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Squamous carcinoma of the hypopharynx in children in Sénégal: between disarray and enigma
1Otorhinolaryngology Department, Aristide Le Dantec Hospital, Dakar, Senegal. ichndiaye@orange.sn
Insights
Hypopharyngeal cancer in children presents with advanced disease and a poor prognosis, often linked to Plummer-Vinson syndrome and HPV. Further investigation is crucial for understanding and managing this rare pediatric cancer.
Area of Science:
- Oncology
- Pediatric Oncology
- Epidemiology
Background:
- Hypopharyngeal squamous cell carcinoma is a significant cause of hospitalization, with a distinct epidemiological profile in Senegal characterized by young patients and female predominance.
- Previous studies highlight unique epidemiological characteristics, but the role of pediatric cases remains under-explored.
Purpose of the Study:
- To investigate the specific characteristics and prevalence of hypopharyngeal cancers in children.
- To evaluate the epidemiological factors and management challenges associated with pediatric hypopharyngeal cancer.
Main Methods:
- A retrospective study was conducted over 11 years (1995-2005) at the University Department of Otorhinolaryngology in Dakar, Senegal.
- Data collected included epidemiological, clinical, paraclinical, treatment, and outcome information for pediatric patients.
Main Results:
- Fifteen pediatric cases of hypopharyngeal cancer were identified, with 93% presenting at advanced stages (T3-T4).
- Commonly observed factors included anemia (86.7%), Plummer-Vinson syndrome (86.7%), and in one case, papillomatosis. No association with smoking or alcohol was noted.
- Treatment was largely symptomatic (tracheotomy, gastrostomy), and the overall outcome was poor, with an 11-case mortality rate (73.33%).
Conclusions:
- This study represents the largest cohort of pediatric hypopharyngeal cancers globally, suggesting a potential role for Plummer-Vinson syndrome and HPV in disease etiology.
- Hypopharyngeal cancer in Senegal affects young women and children, with pediatric cases exhibiting a particularly grim prognosis.
- There is an urgent need for public awareness campaigns regarding the poor prognosis of hypopharyngeal cancer and large-scale epidemiological research to better understand its occurrence in the region.
Introduction:
The squamous carcinoma of the hypopharynx constitutes the first reason of hospitalization in our department. Different studies have been realized about it and showed an epidemiological profile characterized by the young age of the patients and the predominance of female.
Objectives:
To specify the place of the children in hypopharynx cancers. To evaluate the epidemiological criteria and the difficulties in the management.
Materials And Methods:
Retrospective study of 11 years (1995-2005). Collection of the data concerning the epidemiology, clinical and paraclinical findings, the treatment, and the evolution was carried out at the University Department of Otorhinolaryngology in Dakar (Sénégal).
Results:
15 charts of children have been collected. They presented in the majority of the cases, an advanced cancer, with 93% of T3T4. The lesion was localized at the retro-cricoid area in 4 cases, the pyriform sinus in 3 cases, the oesophagus junction in 2 cases, and the posterior wall in 1 case. In 5 cases the lesion was spreading to the totality of the hypopharynx. No case of smoking or alcohol has been noted. The anemia has been noted in 86.7% of the cases. A case of papillomatosis of the mouth and lips has been noted. The treatment was for most of cases as symptomatic, like tracheotomy with or without gastrostomy. The evolution was fatal with 11 deaths (73.33%).
Discussion:
Our set is the richest set through the world of hypopharyngeal cancers in children. The Plummer-Vinson syndrome noted in 86.7% of the cases and the viral infection by HPV could play a role in the genesis of this cancer.
Conclusion:
The cancer of the hypopharynx essentially affects the young women in Sénégal without alcohol or tobacco consumption. It does not save the children, with an awful prognosis, however. So, it is imperative to organize a vast campaign of information of the populations on the bad prognosis of this cancer and to lead a large-scale epidemiological investigation, to get a better understanding of this cancer in our country.
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