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Tumeurs et pseudotumeurs cutanées de la face à  Yaoundé: épidémiologie et histopathologie

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par Yannick MOSSUS
Université de Yaoundé I - Docteur en médecine générale 2006
  

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CONCLUSION ET RECOMMANDATIONS

Au terme de notre travail, nous avons tiré trois conclusions.

· Les tumeurs cutanées et pseudotumeurs de la face étaient rares et constituaient 0,21% des consultations d'Oto-Rhino-Laryngologie à Yaoundé.

· La chéloïde était le type histologique le plus fréquent de ces affections et siégeait généralement sur le pavillon de l'oreille.

· Les carcinomes épidermoïdes étaient les cancers cutanés de la face les plus fréquents dans notre échantillon.

Aussi avons-nous recommandé :

Aux praticiens hospitaliers

Une prise en charge pluridisciplinaire des patients à chaque fois que cela est possible.

Aux étudiants en médecine et médecins en cours de spécialisation

D'effectuer des études sur des échantillons plus larges et étendus en consultation de dermatologie et de médecine générale. Cette approche permettra aussi d'aborder les aspects clinique et thérapeutique de ce groupe d'affections.

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Tumeurs et pseudotumeurs cutanées de la face à Yaoundé : épidémiologie et histopathologie
Thèse de Doctorat en médecine 2005-2006 MOSSUS Yannick

Aux autorités des centres hospitaliers de YaoundéD'améliorer la tenue des archives afin de permettre une exploitation objective des dossiers médicaux.

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Tumeurs et pseudotumeurs cutanées de la face à Yaoundé : épidémiologie et histopathologie
Thèse de Doctorat en médecine 2005-2006 MOSSUS Yannick

SUMMARY

INTRODUCTION

Skin tumours consist of non-physiologic random proliferation of skin cells or its nearby structures.

Facial skin tumours are situated in between the line linking the eye brows and the line linking the inferior borders of the mandibles. The lateral limits of these tumours consist of the retroauricular hair borders.

Pre-carcinomatous lesions, environmental factors, such as prolonged exposure to sunlight, and genetic factors (albinos) are predisposing factors for facial tumours.

The aim of our study was to describe the epidemiologic and pathologic characteristics of facial skin tumours observed in our population.

METHODOLOGY

We carried out a cross sectional study in two phases:

· A five-year and eight-month retrospective phase

· A four-month prospective phase

The study was carried out in ENT services of the Yaoundé Central Hospital, the Yaoundé General Hospital, the Yaoundé Gyneco-Obstetric and Paediatric Hospital and the University Teaching Hospital.

All patients consulting for skin lesions situated within the anatomic landmarks above were recruited.

The diagnosis of a skin tumour or pseudotumour was confirmed by histopathologic examinations by a pathologist. Data was analysed with the SPSS version 11.0.1 and Microsoft Excel software for windows.

Tumeurs et pseudotumeurs cutanées de la face à Yaoundé : épidémiologie et histopathologie
Thèse de Doctorat en médecine 2005-2006 MOSSUS Yannick

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RESULTS

A total of 191 patients were recruited for the study. Forty patients were excluded because of incomplete medical records.

The University Teaching Hospital and the Yaoundé General Hospital accounted for 85.52% of the pool of subjects recruited.

1. Prevalence of facial skin tumours

The prevalence of facial skin tumours at ENT department was 0.21%.

2. Age, sex, profession and residence distribution

Females represented 54.36% of patients while males accounted for 45.65%.

The age ranged from 7 months to 73 years with a modal age group of 20 to 29 years (33.78%). Most of our patients were pupils and students (48.29%).

One hundred and twenty one patients (85.21%) were residents of Yaoundé.

3. Localisations of tumours

Most of our tumours were auricular (29.81%). The ear also accounted for the most common site of benign tumours (36.29%).

Malignant tumours were mostly situated at the jaws (29.62%).

We had 20 tumours with multiple localisations; fourteen cases of keloids, four cases of squamous cell carcinoma, one case of naevus and one case of wart.

4. Histological types

Benign tumours were the most common type with 124 cases (82.12%). Malignant tumours were found in 27 patients (17.88%).

Keloids were the most frequent facial skin tumours (41.73%). They also accounted for 50.80% of benign tumours. Forty one cases (65.07%) were

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Tumeurs et pseudotumeurs cutanées de la face à Yaoundé : épidémiologie et histopathologie
Thèse de Doctorat en médecine 2005-2006 MOSSUS Yannick

females and 34.93% were males giving a sex ratio of 1.86.

Those within the age group of 20 to 29 years were most represented (53.38%). Keloids were chiefly situated on the auricular region (55.55%).

In 22.22% of cases these tumours were overlapping.

Students and pupils were the most affected group (50.80%) with keloids.

Other benign tumors identified were cysts (14.51%), angiomas (11.29%) and papillomas (11.29%). Naevus, and wart, and histiocytofibroma, and lipoma and fibroma were not frequent.

Squamous cell carcinoma was the most frequent malignant tumour (77.77%), affecting mostly males (66.66%) Those within 40-49 years were most represented. This tumour was found at the jaw (28.57%).

Other malignant tumours found were angiosarcomes (11.11%), melanoma, basocellular carcinoma and fibrosarcoma constituted 3.7% for each.

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