Search

Schistosomiasis (also known as bilharziosis) is a parasitic infection still endemic in Madagascar. Its transmission is perpetuated by population lifestyles in tropical countries. A genital location is relatively rare; diagnosis is histological. This is a retrospective, descriptive study of genital schistosomiasis observed in the anatomic pathology laboratory of Sampan'asa luteriana ho an'ny fahasalamana and the Joseph Ravoahangy Andrianavalona University Hospital Center over the 6-year period from January 2010 through December 2015. We collected 13 cases. The mean age of the patients was 31.6 years and ranged from 4 to 48 years. Localization was cervical (n = 10), tubo-ovarian (n = 2), and vulvar (n = 1). Clinical signs were isolated bleeding or associated with other signs for cervical localization, suspicion of cyst for the vulva, and suspicion of mass for the ovary. The diagnosis was based on the presence of schistosome eggs in all cases, associated with tuberculoid granulomas (n = 9), eosinophilic polynuclear cells (n = 1), and giant cells (n = 2). We observed one case of squamous cell carcinoma that developed on cervical schistosomiasis. Schistosomiasis is a neglected tropical diseases. Malignant transformation is possible. A cervical hemorrhage is not synonymous with cancer but may reveal a specific inflammatory lesion. Histological examination is necessary for diagnosis.

Osteosarcoma is a malignant neoplasm characterized by local lytic or plastic processes. We observed a case of radius osteosarcoma in a 10-year-old boy 3 months after intramedullary osteosynthesis in the ipsilateral distal radius. Treatment consisted of amputation of the distal humerus and adjuvant chemotherapy; no complications were observed.

Cervix neoplasms are the most frequent of female neoplasms in Madagascar. The authors reported a prospective study carried out at the Hospital Center of the University of Mahajanga for ten months (January-October 1993). 500 patients were investigated. 465 results of cervix and vaginal smears were considered. The Bethesda group classification was used to interpret lesions. 333 specific pathological lesions were listed. Bacterial infections and trichomoniasis were their principal causes. 4 cases were presumed as human papillomavirus condylomata. 39 SIL low-grade and 24 SIL high-grade were detected. 5 cervix neoplasms were diagnosed. Only few patients had consultation to perform cervix and vaginal smears because these exams are expensive. It may be an explication to the chronicity of lesions, a favourising factor of cancer. The role of viruses, especially human papillomavirus, in the development of cervix neoplasms is mentioned. The authors conclude that the low number of cervix neoplasms they founded is misleading. Cervix neoplasms are the first female cancers in Madagascar. A systematic surveillance of all female genitalia diseases must be programed. While its settling, cervix neoplasms control must be centred on Information--Education--Communication.

In many underdeveloped countries, illegal abortion can lead to death or sequelae. Pregnancy termination is illegal in Madagascar except for medical reasons. We report 23 observed between April 1990 and December 1994 at the Androva Mahajanga University Hospital. Post-abortum infectious complications ranked 19th for hospital admissions. Peritonitis was the most frequent (70%) and most serious complication. The women were young (mean age 24 years, 44% under the age of 20 years). Thirty percent were primigravidae and had poor living conditions (74% were homemakers and 13% were students; 44% were single). Clinical signs were malodorous loss and abdominal pain. A surgical procedure was performed in 74% of the cases: 3 salpingo-oophoectomies, 2 hysterectomies and 10 uterine sutures. Mortality was high, 13%. Illegal abortion must be prevented with better information on contraception and better health education programs. The question of the usefulness of current legislation is discussed.

Determine the sensitivity of the pathology examination of the placenta as a screening examination for malaria and the consequences of this infection on prematurity and birth-weight.Eighty placentas were examined at the Mjunga, Madagascar dispensary at the beginning of the rainy season. The aspect of the placenta was compared with a malaria index and to malaria disease state as a function of parity and anti-malarial prophylaxis used by the mother as well as with the state of the infant.Among the placentas examined, 41.3% were considered normal and abnormal or clearly pathological in 58.7%. Estimating the gestational age on the basis of the histological examination of the amniotic cells was in agreement with the gestational age calculated from the last cycle in 53 cases and in disagreement in 8 cases. The percentage of cases of malaria discovered by the pathology examination (20%) was greater than that after thick swab screening (10%). 75% of the mothers has Plasmodium falciparum infection at the time of delivery and 13.8% of the mothers with negative thick drops had malaria lesions of the placenta. The parity of infected mothers was similar to non infected mothers. All the premature newborns had pathological placentas included 12.5% with malarial lesions. 90% of the hypertrophic newborns had pathological placentas included 50% with malarial lesions. No case of congenital malaria was observed.Pathology examination of the placenta is as sensitive as blood drop tests for screening for malaria. The histological examination of amniotic cells can give a good estimation of gestational age in developing countries.

to estimate the frequency, the age, the size, the bilaterality and the prognosis for "borderline" tumours according to the type of cell found. MATERIAL STUDIED: 132 low grade malignant tumours found in 845 primary ovarian carcinomas diagnosed between 1975 and 1984 in the Institute of Pathology in Strasbourg.borderline serous carcinomas (63 cases) were 16.9% of cases were serous neoplasias. The mean age at which the diagnosis was made was 50.3 years of age, and the tumour measured 10 cm. They were bilateral in 20% of the cases and the mean age of survival was 134.7 months. The borderline mucinous carcinomas (68 cases) were 18.2% of mucinous neoplasias. The intestinal sub-variety was found at the mean age of 50 years and was 15.3 cm in diameter. It was rarely bilateral and in some cases was accompanied by peritoneal pseudomyxomatosis. The endocervical sub-variety (18 cases) was diagnosed at a mean age of 41.5 years with a mean size of 13.5 cm. It was rarely bilateral. The two varieties of borderline mucinous carcinomas had a mean survival rate of 154 months. Only one borderline endometrioid carcinoma was found among the 54 endometrioid carcinomas, and none had clear cells, Brenner cells or mixed cells.under the heading of "borderline" carcinoma are different types of tumour with different prognoses. Only serous mucinous varieties which are more frequent, have a low potential for becoming malignant. Endometrioid types and clear cell or Brenner types which have a similar architecture are usually found out to be benign.