Search

Bone tumors are and remain rare entities in our daily hospital clinical practice. Their appearance seems anecdotal but does not remain absent. They can manifest directly (pain, redness, functional impotence, suspicious mass, etc.) or indirectly (inflammatory or paraneoplastic syndrome, profuse sweating, emaciation, etc.). The most common benign bone tumors are non-ossifying bone fibroma. Then come osteochondroma and solitary bone cysts. For malignant tumors, osteosarcomas and chondrosarcomas are at the forefront. Primary bone lymphoma accounts for less than 1 % of these. In general, lymphomatous bone lesions are frequently metastasis from primary hematological lymphoma and are therefore treated by chemotherapy. An early surgical treatment of the bone tumor is most often not mandatory and a conservative therapy may represent a valuable option.

Objective: Ovarian cancer screening is a difficult problem due to the anatomy of the ovaries. Only histology allows a definite diagnosis. Our objective was to study the contribution of the Adnex score in the histological characterization of adnexal images for adequate management., Methods: It was a retrospective, mono-center, descriptive and analytical. Sixty-five patients were included, those operated for an ovarian cyst and meeting the Adnex criteria: clinical, ultrasound and laboratory., Results: The mean age of the patients was 38.6 years. They were nulliparous in 43 % of cases, and only four had a history of operation on ovarian cyst. Abdominal pelvic pain was the most frequent reason for consultation in 48 % of cases. An abdominopelvic mass was found on abdominal examination in 11 % of cases. Pelvic ultrasound made it possible to objectify the presence of an ovarian mass in all cases, with an average size of 79.66mm and a reassuring appearance in 66 % of cases. The calculation of the Adnex score was done in all patients preoperatively, for a 10 % cut-off, the model showed an 86 % chance of benignity for tumors proven to be histologically benign. The main route of entry was laparoscopy, in 61 % of cases. The treatment was in most cases conservative consisting essentially of a cystectomy., Conclusion: The Adnex score discriminated well between benign and malignant masses, allowing for a better diagnosis preoperatively. It thus deserves its applicability in the clinical setting., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

INTRODUCTION: The use of flexible bronchoscopy in developing countries is limited. We report our initial experience and outcome with the use of flexible bronchoscopy at the Tamale Teaching Hospital in Ghana. This is the first reported case series of flexible bronchoscopy in Ghana. METHODS: A retrospective review of patients who had flexible bronchoscopy from 2017-2019 was analyzed. Patient demographics and outcomes were summarized using frequency distribution and percentages. RESULTS: We performed flexible bronchoscopies in 33 patients with mean age of 43 years. All patients were symptomatic at the time of presentation with the most common symptoms being chest pain (63.6%), dyspnea (57.6%) and cough (48.5%). The indication for bronchoscopy in most of the cases were suspected malignancy in 16 (48.5%) followed by infection 9 (27.3%), trauma 4 (12.1%) and others 4 (12.1%). We observed abnormal bronchoscopic findings in 25 (75.8%) of the cases with most of the pathologies in the right main bronchus. Twelve patients had toilet bronchoscopy, 6 had biopsy, 5 had no intervention and 4 patients had bronchoalveolar lavage (BAL). Culture and sensitivity results were available for 11 patients, of which 7 patients had negative results. Thirteen (13) malignancies and 11 inflammatory/infectious diseases were diagnosed in this case series. The mean procedure time was 32 minutes with mean hospital stay of 7 days. There was no complication or mortality in our series. CONCLUSION: Flexible bronchoscopy is a safe procedure and indispensable in Ghana where there is an increasing incidence of lung diseases.

INTRODUCTION: The aim of this retrospective study is to review patients with malignant goiter, as regards their nature, demographic characterization, clinical presentation and preoperative histopathological data. METHODS: the study focused on a period of 4 years from December 2015 to January 2019. Patients´ demographic data, clinical presentation, Intra-operative findings, Pre and postoperative histopathological staging and grading were all recorded. Postoperative follow up whether early or late were also included. RESULTS: a total of 100% (n = 65) patients underwent surgery. The female to male ratio was found to be 5:1 (48 females and 17 males). Solitary nodule was the main clinical presentation in 80% (n = 52) of cases while 20% (n = 13) were multinodular swellings. Papillary carcinoma was recorded in 80% (n = 52) of patients while in 15.4 % (n =10) of patients were having follicular carcinoma. The remaining 4.6% (n = 3) suffered of lymphoma; no medullary or anaplastic tumors were reported. CONCLUSION: Thyroid cancer is the most commonly encountered endocrinal malignancy at our institute. Fine Needle Aspiration Cytology (FNAC) showed a high percentage of reliability in diagnosing thyroid cancer among our series. It is recommended to adapt this technique in initial screening of goiter patients in our local setting.

Metastases to the heart and pericardium are much more common than primary malignant neoplasms. Primary malignant pericardial mesothelioma is a rare tumor that arises from the mesothelial cells of the pericardium. It is usually characterized by a delayed diagnosis, a low response to treatment, and a poor prognosis with an overall survival up to six months after the onset of symptoms. We report a rare case of a 32-year-old woman with primary pericardial malignant mesothelioma that was diagnosed 4 months after the onset of pericardial effusion as the first clinical manifestation.

Haemophagocytic lymphohistiocytosis (HLH) in Human Immunodeficiency Virus (HIV) infected individuals can either be due to the disease itself or due to associated infections/malignancies. The treatment for HLH requires immunosuppressive therapy but administering immunosuppressive therapy to an already immunosuppressed patient (HIV infection) is complex. We present two such cases of HLH in patients infected with HIV. In the first case, no alternate cause for HLH was found even after extensive investigations and it was attributed to the uncontrolled HIV replication. Patient was started on dexamethasone for the same but succumbed to hospital acquired pneumonia. The second patient was diagnosed with Hodgkin's lymphoma but he succumbed to his illness before initiating immunosuppressive therapy for HLH. We report these cases to highlight the dilemma and a need for further research in this direction.

Gastric diverticula are the most uncommon form of gastrointestinal diverticula. They can either be of true or false type with different pathogenesis. They may be very challenging to diagnose as symptoms are nonspecific and imaging can simulate a malignant lesion. We report an unusual case of pre-pyloric diverticulum in a 69-year-old man, leading to severe gastric obstruction with a poor general condition. As subsequent endoscopy and imaging were alarming and couldn't exclude malignancy, the patient underwent an antrectomy. The final diagnosis was made on pathological examination. We discuss, through this case, the clinical and pathological features of gastric diverticula with an emphasis on the pathogenesis of this rare entity and the risk of a malignant transformation.

Surgical improvement and expansion of immunosuppression have led to the successful development of solid organ transplantation. But long-term medical complications persist and are responsible for a decline in survival from the first year after transplantation. After one year, recurrence of liver disease, chronic rejection, metabolic syndrome, cardiovascular disorders, kidney dysfunction and malignancies are leading causes of morbidity and mortality in this population. Diagnosis, management and prevention of complications after liver trans- plantation are important to improve long term outcomes. Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount. Diligent management of modifiable post-liver transplantation factors including diabetes, hypertension and renal insufficiency may impact long- term mortality. Standardised follow-up combined with organised screening for medical and surgical complications is therefore essential to improve survival after transplantation. [ABSTRACT FROM AUTHOR]

Thyroid nodules are very common and less than 10% of them are malignant. They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature. The study of some clinical and paraclinical factors for presumed malignancy makes it possible to codify appropriate therapeutic strategy. The aim of this study was to investigate predictors of malignancy in nodular goiters and to compare our results with those reported in the literature. This retrospective study consisted of 500 cases of nodular goiter operated in the Department of Otorhinolaryngology (ear, nose and throat or ENT) and Head and Neck Surgery at Avicenne military hospital in Marrakech between 2006 and 2012. The percentage of cancers was 6,8%. The average age of our patients was 46 years, with a sex-ratio of 5 (F/H). The hard nature of the nodule was present in 94,4% of the cases of cancer by palpation; irregular boundaries were present in 64.70% of the cases of cancer. Three nodules were fixed and malignant. Cervical lymphadenopathy were observed in 8 patients, 7 of which had cancer. Ultrasound examination showed hypoechoic appearance in 61,8% of the malignant nodules, with smooth-edges in 88,24% of the cases. Intranodular vascularization was found in 35,3% of the cases of cancers, with microcalcifications in 55,9% of the cases. Perinodular hypoechoic halo was incomplete in 73,5% of the cases of cancer. Our patients were euthyroid in 84,6% of the cases. Predictors of malignancy in nodular goiters were present in our first clinical study: patients over the age of 60 years, hard consistency of nodule, fixity, irregular and poorly defined character by palpation, as well as presence of cervical adenopathy on examination; and echographic features: hypoechoic character, smooth-edges, presence of microcalcifications and visualization of intranodular vascularization with or without peri-nodular vascularization. Although some of these factors are highly predictive of malignancy, only final histology provides certainty of diagnosis. Clinicians should base their clinical practice and patient management on a body of clinical arguments. [ABSTRACT FROM AUTHOR]

“Werner’s syndrome” or premature aging syndrome is a rare autosomal recessive genetic disease. It is responsible of several complications related to age, including atherosclerosis and association with cancer. We report the case of a 36 year-old-patient, admitted to department of Internal Medicine of the military hospital of Tunis for suspicion of systemic sclerosis. The patient had all the major signs of Werner syndrome (bilateral cataract, sclerotic skin, “bird face”, baldness, small size, parental consanguinity) and 4 minor signs (type 2 diabetes, hypogonadism, squeaky voice, and flat feet). She has also a brother with the same morphotype died at the age of 32 by a myocardial infarction. The current follow-up time is 9 years..

An 18-year-old male presented with a mass in the right anterior chest wall. Chest Computed tomography revealed a heterogenous mass of 19X13 cm in the right hemithorax with areas of necrosis. There was associated pleural effusion and infiltration of the soft parts of the chest wall. Bronchoscopy showed a tumor in middle lobe bronchus. CT guided biopsy of the mass was performed. Histological examination showed small round tumor cells with scanty cytoplasm, the nuclei are large and hyperchromatic. The tumor cells were positive for CD99 and neuron specific enolase, negative for cytokeratin, leukocyte common antigen and myogenin. Based on these histologic and immunohistochemical findings, the diagnosis of askin's tumor was made. The extension assessment was negative and the patient was given chemotherapy. Two months later, our patient died. Askin's tumor is a rare, highly malignant tumor affecting children and young adults. It is classified as primitive neuroectodermal tumor of the thoracopulmonary region. Prognosis remains poor. In our case, several prognostic factors may explain the shirt 'term survival, despite no distant metastasis were found: important tumor size, impossibility of surgical treatment and pleural effusion.

Endometriosis with intestinal serosal involvement is not uncommon in women of childbearing age. However, endometriosis presenting as colon obstruction is rare and occurs in less than 1% of cases. The Lack of pathognomonic signs makes the diagnosis difficult, mostly because the main differential diagnosis is with neoplasm, even during the intervention. Reported here is a case of a 35-year �old woman presenting with bowel obstruction due to rectal endometriosis. The patient presented signs and symptoms of bowel obstruction. Colonoscopy and radiological findings were suggestive of rectal carcinoma. Surgeons performed an anterior resection with right salpingectomy. Histopathology diagnosed bowel endometriosis. This case demonstrates the difficulty of establishing an accurate pre- and intra- operative diagnosis and the ability of intestinal endometriosis to mimic colon cancer.

Over the past 15 years, the multidisciplinary team management of many medical conditions especially cancers has increasingly taken a prominent role in patient management in many hospitals and medical centres in the developed countries. In the United Kingdom, it began to gain prominence following the Calman-Heine report in 1995 which suggested that each Cancer Unit in a hospital should have in place arrangements for non-surgical oncological input into services, with a role for a non-surgical oncologist. The report further suggested that a lead clinician with a well established interest in cancer care should be appointed to organise and coordinate the whole range of cancer services provided within the Cancer Unit. Many people have argued that the multidisciplinary team management of patients has resulted in better care and improved survival. However, there are barriers to the optimal effectiveness of the multidisciplinary team. This paper aims to review various studies on the effectiveness of the multidisciplinary team in the management of cancer patients and also discuss some of the barriers to the multidisciplinary team.

Copyright of Italian Oral Surgery is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of African Journal of Cancer / Journal Africain du Cancer is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Pratique Medicale et Chirurgicale de l'Animal de Compagnie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Askin tumor is a rare malignant tumor arising from soft tissues of the chest wall, rarely in the lung. It occurs predominantly in young adults. It still raises many questions about its individualisation and its links with Ewing''s sarcoma. We report a case of Askin tumor in a 5-year-old child with reviewing the different data from the literature. [Copyright &y& Elsevier]

Abstract: Introduction: To study the clinical features and the outcome of polymyositis (PM) and dermatomyositis (DM) in Tunisia. Methods: Retrospective multicentre study conducted by the Tunisian Society of Internal Medicine. Adult patients with confirmed and probable PM and DM, according to the Bohan and Peter''s criteria, were included in the study and followed-up between 1987 and 2005. Results: Twenty cases of PM and 50 cases of DM were included. Female/male sex-ratio was 2.5. The mean age at diagnosis was 40.7 years. Muscle weakness concerned girdle muscles in 94.3% and pharyngeal muscles in 42.8% of the patients. Interstitial lung disease and heart involvement occurred respectively in 35.7 and 20%. Eyelid erythema, peri-ungual erythema and Gottron''s sign occurred in respectively 86, 50 and 36% of the cases of DM. Malignant disease was found in 12.8% of the patients (mainly gynecological and nasopharyngeal cancers). All patients received high dose corticosteroids with additional immunosuppressive drugs in 40% of the cases. The outcome was stabilization or partial improvement in 71.5% of the cases. Death occurred in 20% and was caused by respiratory failure, sepsis and cardiac failure. Conclusion: The particularities of PM and DM in Tunisia are the preponderance of DM, early onset of the disease and high frequency of the nasopharyngeal cancer. [Copyright &y& Elsevier]

Abstract: Malignant nonepithelial ovarian tumours represent less than 20% of ovarian cancers in adults. Apart from haematological tumours, there are mainly germ cell tumours and sex cordstromal ovarian tumours. These tumours affect young women and are diagnosed in early stages associated with a good prognosis. The management of malignant nonepithelial ovarian tumours is difficult because they are rare and because we have to propose an appropriate oncological treatment, preserving fertility for these women of child-bearing age. We propose an update on recent data in the literature, focusing on management. [Copyright &y& Elsevier]

Summary: We report the first case of malignant solitary fibrous tumor of the abdominal wall in a man. Immunohistochemical staining for CD34 and bcl-2 were positive. Surprisingly, estrogen and progesterone receptors were focally positive. Expression of steroid hormone receptor in solitary fibrous tumor was rarely reported in the literature. In a few series, these receptors were identified as a risk factor of recurrences after surgical excision. Six months after complete surgical resection of the mass, our patient has been quite well without any evidence of recurrence. [Copyright &y& Elsevier]

Abstract: Antiphospholipid antibody (APLA) is a family of antibody that exhibits a broad range of target specificities and affinities all recognizing various combination of phospholipids binding proteins. Laboratories diagnosis of APLA can be difficult due to heterogeneity of APLA and a poor standardization of the laboratory tests. The antiphospholipid syndrome (APS) is a form of immune mediated thrombophilia occurring as a recurrent thrombotic event in association with positive laboratory test for antiphospholipid antibodies. The syndrome may be isolated, then defined as primary or secondary when it is associated to different diseases (like malignancies). The thrombotic events associated with APLA can be the first manifestation of malignancy. In patients with malignancy the presence of antiphospholipid antibodies increased the risk of thrombosis. Less than 1% of the patients with APS present a life threatening condition involving multiple organ thrombi and failure named as catastrophic antiphospholipid syndrome. [Copyright &y& Elsevier]

Abstract: Numerous excision and liposuction techniques have been described to correct bilateral male breast enlargement. Yet little attention has been directed towards the rare cases of unilateral gynecomastia which have frequently been suspected to be malignant. The purpose of this study was to investigate the results of surgical gynecomastia management and the roles of different treatment modalities in a large patient cohort with special attention to etiology, treatment and outcome in the cases of unilateral involvement. [Copyright &y& Elsevier]

Abstract: In children with cancer, malnutrition may antedate the diagnosis or be a result of aggressive chemotherapeutic regimens. The prevalence of malnutrition at diagnosis is related to the type of tumour and the extent of the disease, ranging from<10% in patients with standard-risk acute lymphoblastic leukaemia to 50% in children with advanced neuroblastoma. The pathogenis of the energy imbalance that underlies the development of malnutrition is complex, including increased breakdown of fat and protein as well as energy-consumptive changes in carbohydrate metabolism (Cori cycle). Despite several confounding factors (different definitions of nutritional status and the wide variety of measures used for its assessment), studies have shown decreased tolerance of chemotherapy associated with altered metabolism of antineoplastic drugs, increased infection rates, altered quality of life and possibly poor clinical outcome in malnourished patients. In this article, we review guidelines for the nutritional management of a child with cancer and we purpose an algorithm for nutritional support. [Copyright &y& Elsevier]

Abstract: The course of malignancies is frequently associated with decreased oral intakes. Cancer-induced malnutrition is an independent risk factor of cancer treatment side effects, low treatment efficiency, longer hospital stay, and mortality. Oral nutritional supplements could to reduce lack of protein and caloric intake, especially between chemotherapy or radiotherapy cycles. Fish oil enriched supplements could to limit treatment side effects, and course of cancer cachexia. Larger clinical trials are necessary to confirm good indications of oral nutritional supplements in oncology. [Copyright &y& Elsevier]

Abstract: Anorexia is frequent in course of malignancies and inflammatory diseases. Cytokines, produced in excess, have a major role in pathophysiology of anorexia. Early oral or enteral nutrition could prevent malnutrition and its complications (infectious,…). [Copyright &y& Elsevier]