S. Bennis

Carcinome épidermoïde de la vésicule biliaire: à propos d’un cas

Squamous cell carcinoma (SCC) of the gall bladder is rare and aggressive. It accounts for only 1% of gall bladder tumours and 3.3% of malignant tumours. It is associated with a poor prognosis, maximum length of survival being 6 months. It characteristically presents rapid invasive growth and a high incidence of local infiltration and hepatic metastases. Histogenesis is still controversial. We report a case of a 60-year-old woman, presenting angiocholitis with gallstones. The histological examination revealed a squamous cell carcinoma of the gall bladder. This case reinforces the idea that early diagnosis is the most important parameter for improving the survival indices among patients with SCC of the gallbladder. Our focus is to discuss the epidemiological, clinical, histological and therapeutical aspects of SCC of the gall bladder.RésuméLe carcinome épidermoïde de la vésicule biliaire est une tumeur très rare. Il représente 1 % des tumeurs de la vésicule biliaire et 3,3 % des tumeurs malignes vésiculaires, avec seulement une trentaine de cas rapportés dans la littérature. Il s’agit d’une forme histologique agressive d’évolution rapide avec des métastases viscérales précoces. L’histogenèse est toujours controversé e. Son pronostic est sombre avec une survie ne dépassant pas six mois. Nous rapportons l’observation d’une patiente de 60 ans, admise dans un tableau d’angiocholite sur lithiase de la vésicule biliaire, et dont l’examen anatomopathologique systématique de la pièce opératoire a révélé un carcinome épidermoïde de la vésicule biliaire. Vu la rareté de cette entité histologique et son évolution fatale, un diagnostic précoce est indispensable pour améliorer la survie. Notre objectif à travers cette observation est de discuter les aspects anatomocliniques, l’histogenèse et le traitement de cette entité inhabituelle.

Astroblastoma – a rare and challenging tumor: a case report and review of the literature

BackgroundAstroblastoma is a controversial and an extremely rare central nervous system neoplasm. Although its histogenesis has been clarified recently, controversies exist regarding its cellular origin and validity as a distinct entity. Because of its extreme rarity and because its common features are shared with other glial neoplasms, this tumor is prone to misdiagnosis and remains challenging not only in terms of diagnosis and classification but also in the subsequent management. This case report describes a new case of astroblastoma. It discusses clinical, radiologic, pathological, and therapeutic features and differential diagnosis of this rare neoplasm, with a review of the recent literature.Case presentationWe report the case of an 8-year-old Moroccan girl who presented with a 1-year history of epileptic seizure, headache, and decreased visual acuity. Cranial magnetic resonance imaging revealed a right occipito-temporal mass. A tumor resection was performed and histological examination combined with immunohistochemical study confirmed the diagnosis of low-grade astroblastoma.ConclusionsAstroblastoma is a very rare primary brain tumor. Its diagnosis is often challenging because of the astroblastic aspects that can be found in astrocytic tumors, in ependymomas, and in non-neuroepithelial tumors. Considerable confusion surrounds its histogenesis and classification. The low incidence rate makes it difficult to conduct studies to examine tumor characteristics.

The Assessment of HER2 Gene Status by Fluorescence In Situ Hybridization in Invasive Breast Carcinomas With Equivocal HER2 Immunostaining: Experience From a Single Institution:

Background. A subset of breast carcinomas harbors overexpression of the human epidermal growth factor receptor 2 (HER2). Fluorescence in situ hybridization (FISH) should be performed in breast carcinomas with equivocal HER2 immunostaining (immunohistochemistry [IHC] HER2 2+). The aim of our study is to investigate clinicopathologic factors associated with HER2 status in breast invasive carcinomas with IHC HER2 2+ through FISH analysis. Methods. This is a retrospective study including the FISH analysis of 111 patients with invasive breast carcinomas with equivocal HER2 immunostaining. Results. The mean age was 49.51 ± 10.48 years, and invasive breast carcinoma of no special type was the most histological type in our study (96.4%). Most patients had tumors positive for hormones receptors (88.2% positive for estrogen receptor and 81.4% for progesterone receptor). On FISH, the HER2 amplification rate was 22.5%. There was no significant association of HER2 status with any clinicopathologic factors (P > .05). Conclusions. Our study shows that there are no reliable clinicopathologic factors to predict the HER2 status in breast tumors with equivocal HER2 immunostaining, supporting the necessary usage of FISH in such circumstances.

EWSR1 Rearrangement and CD99 Expression as Diagnostic Biomarkers for Ewing/PNET Sarcomas in a Moroccan Population

Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) are a group of round cell tumors. Malignant round cell tumors form a large and diverse group that includes rhabdomyosarcoma, synovial sarcoma, non-Hodgkins lymphoma, neuroblastoma, hepatoblastoma, Wilms tumor, desmoplastic small round cell tumor, and other morphologically similar entities. Differential diagnosis of Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) is difficult. In addition to morphology and immunohistochemistry (IHC), differential diagnosis of these tumors is based on molecular analysis of the EWSR1 gene rearrangement using fluorescent in situ hybridization (FISH) technique. We investigated the diagnostic value of combined CD99 immunostaining and EWSR1 t(22q12) alteration using a dual-color, break-apart rearrangement probe in forty-one formalin-fixed paraffin-embedded (FFPE) tissue samples from pediatric and adult patients diagnosed with EPS. IHC was performed in all cases using the CD99 antibody and showed a positivity of 92.7% in the enrolled cases (38/41) followed by FISH analysis where 48.8% of the cases (20/41) were rearranged. Sensitivity and specificity for IHC assays were 88% and 58%, respectively. Notably, FISH had a sensitivity of 100% and a specificity of 87%. In addition, CD99 positivity was found to correlate with EWSR1 rearrangement (p < 0.05). This report shows that FISH has better sensitivity and specificity than IHC in the Moroccan population, and supports its combination with CD99 immunostaining as diagnostic biomarkers for this rare malignant entity.”

Métastase cérébrale à partir d’un carcinome du col utérin: à propos d’un cas

The occurrence of brain metastasis from a cervix carcinoma is extremely rare. It accounts only for 0.5 to 1.2% of the cases in earlier literature. Its prognosis is poor. We report the clinical history of a 45-year-old woman diagnosed with squamous cell carcinoma of the cervix and who developed an isolated right frontal lobe metastasis after one year of treatment of the primary disease. Intracranial hypertension was the predominant clinical symptom. The patient underwent surgical excision of the cerebral metastasis completed by adjuvant radiotherapy. The disease course was marked by the death of the patient six months later.RésuméLa survenue d’une métastase cérébrale à partir d’un carcinome du col utérin est extrêmement rare et ne représente que 0,5 à 1,2 % dans les différentes séries rapportées. Son pronostic reste pauvre. Nous rapportons l’observation clinique d’une jeune patiente de 45 ans, opérée pour un carcinome épidermoïde du col utérin et qui présente une année plus tard une métastase cérébrale frontale droite. La symptomatologie clinique était dominée par le syndrome d’hypertension intracrânienne. Notre patiente a bénéficié d’une résection chirurgicale complétée par une radiothérapie. L’évolution a été marquée par le décès de la patiente apre`s une durée de six mois.

Tumeur primitive inhabituelle de l’ovaire : lymphome malin non hodgkinien : à propos d’un cas

Non-Hodgkin primary ovarian lymphoma is an extremely rare tumour of which the histogenesis remains debated. Some authors consider it the manifestation of a generalized lymphoma disease. The prognosis is evaluated on the basis of the clinical stage, the histological type and the phenotype.Wepresent the case of a 13-year-old girl who presented with pelvic pain. Pelvic ultrasonography and tomography confirmed the ovarian origin. The diagnosis of B diffuse large cell lymphoma was established from the anatomic specimen after exploratory laparotomy and pathologic examination. Problems related to this rare entity are discussed in terms of diagnosis and therapy.RésuméLe lymphome non hodgkinien primitif de l’ovaire est une tumeur rare dont l’histogenèse est controversée. En effet, certains auteurs le considèrent comme une manifestation initiale d’une maladie lymphomateuse généralisée. Son pronostic dépend de plusieurs facteurs, notamment du stade clinique, du type histologique et du phénotype. Nous rapportons le cas d’une jeune patiente de 13 ans présentant des douleurs pelviennes et dont l’examen objective une masse ovarienne confirmée à l’échographie et à l’examen tomodensitométrique. La patiente a bénéficié d’une annexectomie gauche dont l’examen histologique et immunohistochimique étaient en faveur d’un lymphome ovarien de haut grade de phénotype B. Notre objectif, à travers ce cas, est de soulever les problèmes diagnostiques et thérapeutiques de cette entité rare.

Carcinome métaplasique sein: à propos de cinq cas

Metaplastic carcinoma of the breast is a rare and heterogeneous group of malignancies that accounts for less than 1% of all breast cancers. The histogenesis remains unknown. Clinical and radiological appearances are not specific. The treatment is based on surgery associated to radiation therapy and chemotherapy. There is no place for hormone therapy. The prognosis is poor. The diagnosis is based onmorphological and immunochemical findings. We report five cases of metaplastic carcinoma of the breast originating from an anatomopapthology laboratory, with a literature review.RésuméLes carcinomes métaplasiques du sein sont des tumeurs rares et hétéroge`nes, représentant moins de 1 % des tumeurs mammaires. Leur histogene` se reste obscure. Les aspects cliniques et radiologiques ne sont pas spécifiques. Le traitement associe la chirurgie, la radiothérapie et la chimiothérapie. L’hormonothérapie n’a pas de place. Le pronostic est sombre. La confirmation diagnostique repose sur l’étude histologique et immunohistochimique. Nous rapportons cinq cas de carcinomes métaplasiques du sein, colligés au service d’anatomopathologie avec une revuedela littérature.