Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. This includes complete and partial hydatidiform mole (HM) and gestational trophoblastic neoplasia (GTN). The aim of this study was to report the epidemiological, clinical and therapeutic profile of gestational trophoblastic neoplasia (GTN) over period of ten years in the department of Oncology Radiotherapy at the University Hospital Joseph Ravoahangy Andrianavalona (HJRA) Antananarivo Madagascar. Medical records of women diagnosed with GTD in the department of Oncology Radiotherapy at HJRA from January 1st, 2007 to September 2017 were retrospectively reviewed. Only patients with the FIGO diagnosis GTN were included, while those with the histological diagnosis of hydatidiform mole (HM), also sometimes classified as GTD, were not included in this study. Also excluded were all cases with incomplete or missing data. Twenty four patients were included. Median age of patients at the time of diagnosis was 37 years (range 18-60). Most patients developed GTN following molar pregnancy (75%), had disease duration from antecedent pregnancy of less than 6 months (58.20%), and had the pre-treatment hCG level more than 10,000 IU/L (58.27%). At diagnosis, 14 patients (58.33%) had localized disease (M0). Most common metastatic sites at initial diagnosis were the liver and brain (20.83%). After a median follow-up from initial diagnosis of six months (range 1-24), 58.33% were lost to follow up. This represented an increase in the percentage of patients lost to follow up prior to completion of therapy, when compared with our previous results for an earlier time period. GTN in Malagasy woman displays an aggressive clinic profile. Finding ways to increase treatment compliance provides the best way to minimize recurrences of this potentially deadly disease.
Le retard de diagnostic des cancers broncho-pulmonaires est l'une des sources du retard de leur prise en charge dans les pays en développement. A notre connaissance, l'aspect clinique des cancers broncho-pulmonaires au Centre Hospitalier Universitaire d'Antananarivo-Hôpital Universitaire Joseph Ravoahangy Andrianavalona (CHUA-HUJRA) n'a jamais été étudié. L'objectif était de décrire les aspects cliniques des cancers broncho-pulmonaires primitifs dans le plus grand centre de cancérologie de Madagascar. C'est une étude rétrospective et descriptive des patients atteints de cancers broncho-pulmonaires primitifs vus au service d'oncologie du CHUA-HUJRA du 1er janvier 2008 au 31 décembre 2013. Nous avons recensé 101 patients (80 hommes et 21 femmes). Les circonstances de découverte sont principalement la toux chronique (n = 29), la dyspnée (n = 16) et l'association d'une hémoptysie à la toux chronique (n = 12). Soixante et onze patients avaient un index de performans status ≥ à 2 au moment du diagnostic. On a retrouvé des bacilles de Koch actives dans le crachat de deux patients. Le délai moyen entre l'apparition des premiers signes et la première consultation était de 11 mois. Le délai moyen entre la première consultation et le diagnostic anatomopathologique était de 3 mois. Le cancer broncho-pulmonaire peut avoir des manifestations cliniques non spécifiques parfois trompeuses qui peuvent retarder leur prise en charge. De ce fait, il doit être recherché devant tout signe respiratoire persistant. Par ailleurs, le délai de prise en charge pré-hospitalière et hospitalière de ces cancers doit être amélioré.
Introduction: Colorectal cancer is one of the most common causes of cancer morbidity. The epidemiological and therapeutic data available are very limited in Antananarivo. The aim of this study was to provide an updated report on the management of colorectal cancer and know the survival of patients. Patients and Methods: A descriptive retrospective study during 2018 and 2019 carried out in the oncology department of Joseph Ravoahangy Andrianavalona Antananarivo Hospital. Newly diagnosed patients with histological evidence were included in the study. Results: Sixty-five cases of cancer were collected, including 39 colon cancers and 26 rectal cancers. The average age was 53 years with extremes of 18 and 83 years. In 41.53%, the patients were young people under 50 years old. The sex ratio was 0.95. Four patients (6.15%) had a family history of first degree cancer. The left colon was the most common location in 43.06% of cases. Only 39% of patients were diagnosed within 6 months of the first symptoms. The most common histological type was lieberkuhnian adenocarcinoma (87.69%). None of the patients underwent an immunohistochemistry examination. Stage IV and III accounted for 41.53% and 35.38% respectively. The majority (55.38%) of patients had benefited from surgery. Chemotherapy was performed in 56.89% of cases. One metastatic patient had received targeted therapy. Nine patients (34.61%) among the 26 with rectal cancers had benefited from concomitant radiochemotherapy. Survival at 30 months was 20%. Conclusion: The survival rate of patients at 30 months is very low. Improving the management of colorectal cancer requires awareness-raising and early detection.
We report a case of haemophagocytic lymphohistiocytosis associated with acute myeloid leukaemia. The usual etiologies of haemophagocytic lymphohistiocytosis, including viral infections, were negative. Haemophagocytic lymphohistiocytosis secondary to acute myeloid leukaemia is often underestimated and undiagnosed. Haemophagocytic lymphohistiocytosis may be masked by the tumour process, often making the diagnosis difficult.
Chemotherapy with 5-fluorouracil (5 FU) has been widely used to treat advanced gastric cancer. Knowing the side effects is therefore important in order to better prevent them. Fluoropyrimidine-induced hyperammonemic encephalopathy is a rare complication and characterized neurological status with elevated ammonia level without radiological abnormalities. We report the first case of 5 FU-induced hyperammonemic encephalopathy in women patients on induction chemotherapy for gastric cancer in Madagascar. His ammonia level (NH 3 ) was 102 µmol/l. The patient recovered from his confusional state after two days of treatment with hyperhydration and vitamin therapy.
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