Long-Term Survival of Bifocal Paraganglioma: A Case Report.

Paragangliomas are sympathetic and parasympathetic para-ganglia neuroendocrine tumors of the autonomic nervous system. We analyzed a bifocal paraganglioma case of a 52-year-old patient in December 2013 with hearing loss and right ear pain, headaches, episodes of vomiting, and abdominal pain ten months before her medical consultation. The diagnosis of a right tympano-jugular glomus paraganglioma was based on cerebral magnetic resonance imaging and treated with radiotherapy. In 2016, the patient presented with worsening digestive symptoms; therefore, a second mesocolic localization was suspected by abdominal computed tomography and was histologically confirmed on the resection specimen of the mass. The surgery was the only treatment. After a follow-up of 11 years, the patient remained in good condition. Paraganliomas are rare tumors, their bifocal location in our patient represents an even rarer entity. Given the nonspecific symptomatology, the diagnosis of the retroperitoneal location simultaneously with that of the head and neck was difficult. Our objective is to emphasize the staging workup for paraganglioma, although it is mostly a benign tumor with slow growth.

Primary Cutaneous Apocrine Carcinoma of the Thigh: A Rare Case Report.

Adnexal carcinomas are rare cutaneous malignancies arising from the eccrine and apocrine sweat glands, follicles and sebaceous glands. They occur mainly in elderly people. We report the case of a patient treated for locally advanced apocrine adnexal carcinoma of the thigh, with a review of the literature. The patient was 69 years old, he complained of pruritus on the anterior region of the left thigh four months ago with the appearance of a homolateral inguinal mass without any other associated signs. A left inguinal adenectomy was performed. After almost 15 days, the left inguinal adenopathy reappeared associated with diffuse erythematous nodules on the anterior region of the thigh. The pathological study suggested an adnexal carcinoma of the apocrine type. Surgical treatment was not feasible, therefore primary exclusive radiotherapy was administered at a total dose of 70 Gy in 35 fractions of 2 Gy each. Radiotherapy went well with some adverse events. One-month post-radiation assessment showed clinical and radiological progression.

Apocrine Breast Cancer: A Case Report.

Breast cancer is the most frequent malignancy among women worldwide, including a wide range of histological subtypes, from typical expressions like invasive ductal carcinoma to less common variations like apocrine breast carcinoma. This document discusses the case of a 65-year-old female with apocrine breast cancer, who presented with a chronic mastodynia. This case highlights the importance of being aware of apocrine breast cancer.

Multimodal Therapy of Locally-Advanced Penile Cancer: A Case Report With Literature Review.

Cancer of the penis is a rare tumor that occurs in the elderly. Because of its rarity, it is often not diagnosed early, and its treatment poses difficulties for practicing oncologists. We report the case of an elderly patient treated for locally advanced squamous cell carcinoma (SCC) of the penis, with a review of the literature. A 71-year-old man, who had been complaining of pruritus on the penis two years ago, presented with an ulcerated lesion on the prepuce and the glans. A biopsy of the lesion with pathological study showed a SCC of the penis. Pelvic MRI showed tumor thickening centered on the glans of the penis, infiltrating the fascia and the spongy urethra with discrete upstream dilatation and bilateral inguinal adenomegaly. CT scan of the neck, chest, abdomen, and pelvis showed no secondary localizations. Treatment initially consisted of carcinological surgery by a partial penectomy with bilateral inguinal lymph node dissection. The tumor was therefore classified as pT3N3M0. A PET CT scan performed later was in favor of local and regional recurrence. Surgery was not feasible, so concomitant chemo-radiotherapy was indicated at a total dose of 70 Gy in 35 fractions of 2 Gy concomitantly with platinum-based chemotherapy, withgood evolution.

Exploring Head and Neck Paraganglioma: A Case Report.

Paragangliomas (PGLs) are tumors that are rarely malignant; the majority of them are benign. Similar to pheochromocytoma, they develop from the autonomic nerve system. This system originates from neural crest cells and can undergo neoplastic transformation. PGLs can arise either inside or outside the adrenal glands. Head and neck PGLs are very scarce. The primary locations where this tumor commonly originates within this region are the carotid body, jugular bulb, and vagal body. Hence, in our case report, we attempt to highlight the uncommon presentation of this disease in a 46-year-old female, who initially presented with hypertension and persistent dysphonia. The patient underwent successful external radiotherapy. This case report aims to raise awareness of the characteristics of these rare malignancies.

Adenoid Cystic Carcinoma of the Vulva: A Case Report.

Adenoid cystic carcinoma (ACC) of the vulva represents a highly uncommon type of female malignancy. Due to the absence of specific treatment guidelines, such cases are typically managed by the treatment protocols for vulvar cancer. Here, we report the case of a 52-year-old woman who presented with a painful right vulvar mass, leading to a diagnosis of ACC of the vulva after biopsy and immunohistochemical analysis. She underwent vulvectomy, bilateral inguinal lymphadenectomy, and targeted radiotherapy, and no evidence of recurrence has been found for three years, with ongoing monitoring for post-radiation effects. This case adds valuable insights into the management of ACC of the vulva and underscores the need for further research and guideline development to optimize care for future patients.

Primary cerebral melanoma: An exceptional localization in a case report.

Cerebral melanoma is often related to a secondary location of a cutaneous or mucosal melanoma. However, primary cerebral melanoma is a very rare clinical situation, representing less than 1% of all melanomas and 0.07% of all cerebral tumors. The diagnosis of a primary cerebral melanoma therefore requires rigorous clinical and paraclinical investigations. We report a case of primary cerebral melanoma treated in our onco-radiotherapy department.

Cutaneous metastasis of lung cancer: Case report.

Lung cancer is one of the most common cancers in men, and is often diagnosed at the metastatic stage. It often leads to lung, bone, brain, liver, and adrenal metastases. However, unusual secondary locations are possible, such as skin metastases, which are often associated with a poor prognosis. We report a case of lung cancer revealed by a subcutaneous mass on the forehead.

Solitary plasmacytoma of the skull base: A case report and literature review.

Plasmacytoma of the skull base is a rare entity. We present a case of sphenoid plasmacytoma in a 51-year-old woman who had nasal obstruction, intermittent epistaxis, headaches, decreasing visual acuity, and diplopia. Computed Tomography (CT) scan and magnetic resonance imaging (MRI) showed a large heterogeneous, expansile lesion measuring 75 mm × 54 mm, centered on the sphenoidal bone and the clivus. Biopsy confirmed the diagnosis of solitary plasmacytoma after ruling out systemic spread by the initial assessment. The patient was successfully managed by external beam radiotherapy and a complete response was obtained after 12 months of follow-up.

Pure mediastinal seminoma about a case report.

Mediastinal Seminoma is one of the malignant germ cell tumors of the mediastinum. It is a rare tumor that represents only 1%-4% of mediastinal tumors. We report the case of a patient treated at the Oncology Center of Oujda for a pure primitive seminoma of the mediastinum, with a review of the literature to assess the epidemiological, clinical, therapeutic, and prognostic characteristics of this pathology. This is a 25-year-old man whose aunt is being treated for breast cancer and who complained of persistent dry cough with asthenia without any other associated signs. The initial imaging revealed a voluminous locally advanced tumor process in the anterior and middle mediastinum. Tumor markers Alpha-fetoprotein (AFP) and beta-subunit of chorionic gonadotrophic hormone (BHCG) were normal, as well as testicular ultrasound. The CT- guided transthoracic biopsy with anatomopathological study and immunohistochemistry was in favor of a pure seminoma. The treatment consisted of primary chemotherapy with BEP protocol. The response was favorable with a significant reduction in tumor size estimated at 90%. The residual tumor was inoperable due to its intimate contact with the vascular structures and was treated with external radiotherapy at a total dose of 36 Gy. The evolution at 20 months after treatment was in favor of a good clinical and radiological evolution.

Localized Hidradenocarcinoma of the Scalp: A Case Report.

Hidradenocarcinomas or malignant hidradenomas are tumors developed from the sweat glands, in particular, the eccrine glands. It is a rare entity of skin tumors and frequently appears de novo with a slight female predominance and an average age of 50 years at diagnosis. We report the case of a 57-year-old woman treated for localized hidradenocarcinoma of the scalp, successfully managed by surgery and adjuvant radiotherapy.

Hemangiopericytoma of the central nervous system: a case report.

Hemangiopericytomas or solitary meningeal fibrous tumors are extremely rare mesenchymal tumors. They represent only 1.6% of all central nervous system tumors, occurring mainly in adults between 40 and 50 years of age with a slight male predominance. We report the observation of a 20-year-old man treated at the Oujda Regional Oncology Center for cerebral hemangiopericytoma, revealed by headaches resistant to usual analgesic treatments without other associated signs. Initial imaging a left temporo-parieto-occipital intraaxial tumor process all responsible for a sub-falcoial and temporal engagement whose appearance first evokes a high-grade glial tumor. The patient received a complete excision whose pathological examination with immunohistochemical study was in favor of a grade III hemangiopericytoma according to the WHO 2016 classification. Therapeutic management with adjuvant radiotherapy was supplemented with a volumetric modulated arc therapy (VMAT) technique at a total dose of 54Gy. We will discuss through this case, the clinical and therapeutic peculiarities by a review of the literature.

[A rare case of botryoid sarcoma of the uterine cervix: case report]. / Sarcome botryoïde du col utérin, une localisation exceptionnelle: à propos d'un cas.

Botryoid sarcoma is a subtype of rhabdomyosarcoma affecting soft tissues and exceptionally the cervix. We here report the case of an 18-year-old female patient presenting to the emergency department with a feeling of pelvic heaviness, metrorrhagia and urinary retention. Gynecological examination showed budding mass of the uterine cervix. The biopsy showed botryoid sarcoma. Radiological evaluation revealed heterodense cervico-isthmic corporeal mass measuring 97 / 87 mm, without adenopathies or effusions or tumors at other sites. Treatment involved neoadjuvant chemotherapy with vincristine - adriamycin and cyclophosphamide (V-A-C), followed by surgery (total hysterectomy without adnexal preservation). After a follow-up of 3 years, the patient is still in clinical and radiological remission.

Osteosarcoma of the ethmoid sinus: About a case.

Osteosarcomas of the craniofacial bones account for less than 10% of all osteosarcomas. Primary osteosarcomas of the nasal cavity and paranasal sinus are rare localization (0.5%-8.1% of osteosarcomas occur in this site). Accordingly, we report a case of osteosarcoma arising de novo from the ethmoid bone in a 46-year-old female. Initially, she presented with headache, bilateral epistaxis, and postnasal drip. Biopsy revealed an osteosarcoma ethmoidal. The patient was treated by a neoadjuvant chemotherapy followed by surgical resection and radiotherapy.

A giant primary vaginal sarcoma: A report case and literature review.

Primary vaginal sarcoma is a rare disease entity, reported in less than 3% of cases of vaginal cancers. We report the observation of a patient treated at the regional oncology center of Oujda in Morocco who is presented with a non-metastatic primary vaginal leiomyosarcoma of 20 cm. The treatment consisted of neoadjuvant chemotherapy, followed by hemostatic surgery with tumor resection limits, reinforced by radiotherapy and then a surgical resection with a tumor resection taking away the infiltrated part of the anterior face of the lower rectum and the realization of a left iliac colostomy whose resected tumor part limits were healthy. At present, the patient is 4 years of follow-up without locoregional or distant recurrence.

Validation of Monte Carlo multithreading TOpas 3.6 software in order to simulate the 6 MV Elekta Synergy MLCi2 platform linac.

Background: Monte Carlo simulation is generally appreciated as an extraordinary technique to investigate particle physics processes and interactions in nuclear medicine and Radiation Therapy. The present task validates a new methodology of Monte Carlo simulation based on the Multithreading technique to reduce CPU time to simulate a 6 MV photon beam provided by the Elekta Synergy MLCi2 platform medical linear accelerator treatment head utilizing TOpas version 3.6 Monte Carlo software and the Slurm Marwan cluster. Materials and methods: The simulation includes the linear accelerator (LINAC) major components. Calculations are performed for the photon beam with several treatment field sizes varying from 3 × 3 to 10 × 10 cm2 at a 100 cm of distance from the source to the surface of the IBA dosimetry water box. The simulation was wholly approved by comparison with experimental distributions. To evaluate simulation accuracy, gamma index formalism for (2%/2mm) and (3%/2mm) criteria, Distance To Agreement DTA, and the estimator standard error ɛ and ɛ max are used. Results: Good agreement between simulations and measurements was observed for depth doses and lateral dose profiles, respectively. The gamma index comparisons also highlighted this agreement; more than 97% of the points for all simulations satisfy the quality assurance criteria of (2%/2mm). Regarding calculation performance, the event processing speed is faster using Gate-[mp] compared to TOpas-[mt] mode when running the identical simulation code for both. Conclusions: Consequently, according to the achieved results, the proposed methodology shows the first validation of TOpas in radiotherapy linacs simulations and a reduction in calculation time, capping simulation accuracy as much as possible. For this reason, this software is recommended to be serviceable for Treatment Planning Systems (TPS) purposes.

[Sacrococcygeal chordoma: about a case]. / Le chordome sacrococcygien: à propos d'un cas.

Sacrococcygeal chordoma is a rare disease. It has been described in less than 3% of cases. We here report the case of a female patient with locally advanced sacrococcygeal chordoma treated at the Oujda Regional Oncology Center in Morocco. The treatment was based on exclusive radiotherapy; surgical resection couldn't be performed. At 2-year follow-up the tumor is clinically and radiologically stable and general condition of the patient is good.