Mohamed Allaoui

Periductal stromal sarcoma in a child: a case report

IntroductionPeriductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma made of spindle cells and lacking phyllodes architecture. Its therapeutic management is based on wide surgery with free margins. Adjuvant therapies are not needed. Periductal stromal sarcoma may evolve into a phyllodes tumor with time, as well as a specific soft-tissue sarcoma. To the best of our knowledge, this tumor has never been described in a child.Case presentationA 14-year-old Arabic boy was presented to our hospital one year ago with a nodule of the right breast that was gradually increasing in size without signs of inflammation. The histological examination after lumpectomy revealed a periductal stromal sarcoma with free surgical margins. No adjuvant treatment was given. At 50 months of close follow-up, no recurrence was observed.ConclusionPeriductal stromal sarcoma in a child is a very rare disease which has the same indolent behavior as it does in adults. Therefore, close follow-up is required.

Extragonadal mixed germ cell tumor of the right arm: description of the first case in the literature

BackgroundExtragonadal localization of germ cell tumors (GCTs) is rare; to the best of our knowledge, a location in the soft tissue of the arm has never been previously reported in the literature.Case presentationWe report the case of a 37-year-old man who presented with a primary malignant mixed non-seminomatous GCT (teratocarcinoma variety) in the right arm, treated by a combination of cisplatin-based chemotherapy and surgery. After 18 months of close follow-up, no locoregional recurrence or distant metastases have been detected.ConclusionsA combination of chemotherapy and surgery is the most appropriate treatment strategy for extragonadal GCTs, to ensure both local and systemic control.

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 (p = 0.003) and pathological stage (p = 0.015). In multivariate analysis, HER2 overexpression was associated only with tumor grade (P = 0.04).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.

Primary Chondroblastic Osteosarcoma of the Breast / Memenin Primer Kondroblastik Osteosarkomu

Abstract Pure sarcomas of the breast are uncommon, accounting for less than 1% of primary breast malignant tumors. Mammary osteogenic sarcomas are very rare and less than 100 cases have been reported in literature. They mainly affect older and middle aged women and are highly aggressive. We report an additional case in a 56-year-old woman. Histological and immunohistological characteristics were similar to those described in other localizations. Differential diagnosis involves phyllodes sarcoma, breast metaplastic carcinoma with chondroid and osteoid differentiation, osteosarcoma of the ribs, and metastatic osteosarcoma. The prognosis is poor. Öz Memede primer sarkomlar nadirdir ve primer malign meme tümörlerinin %1’inden azını oluşturur. Primer meme osteosarkomu olarak literatürde 100’den az sayıda olgu bildirilmiştir. Meme osteosarkomu orta-ileri yaş kadınlarda görülen oldukça agresif tümördür. Burada 56 yaşında kadın hastada saptanan primer meme osteosarkomu sunulmaktadır. Histolojik ve immünhistokimyasal özellikleri diğer lokalizasyonda saptanan osteosarkomlarla benzerdir. Ayırıcı tanıda filloides sarkom, kondroid ve osteoid farklılaşma gösteren metaplastik karsinom, kosta yerleşimli osteosarkom ve metastatik osteosarkom yer almaktadır. Prognoz kötüdür.

Primary Desmoid-Type Fibromatosis of the Mesentery: Report of an Unusual Tumor Localization

Since their initial description in 1832, desmoid tumors have been reported to occur in every part of the body. The mesentery is a very rare localization of this lesion [1, 2]. Mesenteric desmoid-type fibromatosis is under-recognized and often subject to misdiagnosis. It is a locally aggressive mesenchymal neoplasm of the mesentery and adjacent tissues that lacks the capacity to metastasize but shows a high risk of local recurrences. It can occur spontaneously or after surgical trauma. A small percentage of patients are affected byGardner syndrome. Mesenteric desmoid-type fibromatosis (DF) has characteristic morphologic features that are similar to those of fibromatosis elsewhere [1, 3]. This report treats a very rare case of primary giant mesenteric desmoid-type fibromatosis, highlighting clinicopathological features and differential diagnostic problems.

Triple malignancy in a single patient including a squamous cell carcinoma of the cervix, a colloid adenocarcinoma of the colon and a lung adenocarcinoma: A case report and literature review

Highlights • Triple malignancy in the same patient is exceptional.• The etiology remains controversial.• The management depend on stages.• Surgery is the standard of care in localized cancers.

Synchronous Primary Renal Cell Carcinoma and Pancreatic Ductal Adenocarcinoma: Case Report and Literature Review

Synchronous primary cancers involving the pancreas and kidney are extremely rare and poorly documented. We report the first case of this association treated with chemotherapy and tyrosine kinase inhibitor. A 70-year-old woman presented with a 2-month history of epigastric pain with weight loss of 12 kg. Two weeks previously, she had presented with jaundice and pelvic pain. A computed tomography (CT) scan of the body revealed the presence of an irregular mass in the body of the pancreas, encasing the celiac trunk, with dilatation of the biliary tract. CT also revealed a heterogeneously right renal mass with bone metastasis in the left acetabular cup and the left iliac wing. A biliary metallic prosthesis was performed with a pancreatic mass biopsy. Histology revealed a moderately differentiated pancreatic ductal adenocarcinoma. Another biopsy was performed in the right iliac wing. Pathological examination with immunohistochemistry confirmed the diagnosis of bone metastasis from clear cell renal cell carcinoma. The patient was treated with a combination of gemcitabine, sunitinib, and denosumab. She had a stabilization disease and a prolonged progression-free survival of 9 months. Side effects were manageable and included grade 2 fatigue and grade 2 hypertension. The patient died at 13 months from diagnosis after disease progression. This report suggests that the appropriate treatment for this association in metastatic or unresectable disease is chemotherapy for pancreatic cancer and tyrosine kinase inhibitor for kidney cancer. We also review the appropriate literature concerning that association.

Inflammatory myofibroblastic tumor of the lacrimal gland: case report of an exceptional location

BackgroundInflammatory myofibroblastic tumour (IMT) is a mesenchymal neoplasm of intermediate biological potential that may affect a wide range of anatomic sites but has a particular predilection for the lung and intra-abdominal soft tissues.Case presentationWe report here an exceptional case of inflammatory myofibroblastic tumor arising in the lacrimal gland and presenting as an orbital mass in a 24-year-old male.ConclusionThis report aims to discuss the importance of histopathological and immunohistochemical findings in arriving at the diagnosis, which helps dictate the management, treatment and prognosis of the patient.

Paraneoplastic syndromes revealing ovarian teratoma in young and menopausal women: report of two cases

Paraneoplastic syndromes are a heterogeneous group of clinical and biological manifestations caused by underling neoplasms. They can reveal ovarian teratoma which express neuroendocrine proteins, or contain mature or immature neural tissue inducing an autoimmune response. The etiological investigation is then crucial to early identification of the tumor in order to optimize the prognosis and to limit neurological sequelae. In case of ovarian teratoma, management is essentially based on surgical resection sometimes associated with immunotherapie. We report two new cases of ovarian teratoma revealed by paraneoplastic syndromes in young and menopausal woman.

Malignant Pilomatricoma: Two New Observations and Review of the Relevant Literature / Malign Pilomatrikoma, İki Yeni Gözlem ve İlgili Literatürü Gözden Geçirme

ABSTRACT Malignant pilomatricoma or pilomatrical carcinoma is a rare malignant hair follicle neoplasm. This tumor is locally aggressive with increased tendency to recur, but a low metastatic potential. Its histopathological diagnosis is difficult and based on a detailed evaluation of the infiltrative nature, the importance of the mummified and necrotic cell component, atypical mitoses, and perineural or vascular invasion. Surgical wide resection is the recommended treatment. It reduces the risk of focal recurrence by 50%. Here we report two new cases including one that occurred on a lesion initially diagnosed as benign pilomatricoma. ÖZ Malign pilomatrikoma ya da pilomatrikal karsinom, nadir görülen bir malign kıl follikül neoplazmıdır. Bu tümör, artmış nüks eğilimi olan lokal agresif bir tümördür ancak metastaz potansiyeli düşüktür. Tümörün infiltratif yapı, mumifiye ve nekrotik hücre komponenti, atipik mitozlar, perinöral veya vasküler invazyon temelinde gerçekleşen histopatolojik tanısı zordur. Tedavide geniş cerrahi rezeksiyon önerilmektedir. Bu tedavi, lokal nüksü %50 oranında azaltır. Bu makalede, biri başlangıçta benign pilomatrikoma tanısı almış, iki yeni olgu sunulmuştur