RESUMO
BACKGROUND: Our review discuss (i) the findings from analyzed data that have examined KRAS, NRAS and BRAF mutations in patients with colorectal cancer (CRC) in North Africa and to compare its prevalence with that shown in other populations and (ii) the possible role of dietary and lifestyle factors with CRC risk. METHODS: Using electronic databases, a systematic literature search was performed for the KRAS, NRAS, and BRAF mutations in CRC patients from Morocco, Tunisia, Algeria and Lybia. RESULTS: Seventeen studies were identified through electronic searches with six studies conducted in Morocco, eight in Tunisia, two in Algeria, and one in Libya. A total of 1843 CRC patients were included 576 (31.3%) in Morocco, 641 (34.8%) in Tunisia, 592 (32.1%) in Algeria, and 34 (1.8%) in Libya. Overall, the average age of patients was 52.7 years old. Patients were predominantly male (56.6%). The mutation rates of KRAS, NRAS and BRAF were 46.4%, 3.2% and 3.5% of all patients, respectively. A broad range of reported KRAS mutation frequencies have been reported in North Africa countries. The KRAS mutation frequency was 23.9% to 51% in Morocco, 23.1% to 68.2% in Tunisia, 31.4% to 50% in Algeria, and 38.2% in Libya. The G12D was the most frequently identified KRAS exon 2 mutations (31.6%), followed by G12V (25.4%), G13D (15.5%), G12C (10.2%), G12A (6.9%), and G12S (6.4%). G12R, G13V, G13C and G13R are less than 5%. There are important differences among North Africa countries. In Morocco and Tunisia, there is a higher prevalence of G12D mutation in KRAS exon 2 (≈50%). The most frequently mutation type in KRAS exon 3 was Q61L (40%). A59T and Q61E mutations were also found. In KRAS exon 4, the most common mutation was A146T (50%), followed by K117N (33.3%), A146P (8.3%) and A146V (8.3%). CONCLUSION: KRAS mutated CRC patients in North Africa have been identified with incidence closer to the European figures. Beside established anti-CRC treatment, better understanding of the causality of CRC can be established by combining epidemiology and genetic/epigenetic on CRC etiology. This approach may be able to significantly reduce the burden of CRC in North Africa.
Assuntos
Neoplasias Colorretais , Proteínas Proto-Oncogênicas B-raf , Humanos , Masculino , Pessoa de Meia-Idade , Feminino , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/genética , Prevalência , Mutação , Sistema de Sinalização das MAP Quinases , Quinases de Proteína Quinase Ativadas por Mitógeno/genética , Tunísia/epidemiologiaRESUMO
A spontaneous rupture of the urinary bladder (SRUB) is an exceedingly rare surgical emergency that might be misdiagnosed, resulting in a high mortality risk. Clinicians should be mindful that secondary peritonitis can occur as a result of a ruptured urinary bladder, which is frequently misdiagnosed and undertreated. The majority of cases are identified during laparotomy. We report a case of a 70-year-old woman who had irradiation for endometrial cancer 25 years ago and had a history of hypertension, diabetes, and recurring urinary tract infections. The current study sought to determine the etiology of SRUB as well as clinical aspects and diagnostic strategies. She was diagnosed with generalized peritonitis. An exploratory laparotomy discovered a perforated urinary bladder. Following further care, the patient was released with no further complaints.
RESUMO
Tuberculosis is a major public health problem in our country. Abdominal tuberculosis ranks third among the extrapulmonary localisations and account for 3% of the various topographic forms in Morocco. The pancreas and peripancreatic locations are much rarer than peritoneal and intestinal lesions. They present a pseudotumoral appearance that creates a diagnostic emergency. We report a case of pancreatic tuberculosis observed in the general surgery department of the 5th Military Hospital.
Assuntos
Pancreatopatias/microbiologia , Tuberculose , Adulto , Feminino , Humanos , Pancreatopatias/diagnóstico , Tuberculose/diagnósticoRESUMO
Tuberculosis is a major public health problem in Morocco. A mammary localisation is very rare. The incidence of tuberculosis remains very low, even in developing countries where it is considered endemic, but the spread of the human immunodeficiency virus has led to an increased number of cases of extrapulmonary tuberculosis, even in the most developed countries. This disease presents essentially diagnostic problems, resolved only by histological and bacteriological study. The treatment is essentially medical, based on antibacterial chemotherapy associated with surgery in some advanced cases.
Assuntos
Doenças Mamárias/microbiologia , Tuberculose , Doenças Mamárias/diagnóstico , Doenças Mamárias/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Tuberculose/diagnóstico , Tuberculose/tratamento farmacológicoRESUMO
Gastric schwannoma (GS) is a rare neoplasm of the stomach deriving from Schwann cells of the peripheral nerves in the stomach. It accounts for 0.2% of all gastric tumors and is mostly benign, slow-growing and asymptomatic. Due to its rarity, GS is not widely recognized by clinicians. Preoperatively, GSs are difficult to differentiate from other mesenchymal tumors, such as gastrointestinal stromal tumor (GIST) or leiomyoma, which develop from mesenchymal stem cells. The optimal management of GS is based on the symptoms of the patient, tumor size and histologic grading. Here, we report the case of a GS in a 73-year-old female who underwent a wedge gastric resection following a clinical diagnosis of GIST. A histological and immunohistochemical study was performed excluding the misdiagnosis of GIST. The histomorphological features of the lesion and absence of c-Kit and strong positivity of S100 indicated the diagnosis of GS.
RESUMO
Skin metastases from bronchogenic carcinoma are rare, indicating advanced disease. We here report a case of skin metastasis from bronchial adenocarcinoma treated surgically in order to improve patient comfort.
Assuntos
Adenocarcinoma/patologia , Neoplasias Brônquicas/patologia , Neoplasias Cutâneas/secundário , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgiaRESUMO
Cervicothoracic cystic lymphangiomas are rare benign tumors developing from sequestration of embryonic lymph sac which is gradually filled with lymph fluid. The diagnosis is based on clinical signs (laterocervical swelling) and imaging (ultrasound and CT scan), then confirmed by histology after surgery which constitutes the basis of treatment. We here report a case of cervicothoracic cystic lymphangioma and review of the literature.
Assuntos
Linfangioma Cístico/diagnóstico , Neoplasias da Coluna Vertebral/diagnóstico , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/patologia , Feminino , Humanos , Linfangioma Cístico/diagnóstico por imagem , Linfangioma Cístico/patologia , Pessoa de Meia-Idade , Neoplasias da Coluna Vertebral/diagnóstico por imagem , Neoplasias da Coluna Vertebral/patologia , Vértebras Torácicas/diagnóstico por imagem , Vértebras Torácicas/patologia , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Post-appendectomy faecal fistula is a rare surgical complication, associated with significant morbidity. Taenia saginata infestation is one of the most common cestode infestation in the gastrointestinal tract. It makes many complications as obstruction, perforation, anastomotic leakage or appendicular stump dehiscence. The objective of our study is to report a very rare case of post appendectomy faecal fistula caused by taenia saginata infestation and was successfully treated conservatively.