[Gastrointestinal symptoms revealing COVID-19 in Malian breast cancer patient undergoing chemotherapy]. / Troubles digestifs révélateurs de la COVID-19 chez une patiente sous chimiothérapie pour cancer du sein au Mali.

In this review, we report a case of a bone's metastatic breast cancer in Malian patient treated by chemotherapy in whom SRAS-COV-2's diagnosis was made 9days after the onset gastrointestinal symptoms. Patient quickly died before any COVID-19's treatment. According to the poor outcomes of cancer patients with COVID-19, authors emphasize to an intensive attention to such patients in order to find the best therapeutic balance between the two pathologies during this pandemic.

Carence en vitamine D et risque de cancer du sein avancé au Mali / Vitamin D deficiency in advanced breast cancer risk in Mali

Objectif : Le but de cette étude était de déterminer une association entre la carence en vitamine D et le cancer du sein avancé chez une population de femmes maliennes. Méthodes : Il s'agit d'une étude prospective transversale, menée pendant 4 mois, d'Août à novembre 2021. Les dosages ont été réalisés au laboratoire Rodolphe Mérieux. Résultats : Nous avons inclus 77 femmes diagnostiquées pour un cancer du sein avancé. L'âge moyen de la population étudiée était de 48,51 ± 13,02 ans. Les concentrations plasmatiques moyennes de 25(OH)D étaient respectivement de 20,65 ± 6,76 et 18,89 ± 6,12 ng/ml (p=0,274) dans les groupes III et IV. Le stade III était majoritaire avec 67,5% et il n'y avait pas de différences significatives avec le stade IV pour les marqueurs biologiques phospho-calciques. Nos résultats ont montré une carence en vitamine D plus importante au stade III qu'au stade IV, avec p=0.782. Le modèle de régression logistique a montré une diminution significative du risque relatif de cancer du sein avancé selon les quartiles de vitamine D (p=0.039). Il n'y avait pas d'association avec la calcémie, la phosphatémie, la créatinine plasmatique et le débit de filtration glomérulaire (DFG) (p>0,05). Conclusions : Nos résultats suggèrent une association entre la vitamine D et le risque de cancer du sein avancé aux stades III et IV. Cependant, d'autres études sont nécessaires pour confirmer le rôle de la vitamine D dans l'évolution du cancer du sein féminin aux stades avancés

Aims: The aim of this study was to determine the association between vitamin D deficiency and advanced BC in a Malian women population. Methods: This is a prospective cross-sectional study, conducted during 4 months, from August 2021 to November 2021. The assays were performed on immunodiagnostic and biochemistry devices in Rodolphe Merieux Laboratory. Results: We included 77 women diagnosed with advanced breast cancer. The mean age of the study population was 48.51 ± 13.02 years. The mean plasma concentrations of 25(OH)D were 20.65 ± 6.76 ng/ml and 18.89 ± 6.12 ng/ml (p=0.274) in groups III and IV, respectively. Stage III was predominant, comprising 67.5% of the cases, and there were no significant differences between stages III and IV regarding phospho-calcium biological markers. Our results showed a greater deficiency in vitamin D at stage III compared to stage IV, with p=0.782. The logistic regression model demonstrated a significant decrease in the relative risk of advanced breast cancer across the quartiles of vitamin D (p=0.039). There was no association with serum calcium, phosphate, plasma creatinine, and glomerular filtration rate (GFR) (p>0.05). Conclusions: Our findings show an decrease of the risk of breast cancer about vitamin D levels in our population. These results suggest an association between vitamin D and the risk of advanced breast cancer. Further studies are needed to determine the mechanism of vitamin D deficiency in advanced breast cancer.

Small cell carcinoma of the endometrium: A clinicopathological study and management of three cases.

Endometrial small cell carcinoma (ESCC) is an extremely rare and aggressive tumor with poor prognosis. It is characterized by early regional and systemic spread leading to rapid development of lymph nodes, pelvic and extrapelvic metastasis and compromising the outcome. In this paper, we reported three cases of ESCC confirmed by pathological and immunohistochemistry studies. In one case, ESCC was associated with endometrioid carcinoma and carcinosarcoma, while the other two cases were pure ESCC. Two cases were diagnosed at early stage IA of the International Federation of Gynecology and Obstetrics (FIGO) cancer staging system. They were treated by surgery followed by pelvic external radiation and brachytherapy with favorable outcome (no recurrence was confirmed and a survival was 1 and 5years, respectively). The third case was diagnosed with visceral metastasis and was treated with 6 cycles of cisplatin plus etoposide. She died 8months after diagnosis. Due to its rarity, there is no standard guideline for the management of ESCC. Its treatment is extrapolated from that of both, the conventional endometrial carcinoma and the small cell carcinoma of the lungs, which share similarities with ESCC. Thus, multimodal therapeutic including surgery, radiation therapy and chemotherapy, seems to be the best therapeutic approach. Randomized clinical trials with multiples cases of ESCC are encouraged to clearly define the optimal therapeutic approach to this rare tumor.