Primary hepatic large B-cell lymphoma following direct-acting antiviral treatment for hepatitis C.

Hepatitis C virus (HCV) infection is a major public health concern worldwide, raising important medical and economic issues. HCV-related end-stage liver disease is one of the most common indications for hepatic transplantation. Chronic hepatitis C is also assimilated to a systemic disease because of multiple extrahepatic manifestations, including lymphoproliferative disorders. The revolution of HCV treatment with the advent of direct-acting antivirals has significantly improved the management with high antiviral efficacy and good safety profile compared with old regimens, thus allowing good outcomes on hepatic and extrahepatic symptoms. However, with the widespread use of these new agents, controversial concerns about unexpected increasing cases of hepatocellular carcinoma were reported. We now report the case of a patient presenting with HCV-related cirrhosis, treated with direct-antiviral therapy and diagnosed with primary hepatic lymphoma shortly after the end of the treatment.

An Acute Jejunojejunal Intussusception Revealing a Metastatic Combined Lung Cancer.

Intussusception is a relatively common disease in pediatric age but it is uncommon in adults. We report a case of a 49-year-old male who presented with an acute jejunojejunal intussusception revealed by abdominal pain and vomiting. He underwent an en bloc resection, and pathological findings concluded to a metastasis of a pulmonary combined small cell carcinoma and adenocarcinoma. A subsequent CT scan revealed the primitive mass of the right lung with no evidence of secondary localization. The biopsy was difficult to perform. The patient underwent a pneumonectomy with lymph node dissection confirming the same diagnosis. He made a good recovery from the surgery, and a postoperative chemotherapy was administrated, and he is in remission until this date.

Pancreatic Metastasis of Renal Cell Carcinoma: A Surgical Indication for a Disseminated Disease.

Pancreatic metastasis (PM) of renal cancer is a rare condition. It is characterized by a long period after initial nephrectomy and a favorable prognosis compared to other pancreatic malignancies. Its diagnosis may confuse clinicians if the medical history is not known. In the era of targeted therapies for metastatic renal carcinoma, surgery stands as the best treatment option for PM of renal cancer. We report the case of a woman who underwent successfully left splenopancreatectomy for corporeal PM of renal cancer treated seven years ago. This case underlines the necessity of long-term follow-up of patients treated for kidney cancer.

Breast cancer screening: a dividing controversy.

AIM: To report the conlcusions of articles and reviews assessing the benefit and harms of breast cancer screening in the world and in Tunisia. METHODS: This is a review of articles searched through specialized medical data bases (Pubmud, Science Direct) using the following key-words: Dépistage / Screening,Cancer du sein/ Breast Cancer, Surdiagnostic/ Overdiagnosis,Mammographie/ Mammography,Controverse/ controversy,Tumeur in Situ/ In Situ Tumour. RESULTS: We reviewed 36 articles published between 2001 and 2018 assessing the benefit of breast cancer screening. The mortality reduction due to breast cancer screening is estimated between 15-30% by the randomized trials. However, overdiagnosis is estimated between 0-50%. CONCLUSION: Breast cancer screening has been useful in the fight against cancer. In the era of innovative and efficient therapies, breast cancer screening remains controversial due to the potential overdiagnosis. However, this concept still need to be defined more precisely and estimated more accuratly.