Maxillary Sinus Ameloblastoma in Turner Syndrome: A Comprehensive Case Report and Long-Term Follow-Up.

This article was previously posted to the Research Square preprint server on 16 August 2023. Maxillary sinus ameloblastoma is an uncommon, locally aggressive odontogenic tumor. In this case report, we present a comprehensive long-term follow-up of maxillary sinus ameloblastoma occurring in a patient with Turner syndrome, managed through partial right maxillectomy followed by adjuvant operative bed radiotherapy.

Factors influencing Quality of life in Moroccan patients with cancer: A monocentric Prospective study.

BACKGROUND: Cancer as a chronic and serious disease affects the quality of life (QoL) of patients, which has increasingly become a major challenge at the heart of cancer management. The purpose of our study was to define the most involved factors in the degradation of QoL in cancer patients. MATERIALS AND METHODS: We conducted a prospective, mono-centric, qualitative and descriptive study carried out within the medical oncology department of the Ibn Sina Military Hospital spread over six months between January and June 2019. RESULTS: Of the 100 patients included, 58% were male with a median age of 54.42 years. 90% were married, 39% were illiterate and 43% were retired while 99% of patients had social coverage. Breast cancer was the most common in 29%. More than 54% of the patients included had localized cancer while 38% were metastatic. The Pain was estimated to be greater than or equal to six on the Visual Analog Scale (VAS) in 23%. In 78% of the cases, chemotherapy was indicated in these patients and treatment with psychotropic drugs was initiated only in 2% of the patients. The analytical study showed that most of the patients had a slightly degraded QoL 63% with a large participation of the psychic dimension, followed by the physical and spiritual dimension while the socioeconomic dimension came last. It was established a clear correlation between the QoL and certain socio-demographic factors (sex, marital status, level of education), and significant correlation with some factors related to the disease (a type of cancer, stage, and treatment received). CONCLUSION: We tried to assess the impact of cancer and to identify factors affecting the QoL of patients to guide the establishment of the support structure and accompanying devices.

Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases.

BACKGROUND: Excavated pulmonary metastasis are rare. We present two cases of excavated pulmonary nodules proved to be metastases from osteosarcoma and gallblader lymphoma. CASE PRESENTATION: The first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide) with partial response. Unfortunately, he died following a septic shock.Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies. CONCLUSIONS: Although pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.

Managing cancer patients during COVID-19 pandemic: a North African oncological center experience.

INTRODUCTION: since the first spread of the novel coronavirus (COVID-19) in Morocco in March 2020, the Moroccan Health System underwent an important pressure and remarkable efforts were spent to provide efficient reactions to this emergency. Public hospitals have set adapted strategies dedicated to overcoming the overload of COVID-19 patients, and our Oncology and Hematology Center (OHC) has implemented a flexible adapted strategy aiming to reduce the burden of COVID-19. We report our single-center experience on the detailed infection control measures undertaken to minimize virus transmission. METHODS: we reviewed all patients treated at the OHC from March 2nd to April 20th, 2020 as measures were taken since the detection of the first COVID-19 case to ensure the protection of patients and healthcare providers, especially a screening zone for any patient entering the center. The patient's data were retrospectively collected and anonymized. RESULTS: we notified a significant decrease in patients' admissions during the lockdown period at the different units of our center. The screening area received a total of 5267 patients during our study period, with an average of 105 patients per day. Interestingly, no healthcare professional was infected and only 8 patients showed symptoms of fever and cough, and all of them had a negative test for COVID-19 (RT-PCR). Thus, the OHC is considered as a COVID-19 free center with zero cases among patients and healthcare providers. CONCLUSION: by having a 0% rate of infection, the efficiency of our measures is proven, but efforts are still needed as we have to measure the impact of this pandemic in our cancer management.

[Management of cerebral radionecrosis: experience in the Department of Neurology at the Mohammed V Military Teaching Hospital]. / Prise en charge de la radionécrose cérébrale: expérience du Service de Neurologie de l'Hôpital Militaire d'Instruction Mohammed V.

Brain radionecrosis is a rare but life-threatening complication of external-beam radiotherapy for ENT cancers, in particular of the nasopharynx, and for brain tumors. Very few studies were conducted on this complication in the African population as well as in the Maghreb population. Therefore our study aims to describe the demographic, clinical, paraclinical, therapeutic and evolutionary features of cerebral radionecrosis in the Department of Neurology at the Mohammed V Military Teaching Hospital in Rabat over a period of 18 years (2000-2017). The study involved 4 women and 13 men, with an average age of 50 years. The mean time between the end of the radiotherapy and the onset of neurological signs was 28 months. Systematic Brain MRI, sometimes complemented by spectro-MRI, allowed the diagnosis in 100% of cases. Etiologically, this complication occurred after radiotherapy for nasopharyngeal carcinoma and cancer of the larynx in all cases. Fifteen patients were treated with a combination of: bolus application of corticosteroids, platelet aggregation inhibitors associated with hyperbaric oxygen therapy with good evolution of two patients in whom oxygen therapy was contraindicated due to a lung problem and ENT cancer, received a combination of bolus application of corticosteroids and platelet aggregation inhibitors with unchanged evolution. These results demonstrate the importance of early diagnosis in patients with potentially serious conditions, in particular neuropsychiatric conditions, as well as of treatment combining bolus application of corticosteroids and hyperbaric oxygen therapy because this is the best guarantee of a favorable outcome, without omitting the crucial role of preventive measures.

[Occipital condyle syndrome: the visible part of the iceberg]. / Le syndrome du condyle occipital: la partie visible de l'iceberg.

Occipital condyle syndrome is a rare clinical disorder, clinically defined by the association of intense occipital headaches and paralysis of the twelfth paired cranial nerve. Its etiology is dominated by metastatic tumor. Imaging is the gold standard for diagnosis allowing to highlight occipital condyle lesion as weel as to find out primary tumor. Treatment is based on pain relief using analgesics, corticosteroids and very often, external radiotherapy. On the other hand, treatment of metastatic tumor is based on cytotoxic chemotherapy, targeted therapies or immunotherapy depending on the molecular profile of the primary tumor.

Radiation-induced chondrosarcoma of the scapula after radiotherapy for lung cancer: a case report and review of the literature.

BACKGROUND: Radiotherapy associated with chemotherapy is a well-established treatment modality for locally advanced non-small cell lung cancers. Radiation-induced second malignancies, particularly radiation-induced sarcomas, are rare. Some authors reported a recent increase in the incidence of this rare complication, especially because of the improved prognosis and survival of patients after radiotherapy. Pathogenic mechanisms of radiation-induced sarcomas are poorly understood. However, diagnosis criteria are well established. Treatment options must be discussed and adapted to the patient's profile. Surgery in irradiated tissue is challenging, with limited treatment options with chemotherapy and radiotherapy. CASE PRESENTATION: We report the case of a 62-year-old Moroccan man diagnosed as having chondrosarcoma of his right scapula, who was irradiated 10 years ago for stage IIIB non-small cell lung cancer. This case was managed by a complete resection of the tumor with good functional and oncological outcomes. To the best of our knowledge, the scapular location of radiation-induced sarcoma after irradiation for lung cancer has never been described in the literature. CONCLUSION: Radiation-induced sarcoma of the scapula represents a rare situation that must be actively researched to have access to an optimal therapeutic approach.

Solitary Fibrous Tumor: Case Report of Intrapulmonary Location.

Solitary fibrous tumors are relatively rare neoplasms that commonly occur in the pleura, especially visceral pleura. However, an intrapulmonary site of this kind of tumors is even rarer. These tumors can be characterized by a heterogeneous evolution and have a benign or malignant behavior. Wide surgical resection is essential to cure the patient and to avoid recurrence. We present here the clinical, imaging, and histological features of a case with solitary fibrous tumor growing inside the lung.

Successful management of retinal metastasis from renal cancer with everolimus in a monophthalmic patient: a case report.

BACKGROUND: The retina is an uncommon site for metastases, in particular from solid tumors. Some authors have reported a recent increase in the incidence of metastases in infrequent sites, such as brain or bone, probably due to the expanded treatment options and the resulting improved survival. Choroidal metastasis is the most common type of intraocular malignancy. The most common primary sites associated with choroidal metastasis are breast cancer in women and lung cancer in men. Treatment options are limited, but they must be discussed and adapted to the patient profile. CASES PRESENTATION: We report a case of a 62-year-old Moroccan man with a history of monophthalmitis secondary to a war injury of 30 years' duration. He has been followed for 28 months for metastatic clear-cell renal carcinoma. The first-line treatment was effective for 24 months, before disease progression as retinal metastasis and accentuation of lung metastases. A second-line treatment with everolimus resulted in marked improvement of symptoms, complete recovery of visual function, and partial response in retinal localization. CONCLUSIONS: Choroidal metastasis of renal cancer is a rare situation that must be actively sought in order to arrive at a suitable therapeutic approach.

Radiotherapy of nasopharyngeal cancer using Rapidarc: dosimetric study of military teaching hospital Mohamed V, Morocco.

BACKGROUND: The aim of the present study is to assess efficacy and efficiency of Volumetric-modulated arc therapy (VMAT) technique in treatment of nasopharyngeal cancer in our institution and to report toxicity related to this technique. METHODS: Between June 2013 and January 2015, thirty-two patients with non metastatic nasopharyngeal cancer were curatively treated using VMAT Rapidarc. Dose prescription was performed using two different schedules, it consisted of either simultaneous integrated boost or simultaneous modulated accelerated radiation therapy delivering 70 Gy in 35 fractions and 69.96 in 33 fractions respectively. The choice was leaved at the discretion of the treating physician. The optimization process was performed by Eclipse software version 10.0 (Varian Medical Systems), using PRO algorithm (Progressive resolutive optimisation) version 3. Data was collected from dose-volume histograms for both planning target volumes (PTV) and organs at risk (OAR). We calculated the homogeneity index and the conformity index as well as the number of monitor units MU and the treatment delivery time. We also reported acute and late toxicity related to radiation therapy. RESULTS: For the PTV high risk (HR), intermediate risk (PTV IR) and low risk (LR) the D95% was 97.21 ± 1.5, 97.5 ± 3.3 and 97.10 ± 6.86 respectively. Whereas, The D5% was 104.6 ± 2.16, 103.8 ± 2.1 and 100.89 ± 7.26. The CI for PTV HR was 0.98 ± 0.02 and the HI was 0.08 ± 0.02. The mean treatment delivery time was 2.3 ± 0.2, and the mean MU number was 527.6 ± 131.4. Grade 4 toxicity was not reported in any case. Grade 3 xerostomia was observed in only 3(9.4%) patients and no patients developed grade 3 hearing loss. CONCLUSION: Our results confirmed the abilities of VMAT to provide excellent coverage of target volumes while sparing OAR especially the nervous structures and salivary glands.

Villoglandular papillary adenocarcinoma: case report.

Villoglandular papillary adenocarcinoma (VPA) is a very rare subtype of adenocarcinoma of the uterine cervix, but a well-recognized variant of cervical adenocarcinoma with a favorable prognosis and generally occurring in women of child-bearing age. Herein, we report a case of VPA diagnosed and managed successfully with conservative measure. This management is particularly desirable in young women to preserve reproductive capability.

Primary non-Hodgkin lymphoma of the vulva in an immunocompetent patient.

The primary non-Hodgkin lymphoma of the vulva is a very rare pathological entity. We report a case of 37-year-old patient that presented a germinating ulcerating tumor in the small right vulva. The histology objectified a B lymphoma with a positive CD20 reaction. The patient underwent three typical chemotherapy sessions by rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone, followed by external radiotherapy on the pelvis and bilateral inguinal lymph nodes areas with an excellent answer and survival without particular events within 36 months of recession. Through this case report, we discuss the diagnostic features of this pathological entity, considering diagnosis and treatment are different compared to other tumors that are commonly found in the vulva.

Diagnostic, therapeutic and evolutionary characteristics of cervical cancer in Department of Radiotherapy, Mohamed V Military Hospital - Rabat in Morocco.

BACKGROUND: Cancer of uterine cervix is the second most common cause of cancer related deaths among women. The aim of this study is to report the experience of Military Hospital Mohamed V in the management of cervical cancer and their results. METHODS: All cervical cancer managed at the radiotherapy department of Military Hospital Mohamed V between January 2005 and February 2010, were included for investigation of their demographic, histological, therapeutic and follow-up characteristics. Of the 162 cases managed, 151 (93.2 %) cases were treated in our department. RESULTS: In our study the median age was 51.5 years (33-82). The median duration of symptoms before diagnosis was four [3, 7] months. The major presenting complaints were abnormal vaginal bleeding (89.8 %). Squamous cell carcinoma cervix was seen in 86.2 % (n = 137), adenocarcinoma in 11.3 % (n = 18) and adenosquamous carcinoma in 2.4 % (n = 4). One hundred seventeen (84.8 %) cases were seen at late stage. An abdominal and pelvic computed tomography (CT) scan was performed in 34.6 % (n = 56) of cases, magnetic resonance imaging (MRI) in 62.9 % (n = 102). The pelvic lymph nodes were achieved in 16.6 % of cases. Over half of patients 58.3 % (n = 88) were treated with a combination of external beam radiation therapy (EBRT) and a concurrent cisplatin based chemotherapy (40 mg /m2 weekly). With a mean of 51.6 months (2 to 109), we recorded 19 (12.6 %) pelvic relapse and 15 (9.9 %) metastases. The median time to onset was 19.4 months (2-84 months). The local control rate was 63.6 % (n = 96) and 21 (13.9 %) patients were lost to follow-up. The overall survival (OS) at 3 years and 5 years was respectively 78.3 % and 73.6 % and the relapse-free survival (RFS) was respectively 80 % and 77.2 %. CONCLUSION: Most of cervical cancer patients in Morocco are seen at late stage necessitating referral for radiotherapy, chemotherapy or palliative care. This may reflect lack of cervical screening in order to early detect and treat pre-malignant disease stage.

Sarcomatoid carcinoma of the lung: a model of resistance of chemotherapy.

CONTEXT: Lung tumors are very heterogeneous histological entities. Pulmonary sarcomatoid carcinoma is a subset of tumors characterized by specific histological features. Their poor prognosis compared to other lung tumors is due to limited responses to different types of chemotherapy. CASE REPORT: WE REPORT TWO PATIENTS WITH SARCOMATOID TUMORS: A 53-year-old woman and a 46-year-old man who presented respiratory symptoms: Dyspnea, cough, associated with a deterioration of general condition. CONCLUSION: Pulmonary sarcomatoid carcinomas remained an unexplored entity, despite their poor prognosis. Based on these cases, we will discuss the histological and immunohistochemical features of these tumors, as well as report their responses to different chemotherapy regimens used in the course of treatment.

Syringomatous carcinoma: case report of a rare tumor entity.

Syringomatous carcinoma is a rare cutaneous neoplasm, most frequently situated on the face and scalp and histologically characterised by an infiltrative pattern of basaloid or squamous cells, a desmoplastic stromal reaction and keratin filled cysts. We report the case of a 76-year-old woman who presented an ulcerative interscapular lesion measuring 3x4cm. After resection, the histological examinations of the specimens have identified a basal cell carcinoma. However, a local recurrence was observed 18 months later; histopathological findings showed a syringomatous pattern and neoplastic epithelial cells arranged in interconnecting cords with microcystic areas. Nests, cords, and tubules of the tumour extended into the dermis and into the adjacent muscle. Sclerosis of stroma around the cords was present. Tumour cells were not connected to the epidermis. The immunohistochemical analysis showed positivity for anti-CK7, AE1/AE3 and negativity for anti CEA and anti CK20. These histological and immunohistochemical analyses were consistent with the diagnosis of syringomatous eccrine carcinoma. Syringomatous carcinoma is an extremely invasive tumor, locally destructive and slowly growing adnexal tumour, derived from eccrine sweat glands. It is often mistaken, both clinically and microscopically, for other benign and malignant entities. The tumour recurrence is high due to extensive perineural invasion, but regional or distant metastases are rare. The local aggressive nature of the tumour and the high recurrence rate may necessitate mutilating procedures. Optimal treatment consists of a complete microscopically controlled surgical excision with clear surgical margins.

[Psychosocial impact of cancer on Moroccan adolescent and young adult: experience of National Institute of Oncology of Rabat]. / Impact psychosocial du cancer sur les adolescents et les jeunes adultes marocains : expérience de l'Institut national d'oncologie de Rabat.

Cancer is an uncommon disease; its imaginary concept is very particularly on adolescent and young adults. It disturbs their lives on the whole. The purpose of this study is to describe the specific psychosocial effects of cancer on adolescent and young adults in Moroccan population in order to help physicians educate and counsel future young patients and their families. During the period from January to July 2009, patients aged between 15 and 30 years with histologically confirmed cancer, were prospectively interviewed by a questionnaire covering socio-epidemiological characteristics, repercussions of disease on physical, psychic, sexual and religious practices. The aim of this study is to determine the impact of cancer, particularly on this young North African population, which is underrepresented in the psychosocial cancer literature.