T. Kebdani

Carcinome adénoïde kystique du nasopharynx : à propos d’un cas

Nasopharyngeal adenoid cystic carcinoma is a rare tumor, few cases have been reported in the literature. The aim of this report is to present a new case of an adenoid cystic carcinoma of the nasopharynx. We report the case of a 50 years-old woman presenting with an adenoid cystic carcinoma of the nasopharynx with diffuse pulmonary metastasis. The treatment combined chemotherapy, based on cisplatin and adriamycin drugs, and palliative radiation therapy at the dose of 30 Gy. The patient died 6 months after diagnosis establishment. The best treatment of adenoid cystic carcinoma is complete surgical resection but extended resection can be difficult in some locations as nasopharynx. The adjuvant radiation therapy seems to improve local control.

Cerebellous metastases in patients with uterine cervical cancer. Two cases reports and review of the literature

Brain metastases from cervical cancer are extremely rare. We report on two patients who developed cerebellous metastases following uterine cervical cancer. The interval between diagnosis of the primary cancer and diagnosis of brain metastasis was 8 months. The main complaint was symptoms of increased intracranial pressure and cerebellous syndrome. Surgical excision of the brain lesion followed by radiation therapy was performed in the first case. The second patient received palliative radiation therapy. The first patient died 8 months after diagnosis. The second patient is alive 2 months after diagnosis.

Isolated thyroid metastasis revealed an unknown lung adenocarcinoma: a case report

IntroductionCancer metastasis to the thyroid is extremely rare. The most common sites that have been reported to metastasize to the thyroid gland are breast and kidney. As to primary lung cancer metastasizing to the thyroid gland, only a few cases have been described in the literature.Case presentationWe report a case of a 37-year-old white Arabian woman who had never smoked tobacco products for whom a malignant thyroid mass revealed a primary lung tumor. She had a surgical excision for both the thyroid and the pulmonary tumors, and received adjuvant chemotherapy. At 1 year, she is still in remission.ConclusionsOur case is rare as it describes a case where the thyroid lesion was the revealing sign of an unknown lung carcinoma. Management of thyroid metastases should depend on the individual situation and surgical excision should be proposed whenever a patient’s condition is favorable.

Chimioradiothérapie concomitante des tumeurs infiltrantes de la vessie : acquis, controverses et perspectives

Radical cystectomy with lymphadenectomy is currently the standard of care for muscle-invasive urothelial bladder cancer; however and because of its morbidity and its impact on quality of life, there is a growing tendency for bladder-sparing strategies. Initially reserved for elderly or unfit patients unable to undergo radical cystectomy, chemoradiotherapy became a true alternative to surgery for highly selected patients. Although there are no randomized trials comparing radical cystectomy with bladder preserving approaches, surgery remains the preferred treatment for many clinicians. Furthermore, comparison is even more difficult as modalities of radiotherapy are not consensual and differ between centers with a variability of protocols, volume of irradiation and type of chemotherapy. Several ongoing trials are attempting to optimize chemoradiotherapy and limit its toxicity, especially through techniques of adaptive radiotherapy or targeted therapies.

Intra Peritoneal Malignant Triton Tumor: A Case Report and Literature Review

BACKGROUND: Malignant triton tumor (MTT) is a variant of the typical malignant peripheral nerve sheath tumors with rhabdomyoblastic differentiation what mostly occur in the context of neurofibromatosis type 1. CASE PRESENTATION: Here, we report on a case of a 15-year-old male with a clinical history of neurofibromatosis type 1 who presented to the pediatric emergency department with an intraperitoneal tumor of about 20 cm of diameter. The biopsy of this tumor confirmed histology of rhabdomyosarcoma. The patient received six cycles of chemotherapy. After that, resection of the tumor was performed. Histological findings revealed a malignant peripheral nerve sheath tumors (MPNST) of Triton type. Then he received 28 sessions of radiation therapy. The child died 11 months after radiation therapy. CONCLUSION: Malignant triton tumor is a very aggressive tumor. A multidisciplinary approach is required for diagnosis and treatment of this rare pediatric tumor.

Erratum to: Métastase vertébrale révélatrice d’un adénocarcinome rectal : à propos d’un cas

Cet article du Journal africain d’hépato‑gastroentérologie s’est vu malencontreusement publié dans la liste des articles Online First d’une autre revue, à la suite d’une erreur d’identification numérique. L’éditeur présente ses excuses aux auteurs et aux lecteurs pour ce désagrément.

Radical Mastectomy Increases Psychological Distress in Young Breast Cancer Patients: Results of A Cross-sectional Study

Micro‐Abstract The present cross‐sectional study aimed to detect the effect of breast cancer surgery on the psychological state of 122 young women aged < 45 years. We found that mastectomy was an independent factor associated with greater rates of psychological distress, increasing the interest of early detection in third world countries to allow for more breast conservative procedures. Introduction: The present study aimed to detect the factors associated with psychological distress (PD) in young Moroccan patients with breast cancer, with a special focus on the type of surgical procedure. Patients and Methods: We collected social, demographic, and clinical data from female patients, aged < 45 years, with localized stage breast cancer who had undergone either radical mastectomy or conservative surgery and for whom adjuvant chemotherapy was indicated. We used the Hospital Anxiety and Depression Scale (HADS) to assess the psychological status. The relationship between the variables and PD was analyzed using simple and multiple logistic regression analyses. Results: A total of 122 women were enrolled, of whom 41 (33.6%) had a HADS global score ≥ 15. The HAD anxiety and depression subscores were ≥ 11 for 10 (8.2%) and 8 (6.6%) patients, respectively. On multivariate analysis, adjusted for marital status and receipt of analgesic and/or anxiolytic treatment, we found that radical mastectomy (odds ratio [OR], 5.747; 95% confidence interval [CI], 1.342‐24.608), living in a difficult emotional (OR, 7.366; 95% CI, 1.727‐31.41) and/or financial (OR, 16.521; 95% CI, 3.574‐76.36) situation, and a lack of social and/or family support (OR, 19.617; 95% CI, 3.549‐108.43) were independent factors associated with PD. Conclusion: Breast‐conserving surgery should be performed whenever possible for young women to avoid the psychological repercussions of radical procedures.

Concomitant Radiochemotherapy in the Management of Nasopharyngeal Carcinoma

Purpose To develop the results of concomitant radiochemotherapy in management of nasopharyngeal carcinoma (NPC) to the National Institute of Oncology at Rabat. Materials and methods Retrospective study of 81 patients with nasopharyngeal carcinoma and who were treated with concomitant radiochemotherapy to the National Institute of Oncology at Rabat in radiotherapy department, for a period of January to December 2012. Results Median age was 43 years old with male dominance to 78,8 %. According to TNM classification passed by AJCC 2010, 43,2% were classified stage IV, 37 % stage III and 19,8 % stage II. Neoadjuvant chemotherapy was indicated in 20 patients (24,7%) or 95% in N2-N3. The Therapeutic result after the neoadjuvant chemotherapy for lymph node was complete in 31,2 %. The concomitant radiochemotherapy treatment consisted in a conformal therapy treatment with lateral 6 MV photon beams dose of 70 Gy in conventional fractioning, and in two series by excluding spinal cord after dose of 40 Gy. We used electrons treatment in addition to treat the lymph nodes. The concomitant chemotherapy consisted of a weekly cisplatin treatment 40 mg/m2. The mean spread was 57,3 days. During the concomitant chemotherapy treatment 60 % of radiomucitis and 30 % nephrotoxicity were observed in patients receiving neoadjuvant chemotherapy. Late toxicities were dominated by hyposcialie (90,1%) and otological disorders (67,9%). After an average follow-up of 30,6 months, we were able to follow the progress of 69 patients (85,2%). Forty-nine patients (75,3%) were in good locoregional control. We observed 20 relapses (24,7 %) including 14 metastatic relapses. The main prognostic factors of metastasis were lymph node involvement in 92,2% (p = 0,04) and T3-T4 stages in 64,2% (p = 0,013). At three years, overall survival at all stages were to 81,9%, survival without recurrence to 71% and local control to 79,2%. Conclusion The nasopharyngeal carcinoma are radiosensitive and radiocurable tumors. Concomitant radiochemotherapy is the therapeutic standard for locally advanced nasopharyngeal carcinoma, and allow to obtain carcinological good results at toxicity notable disadvantage.

Lung cancer: Incidence and survival in Rabat, Morocco

BACKGROUND Lung cancer is the most common cancer worldwide, but epidemiologic data from developing countries are lacking. This article reports lung cancer incidence and survival in Rabat, the capital of Morocco. METHODS All lung cancer cases diagnosed between 2005 and 2008 were analyzed using data provided by the Rabat Cancer Registry. The standardized rate was reported using age adjustment with respect to the world standard population, and the observed survival rates were calculated using the Kaplan-Meier method. RESULTS Three hundred fifty-one cases were registered (314 males and 37 females), aged 27-90 years (median, 59 years). The most common pathological type was adenocarcinoma (40.2%) followed by squamous cell carcinoma (31.9%); the majority of cases were diagnosed at stage IV (52%). The age-standardized incidence rate was 25.1 and 2.7 per 100,000 for males and females, respectively, and the overall observed survival rates at 1 and 5 years were 31.7% and 3.4%, respectively. The clinical stage of disease was the only independent predictor of survival. CONCLUSION The survival rate of lung cancer in Rabat is very poor. This finding explains the need for measures to reduce the prevalence of tobacco and to improve diagnostic and therapeutic facilities for lung cancer.