wide and deep resection, to ensure healthy margins. Highlights The surgeon plays a crucial role in the management of skin cancers in albinos. He resects the cancers. He must also ensure skin coverage during the same operating time or at a different time after large resections, using oncoplastic techniques if necessary. He participates in the prevention of skin cancers in this at-risk group by detecting and removing precancerous lesions. In collaboration with dermatologists and oncologists, he participates in the planning of medical treatments and radiotherapy. He also helps to raise awareness among albinos of the risks and means of protection against skin cancers.

Background Cervical cancer is a major public health problem. In 2018, globally 569,847 cervical cancer were diagnosed and 311,000 deaths were projected due to this preventable disease. Worldwide, therefore, the cervical cancer disease ranks as the fourth most frequently diagnosed cancer and the fourth leading cause of cancer death in women in 2018. The high rate of dysplasia in Senegal and the absence of well-organized screening programs informed this study, which aims to determine the prevalence of cervical dysplasia and its relationship to biological and socio-demographic characteristics. Methods This study is based on 1000 conventional smears collected during routine cervical cancer screening at the Gaspard Camara Health Center and the Histology - Embryology and Cytogenetics Laboratory of the Cheikh Anta DIOP University in Dakar. The smears were read according to the Bethesda and Richart systems. However, all data were returned to the Bethesda system using the correspondence table between the different classifications of squamous cell lesions of the cervix. Some of the patients with abnormal smears had colposcopy and if necessary a biopsy. Other patients with low-grade lesions were recommended to have their smears resumed in 6 months or 1 year later. Results Cytological analysis was performed for 1000 patients aged 16 to 82 years (mean age = 41 ± 11.16). Among these, 176 patients had abnormal smears, 23 had Atypical Squamous Cells of Undetermined Significance (ASCUS), 143 had a low-grade lesion, 9 had a high-grade lesion and 1 had carcinoma. Among the remaining 822 patients, cytological analysis revealed no suspected malignant lesions, but 623 among them had dystrophy and 2 were unsatisfactory. Among patients with abnormal smears, 104 patients (23 ASCUS + 71 low grade + 9 high grade + 1 carcinoma) had performed colposcopy, 40 of whom had normal colposcopy and 64 had abnormalities. Sixty-four (64) biopsies were performed. Four (4) were not satisfactory. However, for 26/60 biopsies, the histology was normal, 21/60 had a low grade, 11 displayed a high grade and only 2 had carcinoma. Among the 176 patients with abnormal smears, 72 low-grade patients had undergone cytological examination 6 months to 1 year later to determine the persistence, regression or progression of low-grade dysplasia. During follow-up, persistence was observed in 25% ( n  = 18) of cases, progression to High-grade squamous intraepithelial lesion (HSIL) was detected in 2.78% ( n  = 2), while 72.22% ( n  = 52) of the patients experienced regression. Conclusion In this study, the prevalence of abnormal smear was 17.60% for cytology. Meanwhile, the Colposcopy and histology confirmed just 3.40%. These results underline the interest and need for a review of the discrepancies observed between pathologists.

Background/Objectives: Triple-negative breast cancer (TNBC) is an aggressive subtype associated with a poor prognosis and limited treatment options. Inflammatory and hematological biomarkers have emerged as potential tools for disease characterization, particularly in low-resource settings. Methods: This cross-sectional analytical study was conducted between July 2022 and February 2024 at Dalal Jamm Hospital in Dakar, Senegal, and included 120 women: 40 with TNBC, 40 with hormone-dependent breast cancer (HDBC), and 40 healthy controls. Blood samples were collected at diagnosis before any treatment to measure complete blood counts and C-reactive protein (CRP) levels. Inflammatory ratios—neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)—were calculated. Results: TNBC patients displayed a distinct inflammatory profile characterized by elevated neutrophil counts, CRP, NLR, and MLR, as well as reduced lymphocyte and basophil percentages compared to healthy controls. NLR > 1.12 demonstrated strong discriminatory ability (AUC = 0.847; sensitivity 90%; specificity 65%). Differences between TNBC and HDBC were less pronounced, except for CRP and basophil levels. Multivariate analysis confirmed independent associations of elevated NLR, CRP, and neutrophils with TNBC. Conclusions: These findings provide new insights into the inflammatory and hematological characteristics of TNBC in this population and support further investigation of accessible biomarkers for early disease stratification in similar settings.

Background Pathogenic variants associated with hereditary breast cancer have been reported for BRCA1 and BRCA2 (BRCA1/2) genes in patients from multiple ethnicities, but limited information is available from sub-Saharan African populations. We report a BRCA2 pathogenic variant in a Senegalese family with hereditary breast cancer. Methods An index case from a consanguineous family and nineteen healthy female relatives were recruited after informed consent. Along with this family, 14 other index cases with family history of breast cancer were also recruited. For the control populations we recruited 48 healthy women with no cancer diagnosis and 48 women diagnosed with sporadic breast cancer without family history. Genomic DNA was extracted from peripheral blood. All BRCA2 exons were amplified by PCR and sequenced. Sequences were compared to the BRCA2 GenBank reference sequence (NM_000059.3) using Alamut Software. Results We identified a novel nonsense pathogenic variant c.5219 T > G; p.(Leu1740Ter) in exon 11 of BRCA2 in the index case. The pathogenic variant was also identified in three sisters and one daughter, but was absent in the controls and unrelated cases. Conclusions This is the first report of a novel BRCA2 pathogenic variant in a Senegalese family with hereditary breast cancer. This result confirms the diversity of hereditary breast cancer pathogenic variants across populations and extends our knowledge of genetic susceptibility to breast cancer in Africa.

BRCA1 and BRCA2 are the most incriminated genes in inherited breast/ovarian cancers. Several pathogenic variants of these genes conferring genetic predisposition have been described in different populations but rarely in sub-Saharan Africa. The objectives of this study were to identify pathogenic variants of the BRCA genes involved in hereditary breast cancer in Senegal and to search for a founder effect. We recruited after free informed consent, 27 unrelated index cases diagnosed with breast cancer and each having a family history. Mutation screening of the genes identified a duplication of ten nucleotides c.815_824dupAGCCATGTGG, (p.Thr276Alafs) (NM_007294.3) located in exon 11 of BRCA1 gene, in 15 index cases (allelic frequency 27.7%). The pathogenic variant has been previously reported in African Americans as a founder mutation of West African origin. Haplotypes analysis of seven microsatellites surrounding the BRCA1 gene highlights a shared haplotype encompassing ~400 kb between D17S855 and D17S1325. This haplotype was not detected in none of 15 healthy controls. Estimation of the age of the pathogenic variant suggested that it occurred ~1400 years ago. Our study identified a founder pathogenic variant of BRCA1 predisposing to breast cancer and enabled the establishment of an affordable genetic test as a mean of prevention for Senegalese women at risk.

Background Male breast cancer is a rare and less known disease. Therapeutic modalities affect survival. In Burkina Faso, male breast cancers are diagnosed in everyday practice, but the prognosis at short-, middle-, and long-term remains unknown. The objective of this study is to study the diagnosis stages, therapeutic modalities, and 5-year survival in male breast cancer at the General Surgery Unit of Yalgado Ouedraogo University Hospital from 1990 to 2009. Methods A cohort longitudinal study concerning cases of breast cancer diagnosed in man. Survival was assessed using the Kaplan–Meier method and survival curves were compared through the LogRank test. Results Fifty-one cases of male breast cancer were followed-up, i.e., 2.6% of all breast cancers. Stages III and IV represented 88% of cases. Eleven patients (21.6%) were at metastatic stage. Patients were operated in 60.8% of cases. The surgery included axillary dissection in 25 (80.6%) out of 31 cases. Lumpectomy was performed on 6.5% of patients (2 cases). Fifteen (29.4%) and 11 (21.6%) patients underwent chemotherapy and hormonal therapy, respectively. The FAC protocol was mostly used. Radiation therapy was possible in two cases. The median deadline for follow-up was 14.8 months. A local recurrence was noticed in 3.2% of cases. The overall 5-year survival rate was 49.9%. The median survival was over 5 years for stages I and II. It was 54 down to 36 months for stages III and IV. Conclusion Diagnosis is late. The lack of immunohistochemistry makes it difficult to define the proportion of their hormonal dependence. Surgery is the basic treatment. Five-year survival is slow and the median survival depends on the diagnosis stage. It can be improved through awareness-raising campaigns and the conduct of individual screening.

Un myofibroblastome de type mammaire est une tumeur molle rare; les myofibroblastomes extramammaires sont particulièrement rare. Un homme de 78 ans s'est présenté en consultation pour des douleurs pelviennes soulagées par la défécation ou les urines. Le toucher rectal retrouve une masse en avant de la paroi rectale antérieure. L'imagerie par résonance magnétique (IRM) montre une masse de 10 x 6 x 8cm, bien circonscrite et hétérogène, située en arrière de la vessie qu'elle refoule vers l'avant, en avant du recto-sigmoïde. L'immunohistochimie montre des cellules tumorales co-exprimant CD34 et la desmine de façon diffuse, expression de Rb dans la majorité des cellules, expression des récepteurs aux œstrogènes, expression intense et diffuse de la P16, un index de prolifération avec le ki67 estimé à 25%. Il n'y a pas eu de récidive après 8 mois de radiothérapie d'induction suivie de chirurgie. Un myofibroblastome de type mammaire est une tumeur rare et bénigne. La récidive n'est quasiment pas observée après traitement local. Ce cas permet de mettre en avance la possibilité d'utiliser la radiothérapie afin de faciliter la chirurgie.

Introduction: Herpes simplex virus (HSV) is the main co-factor for heterosexual transmission of the human immunodeficiency virus (HIV) in sub-Saharan Africa, and could be involved in the dynamics of the HIV epidemic in Senegal. Methodology: Genital shedding of HSV was evaluated in adult females who had visited the provincial healthcare centres in Diass, Louga, and Kebemer in Senegal. Study subjects were interviewed by a healthcare worker for sociodemographic characteristics and sexual behavior, and HIV serology was offered. In addition, cervical secretion lavage samples were evaluated for HSV DNA by real-time polymerase chain reaction (PCR), the melting curve analysis of which permitted distinction between HSV type 1 (HSV-1) and HSV type 2 (HSV-2). Results: Among 302 women (mean age, 40 years) enrolled, none were infected by HIV. The mean age at first sexual intercourse was 20 years, and the mean number of sexual partners in the previous year was 1.3 (range, 1–7). Only 6 of 302 (1.9%) women had cervico-vaginal secretions positive for HSV DNA. No association between HSV DNA shedding and any sociodemographic or biological variables was found. Surprisingly, genital shedding of HSV-1 was found in two (0.7%) women, representing 33% of herpes-shedding women, and HSV-2 in four (1.5%) women. Conclusions: Taken together, our observations indicate a low prevalence of HSV DNA genital shedding in adult Senegalese women.

Bilateral gigantomastia is a rare condition, often associated with pregnancy that is characterized by a diffuse enlargement of both breasts. Here we present a case of a late 20s woman in her seven months pregnancy with a bilateral gestational gigantomastia associated with multiple breast lumps. Histological analysis revealed a fibroadenoma. Her prolactin level after caesarean delivery was found particularly high. A significant decrease in breast size was achieved with bromocriptine treatment in conjunction with a bilateral lumpectomy. This case report highlights the diversity of gigantomastia and emphasizes the importance of a tailored, multidisciplinary approach to the diagnosis and treatment of this condition.