Management of Cisplatin-Induced Encephalopathy: A Case Report and Literature Review.

Cisplatin is a cancer therapy drug commonly used. It is well-known for its antineoplastic properties, as well as for its numerous adverse effects, particularly its neurotoxicity. Symptoms associated with a central nervous system injury are unusual but can present a diagnostic challenge. Here, we report a case of a 62-year-old patient who was diagnosed with undifferentiated nasopharyngeal carcinoma. Cisplatin-based chemotherapy was administrated. Five days following the second cycle of treatment, the patient presented neurological disorders. A full biological workup and brain imaging were requested and revealed no abnormalities. The diagnosis of cisplatin encephalopathy was then suspected. Twenty days after cessation of cisplatin therapy, the neurological symptoms began to improve. Based on our case and a review of the literature, cisplatin-induced encephalopathy remains unusual. Its diagnosis is based on a combination of clinical, biological, and radiological criteria and requires the exclusion of other etiologies for neurological disorders in a patient being treated for cancer. Treatment is symptomatic and depends on stopping cisplatin therapy. These neurological adverse effects are often transitory and disappear without major repercussions.

Uterine Leiomyosarcoma in a 22-Year-Old Young Woman: A Case Report.

Leiomyosarcoma is one of the rarest types of gynecological cancer. It is a relatively rare condition that affects young women. The most frequent symptom of this disease is vaginal bleeding. The primary treatment for localized disease is still surgical intervention. It is widely recognized that leiomyosarcoma has a poor prognosis, with reduced survival rates and a high likelihood of early recurrence. This report presents a case of uterine leiomyosarcoma in a 22-year-old female patient. Following a total hysterectomy and bilateral salpingo-oophorectomy, the diagnosis of leiomyosarcoma was confirmed through a histopathological examination of the surgical specimen.

Malignant Transformation of Reese's Melanosis: A Case of Conjunctival Melanoma and Related Therapeutic Modalities.

Conjunctival melanoma is a rare but aggressive condition that can arise from healthy conjunctiva, pre-existing nevi, or precancerous conditions like Reese's melanosis. This acquired primary conjunctival melanosis can significantly impact an individual's quality of life due to its potential for recurrence and metastasis. Effective treatment typically requires a multidisciplinary approach to optimize outcomes. We present the case of a 56-year-old patient with recurrent Reese melanoma who underwent multiple surgeries. During the last intervention, a malignant transformation into melanoma was discovered. Due to the absence of brachytherapy facilities, the patient received local treatment with mitomycin C eye drops. Despite this limitation, the patient showed no signs of recurrence one year post-treatment. Given the high risk of local recurrence after surgery alone, additional radiotherapy is recommended and should be systematically discussed. Regular monitoring and timely intervention are essential to prevent disease progression. Notably, the frequent BRAF (B-Raf proto-oncogene, serine/threonine kinase) mutation in conjunctival melanoma opens possibilities for targeted therapies, such as BRAF inhibitors, offering promising options for management alongside traditional surgical approaches.

A Pigmented Lesion of the Vulva Revealing Aggressive Melanoma: A Case Report.

Vulvar melanoma (VM) is a rare and aggressive malignancy presenting unique challenges in diagnosis and management. This report presents the case of a 61-year-old female patient and explores the clinical characteristics, diagnostic modalities, treatment strategies, and prognosis associated with VM. The patient presented with a painless mass on the labia majora, which turned out to be an undifferentiated malignant tumor process consistent with melanoma on examination. Immunohistochemical analysis confirmed the diagnosis and subsequent imaging revealed metastatic disease necessitating palliative chemotherapy following radiotherapy. VM is a rare and aggressive form of melanoma. While surgery is the standard of care for early stages, advanced stages require a combination of immunotherapy and targeted treatments. Clinical trials are vital to improve our understanding of this condition and the various aspects of its care. Collaboration among experts is essential to achieve progress in managing these patients.

Jaundice and Higher Procalcitonin Level Revealing a Small-Cell Lung Cancer With Pancreatic Metastasis: A Case Report From Eastern Morocco.

Small-cell lung cancer (SCLC) is highly aggressive, with a severe tendency for metastasis. Pancreatic metastasis in SCLC is uncommon, also jaundice as a major symptom of small-cell lung cancer is even rarer. The diagnosis of pancreatic metastasis is a real challenge for the medical team, it relies on both radiological and pathological details. We report a case of a 58-year-old male admitted for SCLC with pancreatic metastasis and a higher level of procalcitonin. He received platinum-based chemotherapy with a swell response. The focus of this study will be on the characteristics of pancreatic metastasis, along with their diagnosis and treatment approaches. Procalcitonin as a paraneoplastic syndrome will also be discussed in this study.

Primary Mediastinal Dysgerminoma: A Case Report and Literature Review.

Germ cell tumors are malignant tumors that mostly develop in the gonads. Extragonadal localization is rare and may affect the mediastinal and sacrococcygeal regions. Mediastinal seminoma is a malignant germ cell tumor of the mediastinum. The tumor typically occurs in the anterosuperior mediastinum in males and often has a very slow growth pattern and limited potential for metastasis. And symptoms are not very characteristic, with many patients being asymptomatic and the tumor being discovered incidentally. In this paper, we report the case of a 26-year-old patient admitted for the management of a large anterosuperior mediastinal tumor encasing the vital structures of the mediastinum.

Metastatic Epithelioid Hemangioendothelioma of the Bone: A Case Report and Literature Review.

Epithelioid hemangioendothelioma (EHE) is an extremely rare vascular tumor, which can pose a diagnostic dilemma. It affects women more than men and is mainly found in the liver, lung, and bone. To date, there are no known predisposing factors. Limited data are available on the management of EHE at metastatic stages. The only optimal treatments to prevent metastatic dissemination are surgical resection and amputation in addition to radiotherapy at early stages. The oncologist in this rare entity plays an important role in the guided and standardized management of this disease, especially for advanced stages. In this article, we report the case of a 74-year-old patient admitted with swelling on the outer aspect of the right calf associated with pain and total functional impairment of the limb. The diagnosis favored a high-risk vascular tumor resembling EHE, confirmed by bone (tibia) and soft tissue biopsy. The patient underwent staging investigations, revealing diffuse metastases to the liver, bones, and lungs. The objective of this article is to advocate for oncological intervention in this entity, particularly in the advanced stages of the disease. Despite its rarity, the advancement of clinical trials and therapeutic recommendations remains crucial for optimal treatment.

Synchronous occurrence of primary breast cancer and renal cell carcinoma: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Multiple Primary Malignant Neoplasms (MPMNs) are rare and refer to the occurrence of two or more distinct primary cancers with unrelated histopathological features in one patient. MPMNs can be classified as synchronous when tumors appear simultaneously or within six months of each other, and as metachronous when identified six months or more after the initial cancer diagnosis. While breast cancer often co-occurs with other primary cancers such as colorectal, endometrial, and ovarian cancers, the simultaneous presence of invasive lobular breast carcinoma and clear cell renal cancer is rare. CASE PRESENTATION: Here, we present the case of a 59-year-old postmenopausal woman who initially presented with breast carcinoma. Further investigation revealed a mass in the left kidney. The patient underwent a radical mastectomy and axillary dissection, followed by a left nephrectomy. After 8 months follow up, the patient is doing well and disease-free. CLINICAL DISCUSSION: Based on our case and literature review, the co-occurrence of breast carcinoma with renal cell carcinoma (RCC) is uncommon. Most reported cases involve metastatic tumors or metachronous breast malignancy with RCC. The etiology of synchronous malignancy is complex, and treatment options usually include a combination of surgery and/or adjuvant therapy. CONCLUSION: This case report contributes valuable insights to the limited literature on synchronous breast cancer with renal cell carcinoma. The rarity of this simultaneous occurrence underscores the importance of considering such cases. Documenting these cases is crucial for increasing awareness and reducing the resulting morbidity and mortality.

Neck Epithelioid Sarcoma at an Unusual Location Mimicking Lymph Node Metastases of Nasopharyngeal Carcinoma: A Case Report.

Epithelioid sarcoma (ES) is an uncommon soft tissue sarcoma. It is usually located in the extremities and exceptionally in the neck. Its diagnosis constitutes a real challenge which is based on histology and immunohistochemistry staining that must be interpreted with caution given the anatomopathological similarities to other tumors. In this article, we report a case of a 37-year-old man admitted for a locally advanced ES of the neck. There were suspicions of lymph node metastases of nasopharyngeal carcinoma at the first pathological examination. The patient received palliative chemotherapy and was referred to the supportive care department. Through this case, we will discuss the clinical and anatomopathological characteristics and therapeutic options of this extremely rare tumor which poses a diagnostic challenge.

Unusual Metastasis of Gastric Signet Ring Cell Carcinoma to the Breast: A Case Report of a Young Moroccan Patient.

Although gastric cancer is known to be an aggressive tumor that can spread throughout the body, breast metastases are uncommon. This entity is rarely reported in the literature, with an estimated incidence of 0.5 to 1.3%. We report a case of a rare association between a gastric subtype of signet ring cell carcinoma and metastasis to the breast. This uncommon situation is only documented through case reports. Most breast metastases have been detected after diagnosis of primary gastric cancer, during the first year. Several risk factors have been suggested to explain the aggressive behavior of these tumors, which correlates with very poor prognosis and short survival. We report the case of a 22-year-old female patient presenting with widespread metastatic gastric signet ring cell carcinoma with an unusual secondary site in the breast. The diagnosis was confirmed by immunohistochemistry (IHC) and radiology, and the patient was treated with palliative chemotherapy in accordance with the decision of the multidisciplinary tumor board.

A Case Report of Uterine Müllerian Adenosarcoma With Sarcomatous Overgrowth.

Uterine adenosarcoma remains a highly aggressive tumor and is less described in the literature, with an unfavorable prognosis and an increased risk of local and distant recurrence. However, surgery, chemotherapy, and radiotherapy offer local control of the disease, and overall survival remains reduced. We report the case of a 79-year-old patient with stage IIIB uterine adenosarcoma, confirmed by immunohistochemistry and initially diagnosed with postmenopausal metrorrhagia. The patient was managed through a multimodal treatment by conducting a multidisciplinary consultation.

A testicular mass found to be a rare testicular adult-type granulosa cell tumor: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Granulosa cell tumors (GCTs) are rare tumors, which mostly affect the ovaries. GCTs are classified into two types: juvenile and adult. Adult testicular GCTs are potentially malignant sex cord-stromal tumors. CASE PRESENTATION: Here, we report a case of a 63-year-old man who presented with a right testicular nodule. Testicular ultrasound showed a hypoechoic tissue mass, measuring 3 cm and hyper vascularized in the color Doppler. A radical orchidectomy was performed. Histology showed a typical adult-type Granulosa cell tumor. After 12 months follow up, the patient is doing well and disease-free. CLINICAL DISCUSSION: According to our case and a review of the literature, this type of tumor is an uncommon and slow-growing neoplasm. The diagnosis is confirmed by histology, treatment is based on surgery, radical orchidectomy. Long-term follow-up of patients is essential because distant metastases may emerge late in the clinical course. CONCLUSION: This case report adds valuable insights to the limited literature on adult testicular Granulosa cell tumors. Radical orchidectomy remains the optimal treatment, and early diagnosis, coupled with surgery, significantly enhances prognosis.

Undifferentiated Sarcoma: A Rare Tumor of the Prostate.

Prostate cancer is the most common malignant tumor in men. The vast majority of prostate tumors are represented by prostatic adenocarcinomas (up to 95%). Sarcoma is a very rare tumor in adults with a formidable prognosis. Early diagnosis and radical surgery offer patients the best chance of a cure. We report the case of a 44-year-old patient with stage VI unresectable high-grade undifferentiated prostate sarcoma, initially presenting with urinary disorders and a large pelvic mass of prostatic origin, with normal Prostate-specific antigen (PSA) levels. The patient was managed by palliative chemotherapy.

Unusual Synchronous Colonic Metastasis of Ovarian Cancer.

Colorectal metastasis is rare and can be confused with primary colorectal cancer. We report the case of a 63-year-old patient who presented with synchronous metastasis of the rectosigmoid junction and ovarian cancer. Initially thought to be a Krukenberg tumor, the diagnosis of metastasis from ovarian origin was confirmed through an immunohistochemical study of the colonic biopsy.

An Extranodal Site of Diffuse Large B-cell Lymphoma Presenting as Ovarian Cancer.

Due to its uncommon nature, primary ovarian lymphoma has no clinical particularities and can be confused with other ovarian cancers. It poses a twofold diagnostic and therapeutic challenge. An anatomopathological and immunohistochemical study is the crucial step in the diagnosis. Our case was a 55-year-old woman diagnosed with an Ann Arbor stage II E ovarian non-Hodgkin's lymphoma who initially presented with a painful pelvic mass. This case reflects the major role of an immunohistochemical study in the diagnosis workup, leading to the appropriate management of such rare tumors.

Unusual Metastasis From Breast Cancer: Case Report.

Metastatic breast cancer among young women represents a serious public health issue. The most frequent sites of dissemination are bone, liver, lung, lymph nodes and brain. Bladder location is extremely unusual. We present the case of a 33-year-old female who was receiving palliative chemotherapy for bilateral metastatic invasive lobular cancer. Following episodes of macroscopic hematuria, a CT scan was performed, which revealed a suspicious thickening of the bladder wall. After an endoscopic resection with immunohistological analysis, the diagnosis was confirmed. Voiding symptoms in a woman with a history of breast cancer should be evaluated to rule out a secondary urinary tract lesion. As soon as the diagnosis is determined, appropriate therapy should be initiated.

A Report of a Rare Case of an Advanced Adult Granulosa Cell Tumor Initially Diagnosed as Primary Ovarian Melanoma.

Ovarian granulosa cell tumors are rare gynecological cancers with favorable clinical evolution and survival outcomes. We report a new case of this presentation in a patient that was initially diagnosed as a bilateral primary melanoma of the ovary. The patient is a 51-year-old woman with a history of abdominal swelling and deterioration of her general conditions. Physical examination revealed abdominal distension and diffuse dullness with initially highly elevated cancer antigen 125. Contrast-enhanced thoracoabdominal-pelvic computed tomography showed a left-sided ovarian mass and abundant ascites and pleurisy. Ex-lap surgery found two large bilateral ovarian masses associated with peritoneal carcinomatosis and highly abundant ascites. The histopathological examination of the omental biopsy revealed an undifferentiated tumor proliferation of cells with highly positive Human Melanoma Black 45 marker in favor of an achromic malignant melanoma according to the pathologist. Because of her advanced disease, the patient received a combination of six cycles of neoadjuvant dacarbazine, cisplatin, and paclitaxel and showed partial response based on the response evaluation criteria in solid tumors, followed by total abdominal hysterectomy and bilateral salpingo-oophorectomy with cytoreductive surgery. Unexpectedly, the histopathological analysis of the surgical specimens was in favor of an advanced adult granulosa cell tumor with positive inhibin B. Our patient is alive at her 13th month of survival and is being followed by the oncology team. The challenges of the pathological diagnosis of this case are discussed. The diagnosis of primary ovarian melanoma should not be based on one immunohistochemical marker only. A single biopsy of omental implants in peritoneal carcinomatosis during ex-lap surgery should be avoided.

Does Adjuvant Chemotherapy for Locally Advanced Resectable Rectal Cancer treated with Neoadjuvant Chemoradiotherapy have an impact on survival? A Single Moroccan Institute Retrospective Study.

BACKGROUND: In the locally advanced stage, the prognosis of rectal cancer was improved by preoperative chemoradiotherapy and radical surgery including complete total mesorectal excision. At present, the place of adjuvant chemotherapy remains controversial. We aimed to assess the impact of this chemotherapy on our patient survival. METHODS AND MATERIALS: This is a retrospective study including patients with locally advanced resectable cancer in the middle and low rectum, treated by neoadjuvant chemoradiotherapy and radical surgery including complete total mesorectal excision at the Medical Oncology Department of the University Hospital Mohammed VI-Oujda, Morocco over a period of six years from January 2007 to December 2012. Patients were divided into two groups: with chemotherapy (Group A) and without it (Group B). In group A, adjuvant chemotherapy was started 4-8 weeks after surgery, constituted of CAPOX (Capecitabine and oxaliplatin) or Capecitabine alone for 8 cycles. We assessed the median overall survival (OS), the median disease-free survival (DFS), the 3-year OS and the 3-year DFS in both groups. RESULTS: Forty patients were included in this study. Nineteen patients in group A: CAPOX (n= 14), Capecitabine alone (n=5). Twenty-one patients in group B. After a median follow-up of 57 months (range 7-129). Median OS was 94 months in the group A and 119 months in group B [HR = 1.773, 95% CI: 0.759-1.773; P =0.186]. Median DFS was 30 months in group A and 17 months in group B [HR= 1.898, 95% CI: 0.634-5.683; P =0.252]. 3-year OS was 86.4% in group A and 92.5% in group B [HR= 1.549, 95% CI: 0.548- 4.383; p= 0.409]. 3-year DFS was 66.7% in group A and 57.2% in group B [HR=2.166, 95% CI: 0.712- 6.591; p= 0.173]. CONCLUSION: Although there are some limitations in our study, namely its retrospective design and small size of the cohort, adjuvant chemotherapy for locally advanced resectable rectal cancer treated with neoadjuvant chemoradiotherapy did not improve OS nor DFS.

[Lung cancer in Eastern Morocco: where do we stand?] / Cancer du poumon au Maroc Oriental: où en sommes-nous?

INTRODUCTION: Lung cancer is the most common cancer in men living Eastern Morocco. We here present the first report on the clinical, pathological and therapeutic features of lung cancer in Eastern Morocco. METHODS: We conducted a retrospective study of 738 patients diagnosed with lung cancer at the Hassan II, Oncology Center between October 2005 and December 2014. RESULTS: Among the cases studied, 671 patients were men and 67 women; 95.01% of men and 1.54% of women were smokers. The average age of patients was 59.1 ± 11.9 years. Most patients (97%) were diagnosed at advanced stage disease. Only 4 out of 227 patients with advanced adenocarcinoma underwent molecular test. In addition, no patient in our series received targeted therapy. In this series, 20.46% of patients had less than 50 years. Compared to patients aged 50 years and older, cannabis consumption was higher (p<0.001) in patients less than 50 years and as well as a higher rate of adenocarcinoma (p<0.01). By contrast, in these patients, tobacco consumption was lower (p<0.001) as well as the rate of squamous cell carcinoma (p<0.01) and small cell cancer (p<0.05). CONCLUSION: Unlike Western countries, in Eastern Morocco lung cancer is diagnosed late, affects younger people and access to molecular tests is still very limited. These results justify the need to implement effective programs against lung cancer as well as to facilitate access to molecular tests and new therapeutic tools in Eastern Morocco.

[Medical oncology: is it a new medical speciality in Africa?] / L'oncologie médicale, nouvelle spécialité en Afrique?

Cancer is a major public health problem in Africa. Advances in the treatment of cancers over the last decade are undeniable. Multidisciplinary approach is essential for improved patient's management. Medical oncology is a recently-recognized speciality in Africa Indeed, many African countries do not have doctors or a sufficient number of doctors qualified to practice in this medical specialty. The fight against cancer in Africa involves oncology speciality training and the development of curricula in order to ensure optimum patient management.