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.

Cancer in Moroccan elderly: the first multicenter transverse study exploring the sociodemographic characteristics, clinical profile and quality of life of elderly Moroccan cancer patients.

BACKGROUND: Moroccan incidence of cancer is increasing with the lengthening of life expectancy. Data regarding elderly Moroccan cancer patients are lacking. In the context of our project aiming to develop an adapted version of the Comprehensive Geriatric Assessment CGA to the Moroccan population, we launched the first Moroccan multicenter transverse study to explore the characteristics of elderly Moroccan cancer patients. METHODS: The study was conducted in nine Moroccan medical oncology departments. Patients were enrolled over 4 months. Inclusion criteria were patients aged 65 years or over with verified solid cancer. The questionnaire included four sections: socio-demographic and economic data, clinical data, vulnerability and EORTC-QLQ C30. We explored the entire included population. Then, we compared the results according to age (65-70 years old and ≥ 71 years old) and sex. We also explored the correlation between G8 scores and the ability to practice religion as an indicator of fitness level. RESULTS: In total, 164 patients were enrolled. The mean age was 73.18 ± 6.01 years. The majority of patients were married, lived with their children and received their financial income from them. Fifteen percent of families asked to hide the diagnosis from the patient. Breast (23%), colorectal (15.9%) and lung (14%) cancers were the most frequent, and 83.5% had an abnormal G8. The majority of the patients were independent for basic daily activities. Female patients had poorer social and economic conditions. Abnormal G8 was correlated with religious practice and quality of life scores. CONCLUSION: This is the first multicenter prospective study designed to collect data on the lifestyle and clinical profiles of elderly Moroccan cancer patients as an Arab and Muslim population. Our study shows that it is a well-cared-for population with strong social ties. However, there is deep economic vulnerability, especially among women, requiring urgent care. Religious practice is an important daily activity for our elderly patients and should be included in the Moroccan CGA.

Paranasal gossypiboma mimicking an aggressive tumor: a case report.

Even if gossypibomas are extremely rare in the Oro-Maxillofacial region, they should be evoked in bizarre tumors when repeated histology tests are not contributive, especially in patients with a history of dento-sinusal surgery. As it is recommended in general surgery, gauzes should be carefully counted when used in dentistry.

Sarcomatoid Carcinoma of the Maxilla: A Case Report with Literature Review.

Sarcomatoid carcinoma is a very rare malignant and aggressive tumor that can involve the maxillary sinus. We report the case of a 46 y/o male who presented a tumor of the right maxillary sinus with extension to the right nasal cavity. The diagnosis of sarcomatoid carcinoma was set by histology and immunohistochemistry. The patient received concomitant cisplatin based chemoradiotherapy with no response after 3 months of treatment. He died 6 months later. Through the present case and the review of literature we discuss all aspects of this entity: clinical presentation, differential diagnoses, pathology, treatment and prognosis.

[Granulosa cell tumors of the ovary]. / Les tumeurs de la granulosa de l'ovaire.

Ovarian granulosa cell tumors (TGO) are rare neoplasms. They arise from sex cord stromal cells of the ovaries. They are characterized by their slow natural history, and their tendency to relapse long time after the initial diagnosis. Complete staging surgery of the disease is the cornerstone of treatment. Chemotherapy is indicated for localized tumors with a high risk of recurrence, and for recurrent or advanced tumors. Prolonged follow-up is recommended.

Ovarian granulosa cell tumors: a retrospective study of 27 cases and a review of the literature.

BACKGROUND: Granulosa tumors were described for the first time in 1855 by Rokitansky. These tumors are malignancies with a relatively favorable prognosis. They are characterized by a prolonged natural history and a tendency to late recurrences. The aim of this study is to investigate the epidemiological and pathological characteristics of granulosa cell tumors and to investigate the prognosis factor for recurrences. METHODS: The clinical data of patients who were treated in the period from January 2003 to December 2010 at the National Institute of Oncology in Rabat, Morocco for adult granulosa cell tumors of the ovary were investigated retrospectively. Data for age, clinical manifestation, imaging, diagnosis and treatment of the patients were reviewed and analyzed. Post-operative histology was obtained for all patients. RESULTS: Twenty-seven cases were retrieved. The median patient age was 53 years. The most common clinical manifestations at diagnosis were abdominal pain and vaginal bleeding. Mean tumor size was 14 cm. The majority of patients had stage I (63%, n = 17), while (18,5%, n = 5) had stage III, (7.4%, n = 2) had stage IV, and (11%, n = 3) of patients had an unknown stage. In the follow-up period (median = 63.44 months), five (18.51%) patients relapsed. The median time to relapse was 41.8 months, (range: 18 to 62 months). CONCLUSIONS: Granulosa cell tumor of the ovary is an uncommon neoplasm. The adult form progresses slowly and often is diagnosed in an early stage of disease. Surgery is indicated. A prolonged post-therapeutic follow-up is necessary because of the risk of recurrences, late and exceptional for the adult form.

Cutaneous metastasis revealing a relapse of gastric linitis: Another case.

INTRODUCTION: Cutaneous metastasis from gastric cancer is a rare occurrence. The linitis gastric carcinoma accounts only 8.7% of all gastric cancers. PRESENTATION OF CASE: We report a case of female patient who was followed for linits cancer with peritoneal metastasis treated by six cycles of chemotherapy. After seventeen months of control, the relapse of the disease revealed by occurrence of cutaneous metastatsis. DISCUSSION: Cutaneous metastasis from linit gastric is rare and the prognostic remains poor. The treatment is palliative. CONCLUSION: This rare presentation should encourage the practitioners to biopsy any suspicion skin lesion.

A rare case of nephrotic syndrome revealing mycosis fungoide managed successfully with chemotherapy.

The occurrence of the nephrotic syndrome during mycosis fungoide is very unusual. We report a rare case of mycosis fungoide revealed by hydrops related to nephrotic syndrom in a 37-year old male patient. He has been admitted to intensive care unit because of a breathing distress and a hydrophobs. Whole body computed tomography scan revealed bilateral axillary, cervical lymph nodes, tumoral infiltration of the subcutaneous tissue in the cervicothoracic and abdominal regions, multiples bilateral pulmonary metastasis, bilateral pleural effusion, and abdominal effusion; the kidneys were normal. The patient was staged IVb (T3N3M1). He was treated with CHOP (cyclophosphamide, Doxorubicin, Vincristin and prednisone). Evolution after eight cycles of chemotherapy was spectacular. The development of nephrotic syndrom secondary to mycosis fungoide is rare. It requires a multidisciplinary approach with nephrologists and oncologists.

Metastatic Ewing's sarcoma/PNET of kidney in 40 year old patient.

INTRODUCTION: Primary renal Ewing sarcoma/PNET is an uncommon and very aggressive tumor. PRESENTATION OF CASE: : We report the case of a young woman who underwent nephrectomy for a renal mass from unknown etiology. Histologic analysis found small tumoral cells in rosette formation, and immunohistochemical staining was positive for CD99, and focally positive for vimentin and Protein S-100. A post operative abdominal computed tomography (CT) scan revealed a residual renal processus with hepatic wounds and abdominal metastatic nodes. After 6 cycles of chemotherapy including Vincristine, Doxorubicin, Cyclophosphamide, the response was considered as good. DISCUSSION: Ewing's sarcoma/PNET of kidney is a member of the family of small round cell tumors and it should be differentiated from Wilms tumor, neuroblastoma, rhabdomyosarcoma and lymphoblastic lymphoma. The principle management of its treatment have been extrapolated from the treatment of osseous Ewing sarcoma of bone. CONCLUSION: Despite aggressive treatment, primary renal Ewing sarcoma/PNET has a poor prognosis. It requires a multidisciplinary approach including oncologists, urologists and radiation oncologists.

[Gastrointestinal stromal tumors]. / Tumeurs stromales gastro-intestinales.

Gastrointestinal stromal tumors (GIST) are the most common sarcomas of the gastrointestinal tract. They affect all segments of the digestive tract. They develop from the interstitial cells of Cajal. Mutations in the Kit gene is present in 86% of cases and in PDGFR gene in 15% of cases. The marker CD 117 is present in 95% of cases. Surgery is the standard treatment in localized forms. The tyrosine kinase inhibitor, imatinib is standard in first-line metastatic gastrointestinal stromal tumors, as well as adjuvant treatment after surgery. Sunitinib is the standard in second line.

Null phenotype non-Hodgkin lymphoma presenting as a large chest wall mass: case report.

Tumors of chest wall represent a variant entity. Most of them arise from metastasis of malignant tumors or from local invasion by contiguity. However, non-Hodgkin's lymphomas of the chest wall are extremely rare; only a few cases have been reported in the literature. We report a case about a Moroccan woman, with non-Hodgkin null phenotype lymphoma of the chest, treated successfully with CHOP (cyclophosphamide, Doxorubicin, Vincristin and prednisone) followed by local radiotherapy.

Granulosa cell tumor of the ovary and antecedent of adjuvant tamoxifen use for breast cancer.

BACKGROUND: Adult granulosa cell tumor associated with antecedent use of tamoxifen as adjuvant hormonotherapy for breast cancer is rare. The pathogenesis of this occurrence remains difficult to explain. The estrogenic effect of tamoxifen can be one such explanation. CASE PRESENTATION: A 47 year-old women was treated with surgery, chemotherapy, radiotherapy and tamoxifen for stage III estrogen receptor positive breast carcinoma. Ten months after stopping tamoxifen, we diagnosed a stage Ic granulosa cell tumor of the ovary. CONCLUSIONS: Use of tamoxifen has been found to be associated with gynecological tumors like endometrial carcinoma. Its association with granulosa cell tumor of the ovary is uncommon. Only two previous cases have been reported in literature.