Prise en charge d’une tumeur maligne de l’endomètre chez un sujet de plus de 80 ans : A propos d’un cas à l’Hôpital Régional de Fatick

Abstract

INTRODUCTION: The gynecological tumors of the patient aged over 70 constitute heterogeneous entities by their oncological and geriatric clinical presentations, which frequently expose to the proposal of “non-standard”, “adapted” or “exceptional” therapies. In Sub-Saharan Africa, cancer is a scourge whose characteristics remain to be clarified, marked by very limited means, and especially by the context of practice in rural areas. We describe in this clinical case the particularity of the management in a rural context of a case of endometrial tumor in an 83-year-old patient at stage IB. OBSERVATION: This is Mrs. M.G., aged 83 4G 4P 4 children, postmenopausal for 30 years who consults for postmenopausal metrorrhagia evolving for 3 months. A diagnostic hysteroscopy was performed showing an ulcerated mass of the uterine cavity bleeding on contact, a biopsy was performed, the result of which was a low-grade endometrial stromal sarcoma. The abdominopelvic CT scan, which demonstrates thickening of the endometrium without damage to surrounding structures, classified as stage IB endometrial tumor. The patient underwent a total hysterectomy with bilateral pelvic dissection. The postoperative course was simple. The patient was discharged on the 7th postoperative day. The result of the histological report: well-differentiated and infiltrating endometroid carcinoma invading the isthmus and the cervix. Parameters and the 4 right and left lymph nodes are unharmed. The histo-prognostic stage was pT2N0Mx. CONCLUSION: The management of endometrial cancer is possible in the rural context in elderly patients. The prognosis is good if the diagnosis is made at an early stage. Surgery could still be offered even for subjects over 80 with less comorbidity. KEYWORDS: Endometrial tumors; Elderly patient; Senegal.