Per-Operative Discovery of Tympanic Paraganglioma: A Case Report

Background: Tympanic paragangliomas are common middle ear benign neoplasias that develop from endocrines cells situated along the great blood vessels of the head and neck, as well as those of the thoracic and lumbar spine. Primary symptoms of tympanic locations include hearing loss and pulsatile tinnitus. Otoscopy often shows a retrotympanic reddish mass, causing tympanic bulging. Computerized tomography scan findings include a tissue density regular mass located at the promontory and limited within the middle ear cavity. Surgical management comprises tumour excision with control of bleeding, with or without prior embolization. Aim: The aim of this presentation is to report an unusual case of tympanic paraganglioma. Case Presentation: We report the case of a 56-year-old patient whose clinical and paraclinical presentations were consistent with cholesteatoma, though a tympanic paraganglioma was discovered per-operatively. Conclusion: In some rare cases, tympanic paraganglioma can be present like a cholesteatoma.

Impact of Therapeutic Education on the Viral Load of HIV Infected Children and Adolescents on Antiretroviral Therapy at the Douala Laquintinie Hospital, Cameroon

Introduction: One of the biggest challenges for HIV-infected adolescents on antiretroviral therapy (ART) is the long-term maintenance of viral suppression, which is the third 90% goal of UNAIDS. Therapeutic Education (TE), process of acquiring abilities and skills that help the patient to live optimally with his illness is one of the strategies that contribute to the achievement of viral suppression through the therapeutic adhesion contract and the follow-up of the patient. The aim of this study was to evaluate the impact of TE on the virologic response of children and adolescents aged 8 - 19 under ART and followed up at the Laquintinie Hospital of Douala (LHD). Method: A cross-sectional study was conducted at the Pediatric Unit of the HIV/AIDS Accredited Treatment Center (ATC) at LHD from February to May 2016. Children and adolescents aged 8 to 19 years on ART, followed in ATC/LHD whose parents had agreed to participate in the study, and who had achieved at least one viral load before and after initiation of TE, were recruited consecutively during routine medical follow-up. Data were collected from patients’ medical records and questionnaires administered to study participants. Results: A total of 198 children and adolescents were included in this study with an average age of 14 years (±3). In this study population, 86.1% of children aged 8 - 10 years had acquired knowledge of the importance of taking medications, 95.4% and 97.3% of adolescents aged 11 - 14 years and 15 - 19 years had knowledge of medication schedules respectively. Among children and adolescents with undetectable viral load prior to initiation of TE, 76.5% maintained an undetectable viral load after initiation of TE. In addition, 72.3% of those whose viral load was detectable before initiation of TE had acquired an undetectable or decreasing viral load after initiation of TE. The only exposure factor significantly associated with maintaining undetectable viral load after initiation of TE was having less than 10 TE sessions (p = 0.02). Conclusion: The virologic response appears to be better in subjects who acquire skills faster through TE and therefore require fewer learning sessions to adapt. In addition, TE effectively contributes to achieving the third 90% goal of UNAIDS.

Lymphoma of the Nasopharynx in an HIV Sero-Positive Patient in the General Hospital of Douala

Humman immunodeficiency virus (HIV) infection is associated with opportunistic cancers notably Non-Hodgkin lymphoma (NHL). Generally the response to chemotherapy or radiation therapy is satisfactory but requires nursing measures to protect these patients from superinfection to which they are highly predisposed by the double immunosuppression. We report the case of a 54 year-old known HIV sero-positive female with lymphoma of the nasopharynx who presented lately and died of septic shock despite the favorable evolution of the tumor on treatment.

Gross Tumour of Minor Salivary Glands in HIV Sero-Positive Patient

Tumours of minor salivary glands are rare. We report the case of a 58-year-old HIV positive woman with a palatal adenocarcinoma evolving for 15 years, followed by a literature review. The case enlightens on the deleterious effect of delayed specialist consultation, which in our context is multifactorial in origin.

Prognosis and Survival of Nasopharyngeal Cancer in Cameroon

Background: Nasopharyngeal carcinoma (NPC) is an entity belonging to up-per aerodigestive tract Cancers. NPC is more widespread in Southern China and South East Asia. In our country, it is the leading cause of head and neck cancers. Its prognosis remains bleak because of the late stage at diagnostic. Objectives: The objectives of this study were to determine the prognostic fac-tors and survival rate of patients with nasopharyngeal cancer in six reference hospitals in Cameroon. Material and Methods: It was a retrospective analytic study, conducted from January 2009 to December 2018. It was conducted in oncology, surgery and Ear Nose and Throat (ENT) units of six reference hos-pitals. Data from 114 files meeting the inclusion were collected. We have drawn survival curves and determined the different survival probabilities with the help of Kaplan-Meier Method. The different survival curves were compared using the Log-Rank Test (P < 0.05), variables that were statistically associated with the 5% cut off were introduced into the Cox regression model for multivariate analysis, thus allowing us to bring out the prognostic factors significantly associated with survival. Results: The mean age at the time of diagnosis of the 114 patients recruited was 45.30 ± 17.14 years. The predominant histological type was the UCNT (Undifferentiated Carcinoma of the NasoPharynx) representing 84.2%. According to the WHO classification, 2 patients were classified as stage I (1.8%), 33 as stage II (28.9%), 42 as stage III (36.8%), 25 as stage IV A (21.9%) and 12 as stage IV B (10.5%). At the end of the survival assessment period, 34 patients were dead and 73 patients (64%) were still alive. The median overall survival was 44 months. The overall survival rates at one, two, three, and four years were 80%;74%;68%;44%, respectively. The prognostic factors associated with poor survival were: late consultation time of more than 12 months, N3 lymph node involvement, 3 and 4 advanced clinical stages. Conclusion: The study showed a low survival, with a median overall survival of 44 months. The overall survival rates at one, two, three, and four years were 80%;74%;68%;44% respectively. The prognostic factors associated with poor survival were late consultation time of more than 12 months, N3 lymph Node involvement, 3 and 4 advanced clinical stages. In order to improve this survival, it is recommended that special emphasis be placed on early detection.

Prognostic Factors and Survival of Laryngeal Cancer in Cameroon

Background: Laryngeal cancer is a major cause of morbidity and mortality worldwide. It is ranked worldwide as the second ENT cancer with 238,000 new cases and 106,000 deaths each year. In Africa, data on the prognostic factors and the survival of this pathology remain quite limited. Objective: To study the prognostic factors of laryngeal cancer and the survival of patients with laryngeal cancer in Yaoundé and Douala. Methods and Materials: We performed an analytical, longitudinal (retrospective) study over a period from January 1, 2009 to December 31, 2018 including all patients with histologically proven laryngeal cancer, at the ENT, oncological, anatomopathological, radiotherapy and surgery Department of three reference health structures in the cities of Douala and Yaoundé (Laquintinie Hospital and General Hospital of Douala, General Hospital of Yaounde). The data collected were recorded and analyzed by SPSS version 25 and Excel 2013 statistical computer software. Survival was determined by the Kaplan Meier method and the search for prognostic factors was carried out using the Cox proportional hazards model. The significance level was p = 0.05. Results: We selected 80 patients whose vital status we knew and who had been followed up after histological evidence. The sex ratio was 5.66. The median age at cancer diagnosis was 62 years old. 60 (75%) were exposed to tobacco, 52 (65%) had alcohol-tobacco poisoning. The Center and Littoral regions were the most represented with 37.5% and 48.8% respectively. Dysphonia was present in 98.8% of patients. The histological type encountered was squamous cell carcinoma in 78 patients;in the majority of cases the cancer was diagnosed at stage IV and the glottis was the most frequent site (86.2%). The median overall survival was 1.41 with 95% CI [1.08 - 1.74]. The overall survival rates at 1 year, 3 years, 5 years and 8 years were 70%, 18%, 3% and 1.5%, respectively. The poor prognosis factor found was: age greater than or equal to 70 years. Conclusion: Present study showed that survival in laryngeal cancer in Cameroon is very low with a median overall survival of 1.41 years. The overall survival rates at 1 year, 3 years, 5 years and 8 years are 70%, 18%, 3% and 1.5%, respectively. The age greater than or equal to 70 years is the poor prognosis factor, while receiving surgery in combination with neoadjuvant chemotherapy or surgery in combination with adjuvant radiotherapy is the factor of good prognosis.