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Renal artery variations may relate to the origin, course, and end branches of renal artery divisions. To describe the morphology and topography of renal arteries in melanoderm living in Benin. This was a retrospective study from March 1, 2016 to April 31, 2017, i.e. 14 months. The study population consisted of all injected abdominal CT scans clearly highlighting the renal artery and its branches from the CT scan unit of CNHU-HKM. The data collected was entered into CSPro 6.2 software and then processed and analyzed using stata 13 software. The right renal arteries originated in an antero-lateral position on the aorta in 84.4% of cases, while those left in a mediolateral position in 45.9% of cases. They were projected mainly opposite L1 on the right and L2 on the left. Regarding their courses, all the arteries studied were concave posteriorly in the transverse plane and mostly concave above and upwards. Finally, the renal arteries mostly end by bifurcating into anterior and posterior branches in 88.5% of cases, by trifurcating in 1.5% of cases, rarely they divide into 4 branches. The renal arteries arise on the right in an antero-lateral position on the aorta and on the left in a medio-lateral position. They are lower located on the left with a concave path backwards and upwards then head upwards. Finally, they end by bifurcating. This knowledge is essential for patricians working on the kidneys.

Introduction: Gastric cancer is not typically a surgical emergency. However, it can evolve into urgent complications such as a perforation. We report a case of a perforated gastric ulcer that turned out to be a cancer. Observation: A 52-year-old man was admitted to the emergency department of Hubert-Koutoukou-Maga National University Medical Center in Cotonou for generalized abdominal pain. He was diagnosed with acute generalized peritonitis with perforated gastric ulcer, establishing a surgical indication. An antral perforation was found and a simple closure was performed. Anatomopathological examination of the surgical piece revealed a gastric adenocarcinoma within the granulation tissue. Following the impact assessment, he underwent a second surgery where a distal gastrectomy was performed with D2 lymphadenectomy followed by gastrojejunostomy. He developed an anastomotic gastrointestinal fistula during the postoperative period but was successfully medically treated. The patient received adjuvant chemotherapy with Epirubicin, Cisplatin and 5-Fluorouracil. The patient is still alive, 3 years after the gastrectomy. Conclusion: When faced with a perforated gastric ulcer, one must also consider a neoplastic cause. The emergency surgical treatment depends on the general condition of the patient and the pre-existing co-morbidities, the choice being made between a one-stage versus two-stage gastrectomy.

Low-grade endometrial stromal sarcomas are relatively rare tumors. We here report a case of a woman presenting with a giant metastatic low-grade endometrial stromal sarcoma with thromboembolic complications requiring urgent surgical management.A 58-year-old obese female was admitted, with a voluminous abdominopelvic mass, due to complications related to its size and extent. The tumor derived from the uterus and invaded the ureters, bladder and rectum. It compressed the right iliac vessels causing both deep vein thrombosis and pulmonary embolism. She developed a painful irreducible umbilical. We proceeded with a debulking surgery (hysterectomy with bilateral salpingo-oophorectomy). Histological findings were consistent with a low-grade endometrial stromal sarcoma.Low-grade endometrial stromal sarcomas are generally low-grade malignant neoplasms with an indolent clinical course. Surgery is the cornerstone of treatment. In low-income countries, malignancies are more often diagnosed at a late stage, which limits therapeutic options. Cytoreduction is recommended in advanced tumors with extrauterine manifestation, depending on symptoms and with palliative intent.Low-grade endometrial stromal sarcomas are indolent uterine malignancies with metastatic potential. Even in advanced cases, cytoreduction must be considered.

Introduction and importance Adenocarcinoma of the jejunum is a diagnostic challenge for the physician because of its extreme rareness and the fact that it classically presents with vague clinical symptoms. On the other hand, the Sister Mary Joseph's nodule is a rare clinical sign that refers to umbilical metastasis of an internal malignancy. We here report a rare case of jejunal adenocarcinoma revealed by a Sister Mary Joseph's nodule. Case presentation A 55-year-old man presented with an ulcerated umbilical tumor, which was found to be a secondary lesion of an advanced jejunal adenocarcinoma invading the transverse colon. He underwent surgical resection of the umbilical tumor and the intestinal primitive. Clinical discussion The presence of umbilical metastasis usually represents advanced disease but can be its first manifestation. Gastro-intestinal tract tumors such as jejunal adenocarcinomas and gynecologic malignancies are the most common primary sites. Conclusion Practicians must be aware of clinical implication of Sister Mary Joseph nodule. Aggressive surgery when feasible can be beneficial for survival., Highlights • Secondary umbilical malignancies are known as Sister Mary Joseph's nodule or sign • Small bowel represents only 2% of primary sites. • Differential diagnosis includes primary umbilical malignancy and benign lesions • Sister Mary Joseph's nodule represents advanced disease with an associated poor prognosis. • A combination of aggressive surgery and systemic therapies may result in better survival

Background GISTs are rare tumors but the most frequent mesenchymal tumors of the digestive tract. Diagnosis and treatment are challenging in low-income countries due to relatively poor access to immunohistochemistry and targeted therapy. In Africa, there are few studies about it. Imatinib, an oral targeted therapy, has been available in Benin since 2010 and free since 2016. This study describes the diagnosis and therapeutic management of GIST in Cotonou, Benin. Methods This is a descriptive cross-sectional study, with retrospective data collection over a 10-year period from 2010 to 2020, focused on patients with histological confirmed gastro-intestinal stromal tumor (GIST). Cases were identified using the registry database and the archival files of the Hubert Koutoukou Maga National University Hospital of Cotonou (CNHU-HKM). Results Fifteen GISTs were identified during the study period. The median age was 52 and the sex ratio was 2:1 (10 males and 5 females). The most frequent symptom was abdominal pain (n = 12). Delay in care seeking after onset of symptoms ranged from 24 h to 15 years. The most common site for GISTs was the stomach (n = 8). The median tumor size was 11 cm and the majority (n=10) was metastatic or locally advanced at the time of diagnosis. The tumors were often spindle-shaped at histology (n = 13) and the majority expressed KIT (n = 14). Most of the tumors (n = 12) were at high risk of recurrence according to the Joensuu scoring system. The availability of imatinib has improved the outcome of GIST with response in all cases it was used in neoadjuvant setting (n = 7). Conclusion GISTs are rare tumors and preferentially affect the stomach in Cotonou). Most of the tumors were large, unresectable at the time of diagnosis and at high risk of recurrence. Access to imatinib has revolutionized the management of those tumors in our country.

Purpose: authors aimed to compare laparoscopy and open surgery in prosthesis repair of incisional hernias. Methods: in this descriptive and analytical retrospective study of 4years, 179 cases were operated by prosthesis, 120 cases of open surgery and 59 cases of laparoscopy. We compared epidemiologic, anatomic and therapeutic variables using SPSS software. Results: programmed cases have more than 30% of chance of being operated by laparoscopy than by open surgery, OR [95% CI] = 0.3 [0.12-0.92]. Clean cases are statistically 8% more likely to be laparoscopically operated than open surgery (OR [95% CI] = 0.08 [0.01-0.68]). Patients operated by laparoscopy were 30% more likely to have less than 5 days of hospitalization compared to those operated by open surgery, hospital stay ≤5 days: OR [95% CI] = 0.3 [0.03- 2.81]. P-value was 0.42 for duration of intervention and 0.024 for complications. Conclusion: clean and programmed cases preferentially benefit from laparoscopy and the hospital stay is reduced. Open surgery is preferred in an infectious context

To study the epidemiological and histopathological characteristics of sarcomas.This was a multi-center, descriptive, retrospective study realized over a 10-year period. We systematically recruited all medical reports of patients with histologically confirmed sarcoma.159 reports of sarcoma were retained. The average age was 38.9 years. There was a female predominance with a 0.9 estimated sex ratio. Soft tissue sarcomas were the most common (65.4%). The most frequent location was the lower limbs (30.2%).Better access to diagnosis would contribute to a better assessment of the burden of this pathology in Benin.

Introduction Bien que les taux d’incidence du cancer du sein en Afrique soient parmi les plus faibles au monde, les taux de mortalite y sont les plus eleves refletant une survie mediocre des patientes. Au Benin, en particulier, selon les donnees du Centre international de recherche sur le cancer, le cancer du sein est le premier cancer de la femme aussi bien en termes d’incidence que de mortalite. L’objectif de notre etude etait d’analyser les facteurs influencant la survie des patientes atteintes d’un cancer du sein a Cotonou. Methodes L’etude a ete realisee dans deux centres de reference, a l’echelle nationale, dans la prise en charge des cancers du sein : le Centre national hospitalier universitaire Hubert KoutouKou Maga (CNHU-HKM) de Cotonou, et le Centre hospitalier universitaire de la Mere et de l’Enfant Lagune (CHU-MEL) de Cotonou. Elle etait descriptive et analytique avec une collecte retrospective des donnees sur une periode allant du 1er janvier 2014 au 30 septembre 2020. Les cas de cancer du sein histologiquement confirmes et disposant d’une immunohistochimie (Recepteurs a l’œstrogene, Recepteurs a la progesterone, HER2, Ki67) ont ete inclus dans l’etude. L’analyse des donnees, a ete conduite a l’aide du logiciel STATA version 15. Le seuil de significativite des tests statistiques a ete fixe a 5 %. La survie, dans les differents groupes pronostiques, a ete evaluee par la methode de Kaplan-Meier ; le test de log-rank a ensuite ete utilise pour la comparaison de la survie entre les groupes ; et les facteurs pronostiques ont enfin ete determines grâce a un modele de Cox. Resultats Nous avons collige au total 326 cas de cancer du sein. L’âge moyen des patientes etait 48,76 ± 11,73 ans. Le plus souvent, elles n’etaient pas instruites ou avaient un niveau d’instruction bas (50,35 %). Le delai moyen entre la decouverte de l’anomalie mammaire et la premiere consultation etait de 6,21 mois. Les tumeurs etaient surtout classees T3 et T4 (65,95 %) avec un envahissement ganglionnaire N1 et N2 (66,57 %) et des metastases cliniquement notees dans 21,78 % des cas. Les tumeurs “luminal B” (32,57 %) et les tumeurs triples negatives (31,29 %) etaient les types moleculaires les plus frequents. Sur le plan therapeutique les patientes ont beneficie de la chimiotherapie (65,33 %), de la mastectomie radicale associee a curage axillaire (65,33 %), de la radiotherapie (19,02 %), de l’hormonotherapie (21,16 %) et de la therapie ciblee (3,68 %). La survie globale a 5 ans etait de 59,22 %. En analyse univariee, les facteurs de mauvais pronostiques etaient le delai de consultation superieur a 6 mois (p = 0,0368), la taille T3-T4 de la tumeur (p = 0,0001), le grade SBR 3 (p = 0,0005), l’atteinte ganglionnaire (p = 0,0003), la presence de metastases (p = 0,0000), le type moleculaire triple negatif (p = 0,0007), le stade UICC avance de la maladie (p = 0,0000), l’absence de chirurgie (p = 0,0063) et d’hormonotherapie (p = 0,0065). En analyse multivariee, les facteurs de mauvais pronostiques retrouves etaient l’envahissement ganglionnaire (HR = 8,38 ; p = 0,038), la presence de metastase (HR = 6,36 ; p = 0,0000) et l’absence d’hormonotherapie (HR = 3,03 ; p = 0,003). Conclusion La survie des patientes atteintes d’un cancer du sein a Cotonou est influencee par de nombreux facteurs. Elle peut etre amelioree par le diagnostic precoce et un meilleur acces aux differentes modalites therapeutiques. Une attention particuliere devra etre portee a certains types.

Introduction and importance Known as a very uncommon disease, erosive adenomatosis of the nipple is a benign neoplasm of the breast. However, its destructive process can have a considerably negative impact on patient's quality of life. Case presentation We report the case of a 45-year-old woman who presented at the visceral surgery department of the National Teaching Hospital of Cotonou-Benin (CNHU-HKM) for a burgeoning mass of the left nipple. She was diagnosed an erosive adenomatosis of the nipple and underwent a nipple resection with reconstruction. Clinical discussion Erosive adenomatosis is one differential diagnosis for lesion of the nipple. Clinically, it should be discussed with malignant nipple tumours including Paget's disease. Conclusion Surgery is the cornerstone of the treatment, and the prognosis is excellent., Highlights • Erosive adenomatosis of the nipple (EAN) is a rare benign neoplasm of the breast. • Clinically, it should always be discussed with malignant nipple tumours including Paget's disease • Surgery (nipple resection) is the cornerstone of the management • Tissue sparing techniques are advocated for women of childbearing age • The prognosis is excellent.

Breast cancer affects more females than males. It occurs earlier with the black females and is often diagnosed at a stage of complication. This study aims to describe its epidemiological characteristics, the changing stages, and to analyze the treatment and means of interdisciplinary and international cooperation in its care and treatment. Our study was retrospective, descriptive and analytic on breast cancer patients received at CNHU-HKM of Cotonou between January 1, 2001 and December 31, 2013. Breast cancer accounts for 24.24% of mammary pathologies and most affects the left breast. Females aged from 40 to 59 years old are the most affected. For males, the average age was 47.5 years old. Patients mostly consult at a later stage where the tumor is already palpable with nodal metastasis. Breast echography and mammography had been done only for 23.85% of the cases. In an anatomical pathology perspective, the invasive ductal carcinoma was the most common type with 87.2%. For the therapeutical aspect, a radical mastectomy according to Patey was realized in 81.65% of the cases; 48.65% underwent a chemotherapy and 14.7% were able to do a radiotherapy. The chance at life for patients was decreasing while the life time is increasing. Also, the average life span of patients was increased by the combination of diverse types of treatments notably when radiotherapy is done. The incidence of breast cancers in Visceral Surgery A and B department of CNHU-HKM-Cotonou is increasing over years.