Résumé
Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma, and the commonest primary orbital malignancy in children. Studies on ophthalmic RMS are scanty in Nigeria, and other parts of Africa. This study thus describes the pattern of ophthalmic RMS in Ibadan and treatment outcome.
Method: A retrospective, non-comparative, consecutive, interventional analysis of patients with ophthalmic RMS in an ocular oncology unit of a teaching hospital over 20 years was carried out.
Results: Records of 22 patients, 15 males and 7 females, aged 2 months to 50 years (Median 7 years, Range 5- 13 years) were analyzed. All patients presented with visual loss, orbital swelling and proptosis. Histological examination revealed embryonal RMS in 16 (72.7%) patients, alveolar in three (13.6%), pleomorphic in two (9.1%) and “not otherwise stated” in one (4.5%). Treatment outcome was poor as only two (9.1%) patients remained tumour-free 12 and 36 months after diagnosis. Three (13.6%) patients died on admission, while two (9.1%) patients are presently undergoing treatment. Fifteen (68.2%) patients were lost to follow-up, financial constraint and perceived poor response to treatment being the main reasons for incomplete and inconsistent treatment regimen and resultant poor outcome.
Conclusion: Demography and morphology of ophthalmic RMS in Ibadan is comparable to other studies. However, treatment outcome remains poor, mainly due to late presentation, incomplete and inconsistent treatment. Strengthening the national health insurance scheme to cater for the indigent and increased public enlightenment on early presentation of cases may go a long way in improving the outcome in our patients.
Keywords: Ibadan, Nigeria, ophthalmic, outcome, rhabdomyosarcoma,
Résumé
Contexte : Le rhabdomyosarcome (RMS) est le sarcome le plus fréquent des tissus mous, et la plus fréquente tumeur orbitaire primaire chez les enfants. Les études sur les ophtalmiques (RMS) sont rares au Nigeria, et d’autres régions d’Afrique. Cette étude décrit ainsi le motif des ophtalmiques (RMS) à Ibadan et le résultat obtenu des traitements.
Méthode: Une analyse rétrospective, consécutive non-comparative, d’intervention aux patients atteints des ophtalmiques dans une unité d’oncologie oculaire d’un centre hospitalier universitaire de plus de 20 ans a été réalisée
Résultats: Les dossiers de 22 patients, 15 hommes et 7 femmes, âgés de 2 mois à 50 ans (médiane 7 ans, extrêmes 5-13 ans) ont été analysés. Tous les patients présentaient une perte de vision, un gonflement orbital et proptosis. L’examen histologique a révélé le RMS embryonnaire en 16 patients soit (72,7%) alvéolaire sur trois (13,6%), pleomorphic en deux (9,1%) et «aucun cas contraire en un (4,5%). Le résultat du traitement était faible, car seulement deux (9,1%) patients ont été identifiés sans tumeur, 12 et 36 mois après le diagnostic. Trois (13,6%) patients sont décédés pendant l’hospitalisation, tandis que deux (9,1%) patients sont actuellement sous traitement. Quinze (68,2%) patients ont manqué de suivi, pour des raisons financières entrainant une mauvaise réponse au traitement puisque celui-ci est était incohérent et incomplet, expliquant ainsi les mauvais résultats obtenus.
Conclusion: la démographie et de la morphologie des ophtalmiques (RMS) à Ibadan est comparable à d’autres études. Toutefois, le résultat du traitement reste faible, principalement en raison de la présentation tardive, du traitement incohérent et imcomplet. Le renforcement du système national d’assurance santé à la sensibilisation indigente et accrue du public sur la présentation précoce des cas peut toutefois contribuer à l’amélioration de meilleurs résultats chez nos patients.
Correspondence: Dr. O. Fasina, Department of Ophthalmology, College of Medicine, University of Ibadan, Ibadan, Nigeria. E-mail: yemifash2000@yahoo.com
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