Gado Napo-Koura

Cancers in Togo from 1984 to 2008: Epidemiological and Pathological Aspects of 5251 Cases

Objective. To describe the epidemiological and histological aspects of cancers in Togo. Materials and Methods. We made a retrospective review of the epidemiological and pathological features of cancers observed from 1984 to 2008 at the laboratory of pathology of CHU-TOKOIN in Lomé, Togo. Results. During our study period, we found 5251 cases of cancers with an annual average frequency of 210 cases. The sex ratio, male/female, was 0.9 and the average age of occurring was 45.3 years. This average age was 46.9 years for men and 43.8 years for women. The most frequent cancers for men were prostate cancer (12.9%), nonmelanoma skin cancer (10.4%), and gastric cancer (10.3%). For women it was breast cancer (27.1%), cervix cancer (11.2%) and non-Hodgkin lymphoma (6.3%). Histologically, it was carcinomas in 68.1% of the cases, sarcomas in 11% of the cases and non-Hodgkin lymphomas in 12.6% of the cases. Children cancers were primarily Burkitt lymphoma (27.9% of cases) and retinoblastoma (8.5% of cases). Conclusion. This study shows that cancers are frequent in Togo and emphasizes on the necessity of having a cancer register for the prevention and the control of this disease in Togo.

Descriptive Epidemiology of Thyroid Cancers in Togo.

BACKGROUND The purpose of this study was to provide epidemiological and histological data of thyroid cancers in Togo. MATERIALS AND METHODS This was a retrospective cross-sectional study of cases of thyroid cancers diagnosed from 2000 to 2014 (15 years) at the pathology laboratory of the Sylvanus Olympio Teaching Hospital of Lome. All cases of review of a thyroid sample (biopsies, surgical specimens) were collected from the data records of that laboratory. RESULTS Thyroid cancers represented 1.1% (7930 cases) of all cancers registered during the study period. Mean age was 45.4±0.3 years and the proportion of females was 78.3%. We identified 92.4% carcinomas and 7.6% lymphomas. Carcinomas were well differentiated in 80 cases and were dominated by the papillary type (47 cases). Metastasis was observed in 13% of patients. The pTNM classification evaluated in 18 cases showed a predominance of grade I (13 cases). Lymphomas were dominated by lymphoma diffuse large B-cell (5 cases). CONCLUSIONS This study is the first global standard for thyroid cancer pathology in Togo. The high frequency of follicular form suggests an unrecognized iodine deficiency. The improvement of the technical platform of the LAP (immunohistochemistry) will increase the diagnosis of rare forms of thyroid cancer.

Tuberculosis of the thyroid in Togo: a clinicopathologic study of 11 presumed cases

Tuberculosis (TB) remains a real public health concern in Africa; thyroid localisation of the disease is a very rare form of extrapulmonary TB. We conducted a descriptive and cross-sectional study on all histologically proved cases of thyroid TB diagnosed in Togo over the last 20 years. Eleven cases of TB of the thyroid were identified, of which nine were in women, with an average age of 29.4 ± 0.2 years. The clinical signs were the presence of a nodule in seven, an abscess in three and a swelling with cutaneous fistulisation in one. Thyroid involvement alone was found in four, associated with pleuropulmonary TB in six and mammary TB in one. Human immunodeficiency virus (HIV) co-infection was present in six. All histopathology results showed inflammatory granulomata with caseous necrosis. The clinical features are often misleading and pose a real diagnostic problem, especially with differentials of simple abscess and cancer.

Association of Schistosomiasis with Cervical Cancer in Togo: the Consequence of this Association

Objective of the study was to determine the association of cervical cancer association and schistosomiasis infection. We conducted a retrospective and descriptive study of cases of cervical cancer and identified cases associated with schistosomiasis. A total of 1027 cases of cervical cancer were collected, and 19 cases revealed an association with schistosomiasis. This association was mainly related to squamous carcinoma with 18/19 cases. All patients were from rural areas. Of the 19 cases of association, 17 cases showed signs of HPV infection. Our data show a high degree of HPV infection that causes cervical cancer and not schistosomiasis.

Histoplasmosis by Histoplasma capsulatum var. duboisii Observed at the Laboratory of Pathological Anatomy of Lomé in Togo

Our study aimed to describe the epidemiological, clinical, and diagnostic aspects of African histoplasmosis in Togo through a descriptive and cross-sectional study on histological diagnosed African histoplasmosis in Pathology Department of Lomé from 2002 to 2016 (15 years). A total of 17 cases of African histoplasmosis were diagnosed. The sex ratio (M/F) was 1.8. The annual incidence was 1.1 cases. The mean age of the patients was 27.2 ± 0.4 years. All our patients were of social categories with a low socioeconomic level. HIV infection was known in 3 patients and one patient contracted tuberculosis. The clinical manifestations were cutaneous in 7 cases, cutaneous and mucous in 3 cases, cutaneous and lymph node in 3 cases, cutaneous and bone in 2 cases, and disseminated in 2 cases. The samples examined consisted of 14 cutaneous biopsies measuring 2-3 cm and 3 ganglionic biopsies each measuring 4 cm of major axis. Histologically, all cases were of chronic form made of granulomatous reaction with ovoid yeasts measuring between 1 and 2 microns. Despite the low frequency of this disease in our country, it should be kept constantly in mind before any granulomatous lesions, especially in the context of the HIV pandemic.

Primary Neuroendocrine Breast Carcinoma in a 13-Year-Old Girl: Ultrasonography and Pathology Findings

Neuroendocrine carcinoma (NEC) of the breast is a rare disease and has been scarcely reported by African authors. The authors report a case of breast NEC in a 13-year-old African girl initially diagnosed as an atypical adenofibroma by ultrasonography. Ultrasound-guided biopsy and conventional histological examination indicated two potential diagnoses: primary malignant non-Hodgkins lymphoma and undifferentiated carcinoma. According to immunohistochemistry performed on paraffin blocks in France, infiltrating ductal carcinoma with a strong neuroendocrine component was confirmed by CD56, CD57, and chromogranin A markers.

Primary ovarian angiosarcoma in a 12- year -old girl: a case report of an exceptional localization in a context of limited resources country

BackgroundOvarian sarcomas represent less than 1% of all ovary cancers and usually are frequent in adults. Primary angiosarcomas are exceptional in the ovaries within children.Case presentationWe reported a case of primary ovarian angiosarcoma in a 12-year-old girl in a resource-constrained context. Immunohistochemistry study showed the positivity of CD34, CD31, factor VIII, while S100 was negative. The diagnosis of primary non-metastatic angiosarcoma was retained. She was unable to undergo the CWS-2002P chemotherapy since her parents could not afford it.ConclusionThis case report described a rare type of a primary ovarian angiosarcoma within a child, diagnosed in a low-income country in a laboratory with limited resources.

Evolution of the Histo-Epidemiological Profile of Urological Cancers in Togo

Background: Urological cancers are an important public health issue and pose problems with diagnosis and adequate management in developing countries. Our aim was to determine and report epidemiological and histological features of urological cancers in Togo. Materials and methods: A retrospective descriptive study was conducted of cases of urological cancers observed in the laboratory of pathological anatomy of the CHU Tokoin over the last 4 years (2012-2016). The parameters studied were frequency, age, sex, sites of development and histological type. Results: Epidemiological data were collected for 182 cases, representing 16.4% of all cancers (1108 cases). The annual frequency was 45.5±1.1 cases on average. The male: female sex ratio was 8.6 with a mean age of 60.2 years. Regarding location, in decreasing order of frequency, the tumors were found in the prostate (n=121 cases; 66.5%), bladder (n=28; 15.4%), kidney (n=19; 10.4%), testis (n=10; 5%), penis (n=3; 1.7%) and scrotum (n=1; 0.5%). Histologically, prostate cancers were predominantly adenocarcinomas (n=116 cases; 95.8%) with a Gleason score of 6 (n=46; 39.7%) predominant. Bladder cancers were mainly squamous cell carcinomas (n=11; 39.3%) followed by transitional carcinomas (n=9 cases; 32.1%) and adenocarcinomas (n=7; 25%). Kidney cancers were predominantly nephroblastomas (n=10, 52.6%) in children and clear cell carcinomas (n=8 cases; 42.1%) in adults. Testicular cancers were Burkitt lymphomas in 5 cases. The cases of penis and scrotum cancers were all squamous cell carcinomas. Conclusion: Urological cancers are experiencing an upsurge in frequency in Togo, dominated by prostate cancer, with a high frequency of squamous cell carcinoma of the bladder due to endemic bilharziasis.

Descriptive Epidemiology of Cancers in Togo from 2009 to 2016

Background: Cancer is a global public health problem. According to World Report on Cancer in 2000, developing countries are becoming increasingly affected. Methods: This retrospective and descriptive 8-year study of all histological confirmed cancers was conducted using data from the anatomical pathology laboratory registry of Togo’s only laboratory. The parameters were frequency, site and histological type as well as age and gender. Results: We found 1,738 cancers in patients aged from 4 months to 109 years (mean, 50.4 ± 4. The sex ratio (M/F) was 1.3. The most frequent localizations of the cancers were the prostate (10.3%) followed by the breast (9.9%), the stomach (8.4%) and the cervix (7.2%). In women, the median age was 47.4 ± 2.9 years, and the most common cancers were breast cancer (21.2%), followed by cervical cancer (16.3%). In men, the median age was 53.2 ± 7.3 years and the most frequent cancers were prostate cancer (18.5%), non-Hodgkin’s lymphoma (13.2%) and stomach cancer (10.7%). In children, Burkitt’s lymphoma (41.8%), retinoblastoma (11.6%) and nephroblastoma (9.6%) were the most important cancers. Conclusion: Cancers are frequent in Togo, those of the prostate, breast and cervix being most important with a worse prognosis. Emphasis should be placed on early detection and diagnosis.

Diagnostic Difficulties in Pathological Laboratories in Developing Countries: A Case Report of Differentiated Squamous Cell Carcinoma in a Young Togolese Woman.

We report a case of poorly differentiated squamous cell carcinoma of the vulva induced by human papillomavirus in a 23-year-old woman, in whom we experienced diagnostic difficulties.