Introduction: Gastrointestinal stromal tumor (GIST) is the most common non-epithelial, mesenchymal tumor of the digestive tract. Targeted therapy has improved the prognosis but the diagnosis must be accurate before using the existing drugs. Aim: To report the diagnostic difficulty in our context through the clinical polymorphism and define the position of targeted therapy in the management of GIST metastatic stomach. Casuistry: We report 3 cases of gastric GIST with liver metastasis in different circumstances of discovery. Patients were 21, 45, and 73 years old. Discovery circumstances were respectively digestive hemorrhage, severe clinical anemia, abdominal tumor and gastric tumor. There was hepatic metastasis in the three cases. The three patients received Imatinib treatment, adjuvant treatment for the first two cases, and neo-adjuvant treatment for the third case, with a very good clinical response and CT response on metastases. Conclusion: Because of their rarity, GISTs are often difficult to diagnose, and necessarily require immunohistochemistry which is not available in our work context. The effectiveness of targeted therapy even on metastasis needs a rigorous diagnostic approach to improve patient survival.
The purpose of this study is the prevalence of the rheumatologic complications in the sickle cell disease and the associations between haemoglobinopathies and rheumatologic affections. It is a retrospective study from 29 February 2006 to 28 March 2008 conducted in the Internal Department of the University Hospital Yalgado-Ouédraogo. All patients received in the period of study and having an electrophoresis of haemoglobin realized in alkaline pH were included. These patients came from hematologic consultation. Two hundred and seventy-seven patients out of 1451 were included: 142 patients (51.30%) had haemoglobinopathies, including 21 (7.60%) with composite sickle cell disease SC and 17 patients (6.13%) had aseptic necrosis of the femoral head including 7 with haemoglobin SC. The other rheumatologic affections did not have a semiological particularity related to the type of haemoglobin. The prevalence of patients who have haemoglobinopathies is important in rheumatologic practice. The sickle cell disease is strongly associated to osteonecrosis.
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