[Recurrent Darier-Ferrand dermatofibrosarcoma in the abdominal wall: the role of preoperative radiotherapy (case report)]. / Dermatofibrosarcome de Darier et Ferrand récidivant de la paroi abdominale: apport de la radiothérapie pré-opératoire (à propos d'un cas).

Dermatofibrosarcoma is a rare cancer, accounting for 0.01% of all cancers. We here report the case of a 44-year-old female patient presenting with the 5th recurrence of locally advanced Darier-Ferrand dermatofibrosarcoma, that progressed on many cycles of neoadjuvant therapy and required emergency radiotherapy with good response. This allowed to perform wide excision of the tumor with healthy limits. The patient had remission after 1 year of follow-up. Prognosis for patients with Darier-Ferrand dermatofibrosarcoma is generally excellent. Wide surgery and the advent of Mohs surgery have improved local control. The role of radiotherapy is limited for non-resectable tumors or positive margins.

Breast Metastasis From a Non-small Cell Lung Cancer: A Case Report.

Although primary breast cancer (BC) is the most frequent cancer in the world, their mammary metastases are rare. In this paper, we report the case of a 51-year-old male patient diagnosed with a mammary lump and an intracranial hypertension syndrome. Mammography showed the presence of an irregular opacity without microcalcifications. After a cytological and immunohistochemical examination, the breast biopsy showed an adenocarcinoma of pulmonary origin. Computed tomography (CT) scans of the cerebrum, cervicothoracic spine, and abdomen showed a right apical pulmonary tumor associated with Barety's lymphadenopathy, as well as the presence of a mass in the right breast and secondary brain lesions. The patient received total brain irradiation which resulted in a marked clinical improvement. Afterward, he was treated with six cycles of palliative chemotherapy based on carboplatin area under the curve (AUC) 6 and paclitaxel, 175 mg/m² every 21 days, with a good response. After two months, the patient presented with a progression and he was treated with second-line chemotherapy. However, after three chemotherapy courses, the disease rapidly progressed and the patient was altered which required his admission to the palliative care department. The patient died 40 days later. This case shows the poor prognostic survival outcomes in this population of patients.

[Six-year disease-free survival after chemotherapy treatment for metastatic renal peripheral neuroectodermal tumor]. / Six ans de survie sans progression après chimiothérapie pour une tumeur neuro-ectodermique périphérique rénale métastatique.

Peripheral neuroectodermal tumors (PNET) of the kidney are extremely rare. They are often diagnosed at a late stage due to their nonspecific clinical presentation. Treatment of patients with metastases is based on palliative chemotherapy. We here report a case of PNET of the kidney with sudden onset of metastases to the lymph nodes and to the skin. The patient showed good clinical and radiological response and experienced progression-free survival at 6 years after polychemotherapy with vincristine, doxorubicin and cyclophosphamide.

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

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.

Sexuality of Moroccan Survivors of Cervical Cancer: A Prospective Data

Introduction: This is a prospective study aiming to describe how cervical cancer and its treatment can affect the sexuality of a specific population of Moroccan women survivors of this disease. Materiels and Methods: It is a comparison of clinical features and Female Sexual Function Index (FSFI) of 3 balanced groups of women, made up of 100 survivors of cervical cancer, 100 survivors of non-gynecological cancer and a group of 100 healthy women. Results: 97% of the patients stopped their full sexual activity at the time of treatment; the time interval between treatment and regular sexual activity was 8 months for the cervical cancer group, and 5.8 months for non-gynecologic cancer (P =0.001). Vaginal length assessed by pelvic examination during follow up visits was estimated at about 6.2 cm, 9.2 cm and 9.5 cm respectively for the cervical cancer group, non-gynecologic cancer group and the control group (p=0.04). On the basis of the FSFI questionnaire, the analysis of the 6 main sexuality parameter scores did attest worse results for the variables related to sexual function for cervical cancer group, but not in a statistically significant way. Conclusion: In order to preserve an optimal quality of life after cervical cancer, the sexual dimension is a crucial parameter to take into consideration throughout treatment phases, especially radiation (by encouraging sexual intercourses, and using vaginal dilators during the treatment). Moroccan survivors of this disease must be treated according to a multidisciplinary approach, that includs the psychological component.

[Vulvar cancer treatment options: experience in the Oncology Center in Oujda]. / Les traitements du cancer de la vulve: expérience du Centre d'Oncologie d'Oujda.

Vulvar cancer is a rare neoplastic disorder accounting for less than 5% of female genital cancers. This study aims to describe the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of vulvar cancer in the population of the eastern region of Morocco. We conducted a retrospective study of all patients treated for vulvar cancer in the Oncology Center, University Hospital Mohammed VI in Oujda, Morocco from June 2007 to January 2014. The study included 34 patients with an average age of 65.7 years, of whom 52.9% were multiparous. The most frequent reason for consultation was pruritus (94.1% of cases). The median of consultation time was 16 months, ranging from 2 months to 8 years. Ignorance and modesty were the major causes of diagnostic delay, since 73.5% of patients already had locally advanced disease at diagnosis. Surgical treatment was proposed to 61.4% of cases and was based on radical vulvectomy associated with bilateral inguinal lymphadenectomy in 68.5% of cases. Adjuvant radiotherapy was indicated in 41.2% of cases, 5.9% of patients underwent neo-adjuvant radiotherapy while 20.6% underwent exclusive radiotherapy associated with concomitant chemotherapy. Palliative chemotherapy was proposed to 8.8% of patients. The overall survival rate at 3 years was 65%, locoregional or distant recurrence rate was 17.3%. Cultural and social characteristics of patients of the eastern region of Morocco treated for vulvar cancer are factors influencing treatment and outcomes. Additional prevention and awareness efforts should be made in order to reduce the rates of locally advanced tumors and to enable curative treatment for this population.