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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.

Les auteurs rapportent un cas de dermatofibrosarcome de Darier et Ferrand de la region temporo-faciale gauche. La particularite de notre cas vient de sa forme pediculee, non retrouvee dans les series publiees. Le patient avait 43 ans, la tumeur evoluait depuis 5 ans et mesurait 21 cm de grand axe. Notre conduite therapeutique avait consiste en une resection chirurgicale. Les suites operatoires etaient simples mais en marge positive. Le patient etait perdu de vue apres la chirurgie sans possibilite d’une reprise chirurgicale. L’amelioration des plateaux techniques et une meilleure prise en charge social des patients permettraient d’ameliorer le pronostic de ses types de tumeurs.

Resume L’osteosarcome est une tumeur maligne caracterisee par la formation de zones d’osteolyse locale et de processus sclerosants. Nous rapportons l’observation d’un osteosarcome du radius chez un garcon de 10 ans, apparu apres une osteosynthese par embrochage centromedullaire du radius distal ipsilateral. Le diagnostic de l’osteosarcome a ete pose trois mois apres l’osteosynthese. Le traitement a consiste en une amputation de l’humerus distal et une chimiotherapie adjuvante. Les suites ont ete simples.

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.

This is a retrospective study, conducted on thyroid cancer observed for 13 months (from June 1(st) 2004 to June 30(th) 2005). Data were collected from four main surgical pathology laboratories in Antananarivo, Madagascar. Among 6,036 surgical samples, 179 were of thyroid gland, a rate that is near 3% of the total. Among them were found 40 cases of thyroid cancer, which is 0.66% of all screened samples, and 22.32% of all examined thyroid samples. In the studied population was observed a female preponderance (82%) with a mean age of 43.9 years when diagnosis was confirmed. It was evidenced a 50 % of papillary carcinoma and 45% of follicular carcinoma, with a rate of 2.5% respectively for the medullar and anaplastic carcinoma. Metastases were seen in 20%, originated from papillary type for the lymph node involvement and from the follicular type for the bone involvement. In Antananarivo, thyroid cancer is seen mainly in people from the surrounding Highlands, supposed to be sites of endemic goiter related to iodine deficiency. Despite its limits, this study may be used as reference about thyroid cancer in Madagascar. Further studies are required to find out other factors involved in the development of this disease.

Isolated prostate tuberculosis is uncommon. Authors report herein the case of 64-year-old man who presented obstructive syndrome of low urinary tract. After clinical and biological examination, and imagery, prostate cancer was highly suspected. Transrectal biopsy was performed and histological examination showed tuberculosis lesions. We suggest that prostate tuberculosis should be evoked in old patient presenting similar signs and living in tuberculosis endemic zone.

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 Madagascar, as in other places in the world, infertility is associated with social stigmatism and an underlaying long-term risk for separation of the couple. A 12 months prospective study was carried out in 1999 in the Department of Gynecology, Obstetrics and Reproductive Health at the University Hospital in Mahajanga in order to collect data related to possible causes of infertility. For the women, serologic tests for Treponema pallidum (syphilis) and Chlamydia trachomatis were performed. And, in addition to sonography and hysterosalpingography, cervico-vaginal smears were obtained as part of the pelvic examination. A semen sample was obtained from each male partner. Of the 37 couples enrolled in the study 35 were classified as primary infertile (n = 9) or secondary infertile (n = 28). The mean age of the women and the men was 30.7 years (ranged 20 to 41 years) and 34.3 years (ranged 24 to 46 years), respectively. Various potential causes of infertility among the women were observed, such as hormonal disturbance (76%), tubal occlusion (76%), genital infection (70%). The figures indicate that there seems to coexist the possibility of multiply causes of infertility. Of 37 semen samples 24 (65%) were found with abnormalities, predominantly of oligospermia type. In 21 couples a possibly cause of infertility was observed in both partners.

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.

A voluminous tumor of the right breast, weighing 3,950 g, is described in a 42-year-old malagasy woman. On microscopic examination eight of ten slides showed a monomorphic proliferation of spindle cells; on the two slides, they were associated with scarce ducts and rare epithelial cell clusters. This case raises the question of the association of a phyllodes tumor with a spindle cell sarcoma and their prognostic significance.

With the same aspect of multiple peritoneal leiomyomas, the diagnosis of typical leiomyomatosis peritonealis disseminata was established in two women aged 43 and 49, while in a third case the mature metastasis of a primary low-grade bilateral ovarian stromal sarcoma in a woman aged 63 was diagnosed.

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.

Twelve ovarian leiomyomas were seen over a 12-year period, representing one quarter of all reported cases. Most of them were situated in the ovarian hilum (9/12 of our cases), some were situated in the medulla (2 of our cases) and one case was situated in the cortex. They were fairly small and, due to their site, they were generally asymptomatic and rarely diagnosed on ultrasonography.

The relationship between adenofibroma and cystadenofibroma and the frequency and features of carcinomas developed on these benign tumours are little known. Eight-hundred and forty-five epithelial tumours of the ovary diagnosed over a 10-year period have been re-examined. One-hundred and eighteen adenofibromas and cystadenofibromas were recorded. One-hundred were benign and formed an architectural spectrum from which emerged: (1) surface papillary adenofibroma accounting for 5% of the cases and appearing at a mean age of 27 years; (2) cystadenofibroma in 77.5% of the cases at a mean age of 53 years; (3) adenofibroma in 17.5% of the cases at a mean age of 64 years. Adenofibroma was bilateral in 18 cases. Among the other cases were an endometrioid cyst and two simple serous cysts. The cells were serous in 110 cases, mucinous in 6 cases and weakly acidophilic to clear in 2 cases. Eighteen of these tumours were malignant: 13 were associated with epithelial hyperplasia and 5 with a carcinoma. The 13 adenofibromas with atypical epithelial hyperplasia (at a mean age of 60 years) were all made of serous cells; 6 of them were low-grade and 7 high-grade tumours with 3 microinvasions. One patient died at the age of 78, of an unknown cause; the others are still alive after a mean follow-up of 11.3 years. The 5 invasive carcinomas appeared on an adenofibroma at the mean age of 70 years; 3 patients died (2 of metastases), one is alive after 9 years and one was loss sight of.(ABSTRACT TRUNCATED AT 250 WORDS)

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.