Genotype distribution of cervical HPV among Caribbean women in a population-based study in Martinique: The DEPIPAPUFR study

The Caribbean ranks seventh among the world regions most affected by cervical cancer. HPV-prevalence and genotype distributions also differ from regions. Knowledge of HPV genotype profiles is important for patients care and HPV vaccination implementation. The objective of this study was to describe HPV genotype distribution and risk factors in a population-based cohort of women in Martinique. In this study, 1312 women were included and underwent cervical cancer screening with successful sample collection between 2009 and 2014. Sociodemographic and clinical variables were recorded. Cytological examination of cervical vaginal smear was performed and classified(Bethesda). Detection of HPV DNA was performed with the PapilloCheck© Kit from Greiner Bio-one. Genotypes were analyzed for18 high-risk HPV (hrHPV) and 6low-risk HPV(lrHPV) types. A total of 1075 women were included with a mean age of 49.1±10.5 years. HPV prevalence was 27.6% (297/1075) with 19.4% (209/1075) women with only hrHPV, 5.3% (57/1075) with only lrHPV. Multiple infections (hrHPV/lrHPV) were detected in 31/240 cases of hrHPV (12.9%). A total of 353 hrHPV genotypes were analyzed; the most common HPV types were HPV51 (11.0%), HPV68 (10.8%), HPV53 (9.1%) and HPV 52 (7.1%). HPV16 and HPV18 represented respectively 4.8% and 4.0% of hrHPV genotypes. Abnormal cytology was observed in 34 cases (3.2%), with 14 ASCUS (1.3%), 10 LSIL (0.9%), 5 HSIL (0.5%), 3 ASC-H (0.3%) and 2 AGC (0.2%). Fifteen (44.1%) were hrHPV and 4 (14.7%) lrHPV; 7 cases of hrPHV were in the age-group 25-34 years. Among 1041cases of normal cytology, 225 had positive hrHPV detection (21.6%). This is the first population-based study of HPV profiles in our country, and we found a high prevalence of hrHPV. The most common genotypes were HPV51, 68, 53. These results could serve for cancer vaccination strategies and HPV surveillance in Martinique.

[Genital Schistosoma mansoni bilharziasis in women: apropos of 2 cases in Guadeloupe]

Schistosoma mansoni is the only cause of bilharziasis in Guadeloupe (French West Indies). Ectopic ovarian and endometrial involvement is rare with only one case of bilharziasis of the endometrium having previously been described in the literature. This report describes two cases of Schistosoma mansoni bilharziasis revealed by genital tract involvement. In one case involvement was endometrial and led to metrorrhagia. Histological examination of the biopsy sample obtained by curettage of the endometrium demonstrated the presence of eggs with lateral spurs. In the other case ovarian involvement was detected during assessment for associated infertility and chronic pelvic pain. Celioscopic examination showed pelvic and perihepatic adhesions secondary to sexually transmissible infection. Histologic examination of an ovarian growth demonstrated the presence of Bilharzia eggs. Both patients underwent antiparasitic treatment using oxamniquine (Vansil) which led to the resolution of metrorrhagia in the first case.

[Leiomyosarcoma of the Meckel's diverticulum and multiple diverticulosis of the ileum. Apropos of a case]

We report a case of a leiomyosarcoma arising in a Meckel's diverticulum in a man of 90 years, with multiple ileal diverticulosis. The clinical picture was similar to acute appendicitis and diagnosis was not made until resection of an abdominal mass with histological appearance of leiomyosarcoma. 59 cases of leiomyosarcoma of Meckel's diverticulum have previously been reported in the literature. No case until now has been reported in a patient of Caribbean origin neither in association with ileal diverticulosis. Although rare, leiomyosarcoma is the commonest sarcoma of Meckel's diverticulum, and with full resection of the tumor the prognosis is very good.