A. Ameur

Les hématomes spontanés de la loge rénale. À propos de trois observations

Resume Lhematome spontane de la loge renale (HSLR), est une affection rare, son diagnostic preoperatoire est aise en raison des aspects radiologiques caracteristiques, mais sa cause reste souvent difficile a preciser. Les etiologies sont multiples et dominees par ladenocarcinome du rein, ce qui fait conseiller aux auteurs la nephrectomie au moindre doute. A propos de trois nouvelles observations, les auteurs proposent de faire le point sur les aspects diagnostiques et therapeutiques de cette affection rare.

Tumeur neuro-ectodermique primitive (TNEP) de la voie excrétrice supérieure

Primitive neuroectodermal tumors (PNETs) are rare and aggressive malignant small round cell sarcomas. Primitive urogenital location of PNETs is rare and occurs most frequently in the kidney. PNETs of the upper-urinary tract are exceptional (only one case reported in the literature). Its diagnosis is almost postoperative within pathological study of the operatory specimen, supported by immunohistochemistry and cytogenetics. Treatment is similar in all to that of Ewings sarcoma and involves surgery, chemotherapy and radiotherapy. We report a new case of upper-urinary tract PNET and discuss the diagnostic and therapeutic problems posed by this particular tumor.

L'hypoplasie segmentaire aglomérulaire du rein : à propos d'un cas clinique

Resume Lhypoplasie segmentaire renale aglomerulaire est une entite particuliere assez rare chez ladulte, souvent confondue avec une pyelonephrite chronique. Elle en differe par un aspect radiologique et anatomopathologique particulier. Letiopathogenie de cette affection nest pas encore elucidee. La connaissance de cette affection est importante car elle pourrait dans certains cas faire eviter des nephrectomies inutiles.

Expression of human epidermal growth factor receptor 2 in bladder urothelial carcinoma

BackgroundUrothelial bladder carcinoma (UBC) is one of the most prevalent cancers in men worldwide. Human epidermal growth factor receptor 2 (HER2) expression has been detected in a wide range of urothelial carcinoma. Despite many reports in the literature, the prognostic significance of this overexpression remains unclear. The aim of this study was to assess the expression of HER2 in urothelial bladder carcinomas and its association with clinical and pathological parameters.Methods103 cases of UBC were diagnosed in our department between January 2014 and December 2015. The tumor specimens obtained by transurethral resection or cystectomy were evaluated by immunohistochemistry using HER2 antibody.ResultsHER2 protein overexpression was present in 11.7% of cases and associated with tumor grade (pu2009=u20090.003) and pathological stage (pu2009=u20090.015). In multivariate analysis, HER2 overexpression was associated only with tumor grade (Pu2009=u20090.04).ConclusionHER2 protein overexpression is noted in patients with high grade cancer. This expression may select patients for anti HER2 targeted therapy. Future larger and prospective studies will verify the frequency of HER2 alteration and the role of HER2 in the aggressive behavior.

Les sarcomes rétropéritoneaux : aspects thérapeutiques et pronostiques, à propos de 6 cas

Resume Les sarcomes retroperitoneaux representent plus de la moitie des tumeurs retroperitoneales primitives. C’est un groupe tumoral rare (moins de 15 % des sarcomes des tissus mous chez l’adulte). Les auteurs rapportent 6 nouvelles observations et discutent les aspects therapeutiques et evolutifs de cette entite clinique. La chirurgie d’exerese est le traitement de base avec des difficultes non negligeables. Ces tumeurs sont caracterisees par le risque eleve de recidives locoregionales et leur pronostic est lie aux possibilites d’une exerese complete et au grade histopronostique.

Identification of G2607A mutation in EGFR gene with a significative rate in Moroccan patients with Bladder Cancer

The epidermal growth factor receptor (EGFR) is involved in the regulation of several cellular processes and in the development of many human cancers. Somatic mutations of EGFR at tyrosine kinase domain have been associated with clinical response to tyrosine kinase inhibitors (TKIs) in lung cancer patients. In this study, we evaluated the frequency of point mutations in EGFR for future use of TKI in clinical treatment of bladder cancer. A total, 50 Moroccan patient specimens with bladder cancer and 48 healthy controls were analysed for EGFR mutations in the region delimiting exons 18-21 by PCR amplification and direct sequencing. Our results showed the absence of mutations in the EGFR kinase domain in these exons in all analysed specimens. However, sequence analysis of the EGFR-TK domain, revealed the presence of (G2607A) polymorphism at exon 20. Statistical analysis showed significant difference in the frequencies of G2607A polymorphism between cancer cases and healthy controls (p=0.0001) and the frequencies of the GG and GA/AA genotypes among the cancer cases were 28% and 72%, respectively. Moreover, allelic frequencies of G2607A polymorphism showed significant difference between cancer cases and healthy controls (p=0.0025). Data analysis showed no significant association between G2607A polymorphism and patients age, clinical stage and tumor grade (p > 0.05). However, a significant difference was found between this polymorphism and patients sex that could be a sampling bias due to the very limited number of women with bladder cancer. Our findings highlight that, mutations in EGFR kinase domain is a rare event in bladder cancer, suggesting, that treatment of bladder cancer patients with TKI may not be effective. However, the EGFR G2607A polymorphism in exon 20 is frequent in bladder cancer cases and must be further explored for its relevance in the treatment of this disease.

Large prostatic stones with staghorn renal calculus in a 61-year-old man: an unusual presentation of uncommon disease

Prostatic parenchymal calculi are common in ageing men who are evaluated for benign prostatic hyperplasia or prostate cancer. Giant prostatic calculi are very rare, usually associated with local predisposing factors for urinary stasis and infections, and traditionally managed by open surgery. We present the first case of its kind to be associated with a concurrent staghorn nephrolithiasis, and removed successfully by endoscopic approach using an access sheath through the urethra.

Sarcome rénale à cellules claires chez l’enfant : une entité rare

Objectifs Le but de cette etude est de determiner le profil epidemiologique, clinique, radiologique, anatomopathologie et les moyens therapeutiques des sarcomes a cellules claires de l’enfant ainsi que de voir son caractere pronostique. Methodes Entre janvier 1990xa0et decembre 2010, nous rapportons une serie de 21xa0patients ayant ete diagnostique pour CRCC. Nous avons recueilli retrospectivement les donnees epidemiologiques, cliniques, biologiques, radiologiques, therapeutiques et evolutives chez nos malades. Resultats L’âge median etait 26xa0mois (7xa0mois–9xa0ans). Le sex-ratio etait de 1,63. La masse abdominale etait Le signe revelateur quasi-constant. Aucun de nos malades n’avait de syndrome malformatif. L’imagerie a montre une masse renale localisee a gauche dans 12xa0cas et a droite dans neuf cas. La chimiotherapie preoperatoire a ete systematique pour tous les malades selon les protocoles suivantsxa0: SIOP 9, SIOP 93–01, GFA 2005. Une nephrectomie a ete faite dans 20xa0cas. Vingt malades ont eu une chimiotherapie et 11xa0une irradiation postoperatoires. Avec un recul median de 36xa0mois, l’evolution a ete marquee par des rechutes metastatiques osseuses chez quatre enfants et un cas de rechute locale. Onze enfants sont vivants en remission complete, quatre perdus de vue et six sont decedes. Conclusion L’agressivite du SRCC et son aptitude a donner des metastases osseuses, impliquent de ne pas meconnaitre ce diagnostic dressee difficilement par un examen anatomopathologique minutieux, ceci dans le but d’instaurer un traitement adapte qui associe la chimiotherapie, la chirurgie et la radiotherapie.