INTRODUCTIONMyxofibrosarcoma is the most common soft tissue sarcoma occuring in late adulthood [1], and comprises a spectrum of malignant fibroblastic lesions with myxoid stroma, cellular pleomorphism, and distinctive curvilinear vessels [2]. The World Health Organization (WHO) has classified them as a diagnostic entity [3]. These tumors are subdivided into three or four grades depending on the degree of cellularity, nuclear pleomorphism, and mitotic activity [4;5].Patients with myxofibrosarcoma exhibit better disease-specific survival than those with other sarcoma subtypes [6]. The differential diagnosis is based mainly on immunohistological features [7]. Intermediate and high grade myxofibrosarcoma are associated with a high rate of local recurrences [6; 8], for which optimal treatment has not yet been defined internationally [8;9;10].These tumors mainly occur in the lower limbs (77%), followed by the trunk (12%) and the retroperitoneum or mediastinum (8%) [1]. However, rare cases have been reported in the cranial cavity [11], orbit [12], maxilla [13], parotid gland [14], hypopharynx [15], pyriform sinus [16], the vocal cords [17], the thyroid gland [18], the esophagus [19], the breast [11], the heart [20], the aorta [11], the scapular region [21], the buttock [21], the scrotum [23], the pterygopalatine fossa [1;11], liver [10] and scalp [7]. Localised involvement of the scapula is rare.We describe the first case of large intermediate-grade myxofibrosarcoma located on the dorsal aspect of the scapula. In this article, we discuss the presentation and diagnosis of this rare disease of unusual location, drawing attention to the inaccessibility to means of differential diagnosis in a remote setting, at the Academic Medical Center, Kongo Central Province. in the Democratic Republic of Congo.

Mpox with digestive manifestations in a 16-year-old adolescent girl; A case report

Pediatric tuberculosis remains a neglected health emergency, particularly in fragile contexts such as North Kivu province in the Democratic Republic of Congo. While more than one million children contract tuberculosis each year worldwide, the majority of cases remain underdiagnosed, resulting in preventable morbidity and mortality. In North Kivu, armed conflict, massive displacement, chronic malnutrition, overcrowding, and a weak health system create fertile ground for the spread of tuberculosis and complicate child care. Limited access to diagnostic tools (radiography, GeneXpert), insufficient BCG vaccination coverage, and a lack of appropriate pediatric drug formulations exacerbate the situation. National and international tuberculosis control strategies remain largely focused on adults, leaving children on the margins of policies and interventions. This editorial calls for an urgent and targeted response, including active contact tracing, improved access to diagnostic tools, the availability of appropriate medications, community outreach, and the involvement of humanitarian actors. Coordinated and context-specific action is essential to ensure that children in North Kivu no longer remain the invisible victims of a preventable and curable disease.

Introduction: Artificial intelligence (AI) is rapidly transforming medical diagnosis worldwide, but its adoption remains limited in Africa, particularly in the DRC. This narrative review aims to analyze the contributions, challenges, and prospects for integrating AI into medical diagnosis in the Democratic Republic of Congo. Methodology: A comprehensive literature review was conducted in February 2025 in PubMed, Web of Science, Scopus, and Google Scholar databases, as well as reports from international organizations. Studies on the use of AI in medical diagnosis in resource-limited countries, particularly in Africa, were included without language restrictions. The selection followed a two-step process (title/abstract then full text); 13 articles were retained for qualitative synthesis. Results: Studies show that AI enables a 12-15% improvement in diagnostic accuracy in radiology and a 20% reduction in exam interpretation time. It also helps accelerate epidemic detection (30-50% faster than conventional methods) and overcome the shortage of specialists in rural areas. However, its implementation in the DRC is hampered by the lack of digital infrastructure, insufficient training, and the absence of an appropriate regulatory framework. Maintenance and financing issues still limit the effective use of available systems. Conclusion: AI represents a major opportunity to strengthen medical diagnosis in the DRC, improving the speed and quality of care. However, effective integration requires targeted investments in infrastructure, training, and regulation. The development of national pilot projects and a solid ethical framework are essential steps for gradual and sustainable adoption.

IntroductionCemento-ossifying fibroma (COF), as per the World Health Organization’s (WHO) 2022 classification of head and neck tumours, is a well-demarcated neoplasm which consists of fibrous tissue containing varying amounts of mineralised material resembling bone and/or cementum (1). It is a benign fibro-osseous lesion, and is derived from the multipotential mesenchymal blast cells of the periodontal ligament (2).COF was already defined as a benign mesenchymal odontogenic tumour in the 2017 WHO classification. However, it was described under the category of fibro-osseous lesions (3), but is now an integral part of the benign mesenchymal odontogenic tumours in the 2022 classification, completely isolated from the non-odontogenic juvenile trabecular (JTOF) and psammomatoid types (POF) (1).COFs occur mostly in between the second and fourth decades of life with a definitive female predilection in the ratio of 4:1 (4). However, they may be present in children and adolescents, as well as in older adults (5,6). The mandible – preferentially in the molar region – is more involved than the maxilla (7), albeit other cranial and facial bones such as the frontal, periorbital, sphenoid, ethmoid and temporal bones are also affected (8). The tumour is termed central COF when lesions are located intraosseously, whereas peripheral COF refers to extraosseous lesions, or those appearing on the outer soft tissue (9). The tumour is well demarcated by a teeny sclerotic shell of bone. Unpredictably, it may either show a slow growth or appear to be locally aggressive with cortical damage and involvement of several nearby anatomical structures (10).Histologically, the neoplasm is composed of a proliferating fibrous tissue and osseous particles containing bony strands and cementum-like material (5). This lesion is thought to occur in reaction to low-grade irritations such as trauma, calculus, plaque, masticatory forces, ill-fitting dentures and poor-quality restorations (11).Clinically, OF presents as a spherical or ovoid, generally slow-growing, painless and expansive jaw bone mass that may displace the roots of adjacent teeth, and occasionally causes facial deformity and/or functional discomfort (12). Definitive diagnosis requires correlation of clinical, radiographic, and histopathological findings (13). The treatment consists of surgical excision with enlarged resection depending on the size and location of the lesion (10,14).For an optimal management of COF, an accurate diagnosis is necessary. Clinical presentation is not unique, and the radiological patterns depend on the degree of mineralisation of the tumour. The clinician is then confronted by the overlapping patterns of the broad spectrum of fibro-osseous tumours, and the presence of unusual patterns makes the diagnosis even more challenging. We present a rare case of COF in a 22-year-old female patient in the lateral maxilla, which is an unusual site of occurrence.Case reportA 22-year-old female patient was referred to the Department of Oral and Maxillofacial Surgery with a painless swelling in the upper right region of the jawbone since 10 years. The swelling sprouted as a small painless nodule when the patient was 12, and grew with time. As the swelling was increasing, only the vision was shielded, but the deglutition and breathing were not affected. Mastication on the right side and speech were also affected. No pain, fever, or any comorbidity were reported. There was no history of previous similar swelling, toothache, numbness, trauma, surgery, or radiotherapy. Although the patient was from a low socio-economic status, her parents and siblings were all well. There was no similar swelling in the family.The patient’s general condition was otherwise good with fair nutritional status. Extraoral examination showed a bulky, dome-shaped, and well-defined swelling extending over the right hemi-maxilla with a frontward expansion causing facial disfigurement. The dome of the swelling was budding and ulcerated. The palpation of the swelling revealed a bony hard consistency, with no tenderness elicited. The mass was immobile on mobilisation and measured approximately 40 cm × 12 cm in size (figure 1). On intraoral examination, all the teeth of the right hemi-maxilla were buried under the swelling.There was no palpable lymphadenopathy. Neurological examination, as well as respiratory, digestive, and urogenital explorations did not reveal any abnormality.A maxillofacial computed tomography (CT) was performed, and revealed a well-circumscribed exuberant mass in the right facial region, spanning from the right palatal and maxillary bones and extending into the right malar bone. Detailedly, an osteoforming excrescence with a regular margin, and a mixed density content made of soft tissue and diffuse scattered calcified foci, with teeth 21 to 28 engulfed in the mass (figure 2). Also, CT image showed a mass effect of the tumour causing left deviation of the nasal septum, with a narrowed osteo-meatal system, yet preserving its anatomical structure (figure 3).A provisional diagnosis of osteoblastoma was recorded, with fibrous dysplasia and ossifying fibroma being considered in the differential diagnosis.An excisional biopsy (16 × 10 cm) of the tumour was performed, and the histopathological examination revealed a well-circumscribed fibrous tissue containing dispersed foci of calcification. The mass harboured dense bundles of fibrocollagenous connective tissue in a cellular stroma (figure 4). The matrix was formed by interconnected trabeculae of mature lamellar bone with fibroblastic rimming (figure 5). No atypical cells nor mitosis were observed, and the lesion also showed an ulcerated stratified squamous epithelium. On the basis of histopathological findings, and correlating them with clinical and radiological features, a final diagnosis of (peripheral) cemento-ossifying fibroma was established, excluding JTOF and POF subtypes.As management, a surgical resection of the tumour was performed, followed by curettage. Postoperative period was uneventful, and a clinical follow-up plan was established for review after 3 months, 6 months, and 1 year after surgery.

Background and Aim: Myelodysplastic syndromes (MDS) are a heterogeneous group of clonal disorders characterised by ineffective haematopoiesis and an increased risk of progression to acute myeloid leukaemia. In the Democratic Republic of Congo (DRC), healthcare institutions face major diagnostic challenges due to minimal infrastructure, limited access to testing equipment, and a shortage of trained professionals. This study analyses MDS diagnostic practices in the DRC, identifies unmet needs, and proposes strategies for improving early and accurate detection. Methods: A comprehensive literature review was conducted using international databases (PubMed, Google Scholar, and Scopus) alongside local health reports. The research synthesised data from peer-reviewed articles, hospital-based studies, and World Health Organisation (WHO) guidelines, with a focus on MDS diagnosis in sub-Saharan Africa, particularly in the DRC. Results: The findings reveal persistent diagnostic barriers in the DRC, including limited availability of bone marrow aspiration tools, under-resourced laboratories, and a lack of trained hematopathologists. MDS diagnosis largely depends on peripheral blood analysis and basic marrow examinations, leading to frequent underdiagnosis and misclassification. The absence of standardised diagnostic protocols and inconsistent reporting practices further hampers accurate disease identification. Moreover, brown pigmentation in cases of acute myeloid leukaemia can obscure proper diagnosis, underscoring the need for timely and precise detection methods. Conclusion: MDS diagnostic evaluation in the DRC is hindered by systemic and technical limitations, including infrastructure deficits and workforce shortages. Addressing these issues requires strengthening laboratory capacity, expanding access to diagnostic technologies, and investing in specialist training through international collaborations and local educational initiatives. There is an urgent need for a national diagnostic guideline tailored to the DRC’s healthcare context to ensure accurate classification and improve patient outcomes.

A document by Criss Koba. Click on the document to view its contents.

Introduction: Cancers in children under the age of 17 have specific epidemiological and management aspects. The objective of this study was to determine the epidemiological and histological profile of childhood cancers in Lubumbashi. Method: A cross-sectional descriptive study conducted at the University Clinics of Lubumbashi over a lap of two-year. The data collection was done using a form with a number of parameters. Results: We noted a prevalence of (3.27%) childhood cancer in Lubumbashi and the percentage had increased in 2018 (53.5%) comparing to the previous years. The average time between the onset of the disease and the first consultation was 33.5-7.1 weeks and only (71%) cases had consulted a general practitioner at first sign of the disease. From the histological point of view retinoblastoma led the way with 29.2%, followed by Nephroblastoma (23.3%), lymphomas of all forms (13.2%). Other types of cancers were repeated, representing 28.3%. Conclusion: This pathology is a reality that is experienced in large numbers in our environment diagnosis and early treatment remain essential to the reduction of the mortality rate

Background: Pediatric cancer is one of the leading causes of death and a matter of constant concern worldwide. The objective of this study was to estimate the financial cost of treating children suffering from cancer in Africa. Methods: We conducted a systematic review and meta-analysis of expert opinions with peer review by searching PubMed and other databases for World Health Organization data for the African region published in French and English between March 2000 and March 2020. The key search terms included ‘cost’, ‘cancer’ and ‘child’; we selected articles that specifically addressed the financial costs of childhood cancer in African countries. Results: Of 79 articles found, 15 met the inclusion criteria; four of the articles came from Rwanda. Cancer care was a heavy financial burden in most of the countries studied, although costs varied from country to country; the average healthcare expenditure was US$1017.39 ± US$319.1 per year. In countries without a health insurance system, the highest proportion of cancer care costs, 62.7%, was indirect (e.g., travel costs to a different country for oncology care), whereas in countries with a cancer financing system, the direct cost of treatment was low, 37.3%. Conclusion: The cost of treating childhood cancer is high in Africa in relation to the standard of living of individuals residing in this region. More studies on financing cancer care on this continent could improve treatment and patient management. Keywords: Childhood cancer, financial costs, Africa, systematic review, meta-analysis.