Childhood Bone and Soft Tissue Tumours: A review of 43 Treated at two University Teaching Hospitals in Rwanda (CHUB and CHUK) in RWANDA

Back ground: Cancer represents one of the major causes of death in the world estimated at 1 out of 10 deaths. Globally, 160,000 children are diagnosed to have cancer each year. In the developing countries, one child out of two with cancer will die because of this disease mostly because they present with advanced disease or due to limited resources for proper management1,2. This study was aimed at determining the prevalence, the histological types and the management outcome of childhood bone and soft tissue tumours in Rwanda
Methods: A retrospective descriptive study of 43 histologically confirmed cases of bone and soft tissue tumours in children was done in the Surgery Departments of University Teaching Hospitals (CHUB and CHUK). The period of study was 6 years from January 2001 to December 2006. Only children aged 16 years or below were included in the study. Data was obtained from patient’s clinical files, pathology register and theatre registers. Information obtained was recorded using a special questionnaire; Data obtained was analyzed using Epidata 2.1b, SPSS 11.5 computer programs. Statistic test Pearson Chi-carré (P) was considered significant if P value was less than or equal to 0.05.
Results: During 6 years period, 43 children aged 2 to 16 years were seen having bone and soft tissue tumours. Males accounted for 28 (65.1%) of the cases. The 10 to 16 year age group was predominantly affected, accounting for 72% (n=31) of all cases.. Pain and swelling were the main clinical signs in 100%of cases. Tumours were benign in 17 (40%) and malignant in 26 (60%) of cases. History of local trauma and pain was associated with malignant bone tumours (P=0.003 and P=0.000), respectively (n=23). Delay time between the onset of symptoms and consultation to hospitals was associated with death for malignant tumours (P=0.049). The bones were affected in 76.7% (n=33), being malignant in 23 (69.7%)of them. The hospital mortality rate was 18% for malignant tumours. Pulmonary and bone spread of the disease were observed in all fatal cases.
Conclusion: Limitation of diagnostic and therapeutic means and lack of an oncology department that would provide chemotherapy and radiotherapy) in our University teaching hospitals (CHUB and CHUK) made the management of malignant tumours and the follow up after discharge inadequate, unsuitable and difficult.