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Introduction : La Covid-19 constitue une cause de plusieurs affections mentales, notamment chez les patients atteints de cancer qui sont déjà considérés comme une population vulnérable. Ainsi, l’objectif de la présente étude était d’évaluer les troubles psychologiques des patients suivis pour une maladie tumorale maligne, sous traitement médical systémique, ayant eu une infection au SARS-CoV2 ; ainsi que les conséquences que ces troubles psychologiques peuvent avoir sur l’adhésion aux soins oncologiques. Méthode : Il s’agit d’une étude transversale sur une période de quatre mois (pic de la pandémie) menée au département d’oncologie médicale du centre hospitalier universitaire Hassan-II de Fès, Maroc. Les symptômes anxieux/dépressifs et le stress post-traumatique ont été évalués avec les échelles HADS, PCL-5. L’échelle mini-MAC était utilisée afin d’évaluer l’ajustement psychologique des patients atteints de cancer dans le contexte d’infection à la Covid-19. Résultats : Au total, 53 patients ont été rencontrés : 45,2 % des patients présentaient des symptômes significatifs de stress post-traumatique et 20,7 % une symptomatologie dépressive. Une symptomatologie anxieuse importante était objectivée chez 69,8 % des patients. L’âge inférieur à 65 ans, le sexe féminin et la stratégie thérapeutique envisagée (curative versus palliative) étaient des facteurs prédictifs de survenue de troubles anxieux. Tous les patients sont revenus pour reprendre leurs soins oncologiques après l’épisode infectieux. Conclusion : Les troubles anxieux et le stress posttraumatique sont très fréquents chez les patients atteints de cancer et positifs à la Covid-19 par rapport à la population générale. Nos résultats suggèrent la nécessité de mettre en place des soins de support psycho-oncologiques personnalisés durant le contexte pandémique.

Mucoepidermoidcarcinoma (MEC) is a rare neoplasmthat arises from the exocrine glands and iscommonlyfound in the salivary glands. However, MEC of the pancreasis an exceedingly rare entity, withonly a few documented cases in the literature. Here, wepresent the case of a 69-year-old male patient whowasdiagnosedwithmucoepidermoidcarcinoma of the pancreasthathadmetastasized to the liver. MEC of the pancreasis a highlyaggressivemalignancythatisassociatedwith a poorprognosis due to itsability to invadesurrounding tissues and to metastasizeearly. In this report, wedescribe the patientsclinicalpresentation, diagnostic workup, and management, as well as a review of the currentliterature on this rare tumor.

Background: Breast cancer is a major public health problem worldwide. It's the most common cause of death from cancer in women, it considers a heterogeneous disease, shows variable morphological and biological features, they have different clinical behavior, and prognoses, and respond to therapy differently despite similarities in histological types, grade, and stage. The classication aims for an accurate diagnosis and prediction of behavior, however, histological classication isn't enough in this era of personalized medicine, this results in « overtreatment » of many patients, so, molecular proling allows tumors to be dened by the expression pattern or genomic alteration of thousands of genes. A Methods: retrospective, descriptive and analytic study was performed among 1040 women with invasive breast carcinoma, which was diagnosed in the department of surgical pathology at University Hospital Center of Hassan 2 of Fez in Morocco, during a period ranging from 2012 to 2019. The prevalence of different molecular subtypes of breast carcinoma was estimated, in addition, clinicopathological features such as age, tumor size, tumor grade, lymph node involvement, hormonal receptors prole, and HER2 status have been compared. The mean age of diagnosis was Results: 49.5 years (DS12,5 years, 17-88 years), among these, 637 (55%) were under 50 years. NOS invasive breast carcinoma was the histological type the most common in 1030 (89%), with an SBR II in 60% of cases. The Mean tumor size was 2.8cm. Axillary lymph nodes (LN) were metastatic in 60% of cases. 76% of cases showed positive staining for estrogen receptors, 75,5% for progesterone receptors, and 18,5% for HER2/neu. Luminal A subtype was found in 22% of patients while Luminal B was present in 62,5% of patients, HER2 enriched in 5%, and triple-negative (TN) in 10,5 % of cases. There is signicant difference between the 4 subclasses by age (P=0.02), SBR grading (p

Despite advances in drug therapy, pain management for patients with lung cancer remains complex.Lung cancer is known to be one of the most painful cancers. Objective:In this study we evaluate the management of pain in patients treated for lung cancer, all stages combined, in the oncology department of the Hassan II University Hospital of Fez. Mean: cross-sectional study of 71 patients collected over a period of one year using a questionnaire specifying the characteristics of the pain, its etiology, the stage of the disease, the analgesic treatments prescribed and the relief obtained by the treatment. Results:The mean age of the patients was 63.5 years with extremes ranging from 48 to 85 years. Male gender was predominant (68%), 67% of patients had metastatic cancer: 42% had bone metastases. Nociceptive pain was assessed by the visual analog scale (VAS) and neuropathic pain by the DN4 Questionnaire. Severe pain, characterized by a VAS score higher than 7, or of moderate intensity with impact on sleep and daily activity, was reported in 60.5% of our patients, mostly young subjects, all with advanced cancer.The pain was acute in 5% of cases, subacute in 32% of patients and chronic in 63% of cases. Neuropathic pain was found in 23% of patients. The pain was controlled by analgesics, level II, in association with an anti-inflammatory agent or antidepressants in 37.3%. 62.7% of patients required morphine. An average daily dose of 60mg of morphine was required to relieve pain, 15 patients reported paroxysmal pain attacks of strong intensity requiring the prescription of sublingual Fentanyl. The use of analgesic radiotherapy in combination with morphine was noted in 10 patients (9.8%). However, a small percentage (2.8%) of patients were resistant to the above-mentioned analgesics, requiring the use of non-drug techniques to relieve them. Conclusion:Our survey confirms the persistent problem of inadequate management of cancer pain. An interesting approach is to improve &nbsp

Kaposi sarcoma is a rare condition, it is an incurable disease with a poor prognosis, the treatment of this pathology is variable including surgery, Radiotherapy, chemotherapy and antiviral treatments. A number of drugs approved for the treatment of KS associated with AIDS, in particular the pegylated liposomal doxorubicin (DLP) which is currently the standard, Paclitaxel, have also shown efficacy against advanced SK. We report a case of a patient with kaposi's sarcoma associated with HIV metastatic in the lung, liver and lymph nodes and who presented an almost complete response after 4 months of chemotherapy with weekly Paclitaxel at a dose of 100 mg in our department of medical oncology at CHU Hassan II in Fez. Of interest is the complete response to paclitaxel treatment in a patient followed for metastatic kaposi sarcoma.

Background: Lung cancer is a public health problem in Morocco. Multiple clinical practice guidelines recommend rapid evaluation of patients with suspected lung cancer. It is uncertain whether delays in diagnosis and management are correlated with outcomes. The objective of this study was to evaluate if these delays have any negative effect on outcomes. Methods: This retrospective study included 140 patients diagnosed with non-small cell lung cancer (NSCLC). It was conducted at the Medical Oncology Department of Fez from January 2016 to December 2017. We have studied many wait times and considered that: wait time to consult (WTC) is the delay from the first symptom to initial consultation, wait time to diagnosis (WTD) is the delay from initial consultation to diagnosis, wait time to referral (WTR) is the delay from diagnosis to referral to the oncologist, and wait time to treatment (WTT) is the time from referral to treatment initiation. Our analysis used Kaplan–Meier method to estimate the overall survival (OS). To compare the OS between wait time categories, we used the logrank test. Results: The median age was 59.46 years. The sex ratio was 6 men for 1 woman. The most common histological subtype was adenocarcinoma (58.6% of cases). Eighty-two percent of patients were diagnosed at stage IV. The median WTC was 240 days (range, 15–280 days), WTD was 45 days (13–65), WTR was 54 days (13–63), and WTT was 32 days (12–40). The only factor that was associated with a long WTD was long distance (> 60 km) to the hospital (p = 0.05). We found that short WTC, WTD, and WTR had better OS: 12 versus 3 months (p < 0.0001), 12 versus 4 months (p < 0.0001), and 14 versus 5 months (p < 0.0001), respectively. We found no difference in OS between short and long WTT. Conclusion: In our study, patients with lung cancer experience significant delays from development of symptoms to first treatment initiation. We found a clear association between survival and short delays from initial symptoms to consultation, from consultation to diagnosis, and from diagnosis to referral to the department of oncology.

Nuclear protein in testis (NUT) midline carcinoma (NMC) is a very rare and aggressive human cancer characterized by overexpression of the nuclear protein in testis (NUT) most commonly due to a chromosomal translocation that fuses the NUT gene on chromosome 15 with the BRD4 gene on chromosome19. It has been described mainly in younger individuals in the mediastinum and head and neck regions and known to be highly aggressive with poor outcomes. We report the case of 23 years old male, diagnosed with locally advanced mediastinal malignancy metastatic to the lung with elevated serum alpha-fetoprotein (AFP) suggestive of germ cell tumor. However, pathology with immunohistochemistry excluded the dignosis of germ cell tumor and confirmed the diagnosis of poorly differentiated carcinoma. Despite aggressive treatment, evolution was marked by rapid clinical deterioration leading to death within 1 month of initial diagnosis. We report this case to underline the rarity of this disease, clinico-radiological and pathologic features, especially misleading presentation with germ cell tumors, treatment management and prognosis.

Le sarcome epithelioide proximal d'origine pleural revele par un epanchement pleural reste rare dans la litterature, nous rapportons le cas d'une jeune patiente, admise au service d'oncologie medicale pour prise en charge d'un sarcome epithelioide pleural proximal metastatique. A la fin du premier cycle de chimiotherapie, la patiente est decedee dans un tableau de detresse respiratoire aigue. Notre observation illustre le caractere potentiellement trompeur et agressif du sarcome epithelioide presentant un piege clinique pouvant mettre en jeu le pronostic vital et dont le diagnostic positif est strictement anatomopathologique. The Pan African Medical Journal 2016;25