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.
xx
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.
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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
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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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