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With Andre Onana on the bench, and watching on, Gambia were arguably the better side in the first half, and created more than one excellent chance, but their profligacy meant they were unable to find a way through.
An exceptional save from Fabrice Ondua, in for his cousin Onana, was required to keep the scores level heading into half-time, as he denied Modou Barrow on the spin with superb reactions.
After half-time, Cameroon finally carved out a gilt-edged chance, as a deep cross found Georges-Kevin N'Koudou free at the back post, but his rasping drive rattled the crossbar and bounced clear.
The momentum kept flowing and Karl Toko-Ekambi headed home a superb N'Koudou delivery to break the deadlock.
But Gambia kept pouring forward, and on the 71st minute, they shockingly levelled through Ablie Jallow, as he volleyed home a superb delivery to leave Ondua rooted.
And they added a deserved second just minutes later, leaving their players in tears, as Ebrima Colley found the back of the net after being slipped through one-on-one.
But within a minute of the restart, Cameroon equalised, as James Gomez scored a heartbreaking own goal while trying to cut out a cross.
And Cameroon appeared to steal it late on as Christopher Wooh powered a header into the bottom corner from an N'Koudou corner.
In the 94th minute, Gambia thought they had an equaliser through Muhammed Sanah, but the ball clearly came off his hand before nestling in the bottom corner, and was subsequently booked.
THE MVP
N'Koudou was brilliant for Cameroon throughout. He may have missed a superb chance, but he provided two absolutely superb assists, and his pace left Gambia chasing shadows at times.
THE BIG LOSER
Muhammed Sanah tried to do a Diego Maradona in the age of VAR, which is a wild thing to do at the best of times. Doing it in injury time, when losing 3-2, and in need of a goal, as the ball was there to be headed, is even wilder. He was booked, he probably deserved to be sent off.
WHAT COMES NEXT?
Cameroon can now prepare for the knockout stages. Gambia, by comparison, will have to lick their wounds, but this was a performance to be proud of for the minnows.
