[Comparative study of inflammatory and non-inflammatory locally advanced breast cancer - the experience of a Moroccan hospital]. / Étude comparative du cancer du sein localement avancé inflammatoire et non inflammatoire : expérience d'un centre hospitalier marocain.

OBJECTIVES: The locally advanced breast cancer (LABC) covers large tumor heterogeneity. It consists of non-inflammatory LABC and inflammatory breast cancer (IBC). This study aimed to compare the epidemiological, clinical and pathological, as well as the prognosis of IBC versus non-inflammatory LABC. METHODS: This is a retrospective study of 150 cases of IBC and non-inflammatory LABC collected in medical oncology department of the CHU Hassan II of Fez during a period of 4 years [January 2009-January 2013]. Overall survival (OS) and disease-free survival (DFS) were calculated using the Kaplan-Meier method. Analysis of the various prognostic factors was performed according to the Cox model. RESULTS: IBC represented 28.7% of LABC. The median age was 47 years. The median tumor size was greater in non-inflammatory LABC compared with IBC (9.5 versus 6cm; P=0.0014). Lymph node invasion was more common in the IBC (49.7% versus 45.9%; P=0.01). An SBR grade 3 was more frequently noted in the IBC (P=0.011). The two groups were well balanced with regard to HR, HER2 status and pathologic complete response. Non-inflammatory LABC had the best OS and DFS (24 vs. 22 months; P=0.03 and 18 vs. 17 months; P=0.025 respectively). CONCLUSION: IBC has a worse prognosis compared to non-inflammatory LABC. New therapeutic approaches are needed to improve the prognosis of these patients.

Primary breast leiomyosarcoma.

Primary leiomyosarcoma of the breast is an extremely rare neoplasm. Only few cases have been reported in the literature. We report here a case of breast leiomyosarcoma in a 44-years-old female and we discuss the data of the existing literature.

A Case of a Metastatic Disease to the Pancreas from a Small-Cell Lung Carcinoma Documented by a CT-Scan-Guided Trucut Biopsy: The Diagnostic Role of Cytomorphology and Immunohistochemistry.

Unlike primary pancreatic carcinoma, metastatic lesions of the pancreas are uncommon and account for approximately 2% of pancreatic malignancies. Small-cell lung carcinoma (SCLC) represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and reports on metastatic small-cell carcinoma (SCC) in the pancreas, either of pulmonary or extrapulmonary origin, to be diagnosed by CT-scan-guided trucut biopsy (CT-TCB) are very rare. A 56-year-old man presented with a laterocervical lymphadenopathy associated to a mixed-density lung mass and a mass in the pancreatic body. CT-TCB slides from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytomorphological and histological diagnosis was metastatic SCC. Immunocytochemical staining showed that a variable number of neoplastic cells were positive for cytokeratin 7, TTF1, chromogranin A, and synaptophysin but negative for leukocyte common antigen and cytokeratin 20 with a very high expression of KI67. The transbronchial needle biopsy confirmed the diagnosis of an SCC. This case represents a rare metastatic lesion in the pancreas from SCLC, diagnosed by CT-TCB histological and immunohistochemical studies.

Signet Ring Cell Carcinoma of the Vater's Ampulla: A Very Rare Malignancy.

Most tumors affecting Vater's ampulla are adenocarcinomas, and other histological variants are less frequent. Signet ring cell carcinoma is more commonly found in the stomach than at other sites of the digestive system. Signet ring cell carcinoma of the Vater's ampulla is extremely rare, and only 15 cases have previously been described in the literature. It mainly occurs in elderly patients (median age = 57 years). We report a case of advanced signet ring cell carcinoma of the ampulla of Vater, with invasion of the duodenum (D3) admitted in the Medical Oncology Unit of HASSAN II University Hospital.

[Pleomorphic carcinoma of the lung: a case report]. / Le carcinome pléomorphe du poumon. À propos d'un cas.

Pleomorphic carcinoma is a rare malignancy belonging to the family of nonsmall cell lung cancers. A 40-year-old man, a smoker, was hospitalized for thoracic pain and dry cough with a deteriorating general condition. The imaging showed a "drop ball" of both lungs. The pathological evidence was obtained by lung biopsy under scanographic control. The presence of supraclavicular and abdominal nodes classified the tumour as stage IV. The patient received six cycles of first-line chemotherapy associating cisplatin and vinorelbine. However, the disease continued to progress and distant metastases were observed. The patient died 6 months after the diagnosis. Pleomorphic carcinoma is identified by purely histological criteria: the concomitant presence of malignant epithelial and homologous sarcomatoid spindle-cell components. Like the other nonsmall cell lung cancers, the treatment is primarily surgical, and the invasive nature of this tumour makes it very difficult. Pleomorphic carcinoma has a poorer prognosis than conventional nonsmall cell lung cancers despite surgery, irradiation and chemotherapy, because relapse occurs early.

Genitourinary complications as initial presentation of inherited epidermolysis bullosa.

Epidermolysis bullosa (EB) is a rare disorder that presents with urological complications. We present a 6-year-old boy admitted with urological symptoms that revealed an inherited EB misdiagnosed. We also review the literature on this disorder and management of the common urological complications.

Small cell cancer of the bladder: pathology, diagnosis, treatment and prognosis.

Small cell carcinoma of the bladder (SCCB) is rare, highly aggressive and diagnosed mainly at advanced stages. In addition, coexistence of SCCB with other types of carcinoma is common. Hematuria is the main symptom of this malignancy. Histological tests show a tumour, which is indistinguishable from small cell lung carcinoma (SCLC). Then immunohistochemistry tests may be helpful for a more precise diagnosis. Pathogenesis is uncertain; however the multipotent stem cell theory applies best to this case. The most common staging system used is the two-stage system (limited-extensive). Because of the rarity of the disease, the management is extrapolated from that of SCLC. Limited-stage disease should be treated with etoposide-cisplatin chemotherapy in combination either with radiotherapy, or surgery or both. Extensive-stage disease should be managed by combined chemotherapy. Further research programmes are needed to improve the diagnosis and the treatment of SCCB tumour. This paper would provide a comprehensive review of the epidemiology, clinical features, diagnosis, pathologic features, histogenesis, molecular genetics, staging, treatment, and prognosis of SCCB.