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Endometrial cancer is the fourth most common malignant tumor in women in developed countries, and in Morocco it represents the third most common gynecological cancer. It primarily affects postmenopausal women. Our study is a retrospective descriptive study conducted from 01/01/2014 to 01/01/2018 at the radiation therapy department of the National Institute of Oncology in Rabat. Data were collected from medical records and included epidemiological, clinical, therapeutic and prognostic aspects of this cancer. The median age at diagnosis was 61 years. The median delay to consultation was 6 months. The histological diagnosis was made by endometrial biopsy in 52.3% of cases. Pathological examination revealed endometrioid adenocarcinoma in 91% of cases. 32 patients received adjuvant treatment consisting of external radiotherapy at a dose of 46 Gy in 23 fractions, followed by vaginal brachytherapy (37%), of which 6 of these patients also received sequential chemotherapy (7.1%). 21 patients were treated with brachytherapy alone (25%), 11 patients with external radiotherapy alone (13%), and 21 patients with concurrent radiochemotherapy (25%). The treatment interval between diagnosis and surgery was 42 days. In our series, the overall 5-year survival rate was 93.6% for all stages combined.

The announcement of the diagnosis of cancer represents a fundamentalstep in the patientshistory, it conditions the quality of the bond of trust with the doctor and requiresveryspecial attention. It is for thisreasonthat the announcement consultation must beidentified in the course of care for cancer patients. The objective of oursurvey of 80 patients followed in the radiotherapydepartment at the National Institute of Oncologyis to analyze the methods of announcing cancer and the feelings of patients in order to target possible points for improvement for a better care whileaddressingsomepsychological and communicationalcharacteristics of the announcement of bad news, ethicalconsiderations and regulatory and deontologicalframeworksthat structure thisapproach in Morocco. &nbsp

Endometrial cancer is the fourth most common malignant tumor in women in developedcountries, and in Morocco it represents the third most common gynecological cancer. It primarily affects postmenopausal women. Our study is a retrospective descriptive study conducted from 01/01/2014 to 01/01/2018 at the radiation therapy department of the National Institute of Oncology in Rabat. Data were collected from medical records and included epidemiological, clinical, therapeutic and prognostic aspects of this cancer. The median age at diagnosis was 61 years. The median delay to consultation was 6 months. The histological diagnosis was made by endometrial biopsy in 52.3% of cases. Pathological examination revealed endometrioid adenocarcinoma in 91% of cases. 32 patients received adjuvant treatment consisting of external radiotherapy at a dose of 46 Gy in 23 fractions, followed by vaginal brachytherapy (37%), of which 6 of these patients also received sequential chemotherapy (7.1%). 21 patients were treated with brachytherapy alone (25%), 11 patients with external radiotherapy alone (13%), and 21 patients with concurrent radiochemotherapy (25%).The treatment interval between diagnosis and surgery was 42 days.In our series, the overall 5-year survival rate was 93.6% for all stages combined. &nbsp

Adenoid cystic carcinoma of the nasal cavity is a rare malignancy. It is a slowly progressive disease, characterized by local recurrences and distant metastases and requires early and adequate management. We report a case of Adenoid cystic carcinoma of the nasal fossa and will discuss the diagnostic and therapeutic characteristics in the highlight of a review of the literature. &nbsp

Paratesticular Rhabdomyosarcoma (RMS) is a rare tumor. Treatment must be multimodal and based on surgery, chemotherapy and radiotherapy. We report an observation of a paratesticular RMS in a child and willdiscuss the diagnostic and therapeuticmodalities in the highlight of a review of the literature. &nbsp

Introduction: To determine the proportion and the reasons which lead to palliative treatment in patients initially a candidate for concomitant chemoradiotherapy (CCRT). Methods: A retrospective study including patients followed for locally advanced lung cancer newly diagnosed from April 1, 2016, to 12/31/2017 in the radiotherapy department of the National Oncology Institute who received palliative treatment. Results: We collected 52 patients out of a total of 225 stage III patients (23%) followed by lung cancer candidates for CCRT who had undergone palliative treatment. The mean age in our series was 61.23 years [22 - 81] with 86% male. The majority of patients (71%) had Performance Status (PS) ≤ 2. Histological confirmation was obtained by pathological examination in all our patients. It was an adenocarcinoma (ADK) in 54% of cases; squamous cell carcinoma in 46% of cases. The reasons for palliative treatment were mainly due to dosimetric constraints: large tumor volume 22/52 (42%); the tumor location close to the bone marrow in 15 of 52 (29%) patients; and general Performance Status impairment (29%) in 15 of 52 patients. Palliative treatment consisted of palliative chemotherapy in 37 of 52 patients (71%), among whom 19 (51%) were stable after 2 months of chemotherapy, in palliative dose chest radiotherapy on the pulmonary parenchyma and/or mediastinum in 10 of 52 (19%) patients, and supportive care in 5 (10 %) patients. We observed 40/52 (77%) cases of stationary course, 04/52 (8%) cases of progress to metastases, and 08/52 (15%) deaths before radiotherapy. Conclusion: A large proportion of patients followed for locally advanced non-metastatic lung cancer are not eligible for curative treatment. The reasons for the palliative treatment of patients followed for lung cancer candidates for CCRT are variable but for a large proportion of patients due to the deterioration of their state of health during their diagnostic journey. Hence, there is the need to improve the early diagnosis and early management of patients with lung cancer to avoid delayed care.

Ameloblastoma is a benign odontogenic tumor. It is locally invasive and unlimited growth capacity, with a propensity for recurrence if not entirely excised. The therapeutic challenge in this type of tumors is to have an adequate resection with a wide margin of normal tissue but also a functional and aesthetically acceptable reconstruction of the residual defect. The role of radiotherapy is currently demonstrated in inoperable cases. We are reporting a case of a 45 years-old male patient with large ameloblastoma of the mandible recurrent 10 years after surgical resection. The patient benefited from exclusive radiotherapy at a dose of 60 Gy.

Purpose: Small cell neuroendocrine bladder carcinoma is a rare entity, account for less than 1% of all bladder tumors. They are of particular histological entity characterized by an aggressive clinical behaviour, high potential for metastatic spread and poor prognosis. The aim of this study was to describe the epidemiological, clinical, therapeutic modalities and the evolution data of small cell neuroendocrine bladder carcinomas. Patients and methods: During a period of 10 years, four patients with neuroendocrine bladder carcinoma were treated at the National Institute of Oncology in Rabat. Results: The median age was 66 years. There were three men and a woman. Neuroendocrine carcinoma was pure in one case and associated with transitional cell carcinoma in the other three cases. Two patients were diagnosed with lymph nodes involvement and one patient at a metastatic stage. A cystectomy was performed in one case. Two patients received a concurrent chemoradiation and the fourth patient received chemotherapy alone. A single case of complete remission was observed. Median survival was 18 months (6–30 months). Only one patient is still alive 30 months after diagnosis. Conclusion: The management of neuroendocrine carcinoma of the bladder remains debated and vary from institution to author. Despite multimodality regimens, the prognosis of these tumours remains poor.

It’s a 24 years old female patient who presented with rhinological burning pain evolving since 1 year. She didn’t consult until a blistering lesion filled half of the oral cavity. The initial biopsy of the tumor was interpreted as a round cell tumor process. It’s a 24 years old female patient who presented with rhinological burning pain evolving since 1 year. She didn’t consult until a blistering lesion filled half of the oral cavity. The initial biopsy of the tumor was interpreted as a round cell tumor process. An immuno-histochemical complement showed a poorly differentiated neuroendocrine carcinoma (Pancytokeratine+, Ki67 at 30%, Chromogranine+, Synaptophysine-). CT scan showed a locally advanced maxillary nasal sinus tumor of 74 mm in the greatest diameter. The remainder of the staging didn’t reveal any metastases. The patient received 3 courses of chemotherapy with Etoposod-cisplatin. The clinical and radiological evaluations showed a progression of disease [Figure 1].

Background: Bladder extrophy is a rare congenital anomaly, it is now well reconized that an exstrophy of the bladder is associated with an increased risk of bladder cancer. Case presentation: We report the case of 34-year-old male with squamous cell carcinoma of an unreconstructed exstrophic bladder. Because of the locally advanced disease, he received neoadjuvant chemotherapy with favorable response. Then, he underwent a total cystectomy with uretero-intestinal anastamosis. Results: The patient progressed three months after the surgery. Chemotherapy was established and he received 2 cycles, however, he died 2 months later. Conclusion: Squamous cell carcinoma associated with bladder extrophy remains relatively high. These tumors tend to be aggressive, follow-up is mandatory in these cases.

Background Leiomyosarcoma of the rectum is a rare entity that comprises less than 0.1 % of all rectal malignancies. Given the uncommon nature of this tumor and the controversy about its treatment we report one case and review the literature in an attempt to report a particular evolution and to discuss the most appropriate treatment. Case presentation This case report describes the presentation of leiomyosarcoma of the rectum. A 30-year-old man from the north of Morocco presented with rectorrhagia and constipation. On physical examination we found a mass in his rectum approximately 6 cm from his anal margin. Pelvic magnetic resonance imaging showed a rectal mass with a parietal attachment that invaded the fascia and his perirectal tissue. Before any treatment he defecated spontaneously the tumor. On histopathological examination a diagnosis of leiomyosarcoma was made. An anterior resection of his rectum was performed with adjuvant radiotherapy at a dose of 50 Gy. After 1 year of surveillance, he has not presented any clinical symptoms and pelvic magnetic resonance imaging was normal. Unfortunately, histological analysis of a superficial biopsy of a rectal leiomyosarcoma may not be reflective of the entire tumor mass, and a diagnosis is based essentially on postoperative pathological examination. The optimal treatment modality in patients with rectal leiomyosarcomas is controversial. Prognosis is also poor; tumor size, histological grade, mitotic index, and local staging are the most known prognosis factors. Conclusion The prognosis of rectal leiomyosarcoma is poor; more investigations are necessary to understand the progression of these tumors and to define an optimal treatment modality.

Introduction: In Morocco, cervical cancer is the second most common cancer,and the third cause of death. Our department recruits more than 500 patients each year and proximally half of the cases are diagnosed at an advanced stage. Patients and methods: Between January 2011 and December 2011, all patients diagnosed with cervical cancer and treated with concurrent chemoradiotherapy were retrieved. We analyzed overall survival, local control, and defined prognostic factors influencing outcomes in this population. Results: At 3 years the overall survival rate for the cohort was 89.8% and the overall LC rate was 80.8%. The most important prognostic factors for OS and LC were the pretreatment hemoglobin, total duration of treatment, and the use of brachyteherapy. Of the included patients, 20% experienced late Grade 3 or 4 toxicity. Conclusion: The results of our study have shown that besides tumor stage, the use of brachytherapy, and lymphnode status, other factors such as pretreatment hemoglobin and treatment duration should be analyzed carefully and should be considered taking into consideration influence of all of the aforementioned factors.

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Introduction: In Morocco, cervical cancer is the second most common cancer, and proximally half of the cases are diagnosed at an advanced stage. The standard treatment approach is concurrent chemoradiation followed by intracavitary brachytherapy (BT) boost to the cervix. Patients and methods: 293 patients diagnosed with cervical cancer and treated with concurrent chemoradiotherapy between January 2011 and December 2011 at our department was retrieved. We analyzed defined prognostic factors influencing outcomes. The aim of our study is to analyze the effect of the use of brachytherapy on treatment outcomes (overall survival and local control) and to report the toxicities for each treatment approach. Results: At 3 years, the use of brachytherapy as boost was found to be a significant factor impacting both OS (P=0.0001)), and LC (P=0.001). Also in the multivariate analysis, brachytherapy was an independent prognosis factor affecting both OS (hazard ratio [HR], 3.29; 95% CI, 1.50-7.21, P=0.03) and LC (hazard ratio [HR], 2.33; 95% CI, 1.30-7.21, P=0.005). Conclusion: At present, brachytherapy is still the standard approach to boost the cervix in patients with locally advanced cervical cancer.

Introduction: Treatment duration has always been related to treatment outcomes in cervical cancer. Our study is aiming to evaluate this parameter and its effect on treatments’ results in patients with locally advanced cervical cancer treated with concurrent chemo radiation. Patients and methods: Between January 2011 and December 2011, all patients diagnosed with cervical cancer and treated with concurrent chemo radiotherapy were retrieved. Treatment duration was calculated from the first day of EBRT to the last day of brachytherapy or EBRT, whichever was last to complete, Fifty-six days (8 weeks) was used as a limit, we analyzed the impact of treatment duration on the overall survival and local control. Results: The median time to complete pelvis RT was 37 days (34-42 days). A median of 15 days (13-26 days) between the last day of Pelvic RT and the start of the first Brachytherapy fraction (Pelvis RT-BT interval) was noted. The median time to complete EBRT in association with BT was55 days (50-69 days) while the median total treatment duration was 61 days (53-71 days). At 3 years the overall survival (OS) rate of the studied cohort was 89.8% and local control (LC) rate was 80.8%. In the univariate analysis, total treatment duration (>56 days) was found to be a significant factor impacting both OS (P=0.014)), and LC (P=0.014). Also in the multivariate analysis, total treatment duration was associated independently with prognosis, and affected both OS (hazard ratio [HR], 2.8; 95% CI, 1.07-7.54, P=0.035) and LC (hazard ratio [HR] 3.2; 95% CI, 1.57-6.64, P=0.001). Conclusion: Extended treatment duration significantly affects treatment outcomes in cervical cancer, efforts should be made to shorten it in a way to improve cancer prognosis.

Cervical cancer (CC) is one of the most widespread gynecological malignancies in women worldwide. Treatment strategies and screening modalities have largely evolved these past years resulting in an improvement of survival. However, treatment modalities are associated with long term side effects that significantly impacts quality of life (QOL) in cervical cancer survivors. The aim of this study is to evaluate QOL (General and sexual QOL) in cervical cancer survivors up to 10 years after the diagnosis. In a cross-sectional descriptive study design, 110 cervical cancer survivors (CCS) and 80 healthy controls completed questionnaires assessing QOL. Participants were Arabic White, sexually active. The mean age at diagnosis was 34 years and was 43 years at the time of the interview. In our series long term CCS have generally a good global QOL comparable with healthy controls. However, issues concerning emotional functioning were over expressed by CCS. As to the sexual impact of cervical cancer; CCS experienced less sexual functioning and enjoyment and less satisfaction with their body image when compared to healthy controls. In a multivariate analysis, spiritual well-being and social support were the predictor factors that statistically affected QOL among the studied cohort, it accounted for 81 % of the variance in QOL scores. A better understanding of the complexity of the relationship between QOL and cervical cancer sequelae in one hand and socio-demographic factors in the other hand is necessary to improve QOL among cervical cancer survivors. More efforts should make to inform disease free patients about expected side effects and symptoms to face the physical changes that would affect their QOL and sexual activity.

We performed a population-based study to determine the significance of adenocarcinoma and to evaluate its behavior over the last 10 years among patients treated in the National cancer institute of Morocco. This is a retrospective study that was conducted in the national cancer institute of Morocco. Over a period of 10 years, we retrieved 350 cases of cervical invasive adenocarcinoma. Survival was analyzed according to the Kaplan–Meier method. A univariate analysis of prognostic factors was performed using the test of log rank. Cox regression model was used for the multivariate analysis of prognostic factors. Mean age at presentation was 46 years. Sixty seven percent of the patients had locally advanced stage. Radiotherapy was prescribed in 73.3 % of the cases. The mean follow-up time for surviving patients was 51 months. The 5-year survival rates according to clinical stages were as follows, 76 and 62 % for stages I and II, respectively, 32 and 9 % for stages III and IV, respectively. Tumor stage, tumor grade, positive lymph nodes status, lymphovascular space involvement and patient’s age were significant prognostic factors in a univariate analysis. While only stage and lymph node involvement remained significant independent predictors for survival in the multivariate analysis. Although in our country incidence of adenocarcinoma is lower than the ones reported in western countries, in general our results are consistent with those reported in the literature. Better outcomes are observed in both early stages and young patients. Also, we found that FIGO stage, grade and lymph node metastases to be significant prognostic factors for survival in cervical adenocarcinoma.

Introduction Cancer metastasis to the thyroid is extremely rare. The most common sites that have been reported to metastasize to the thyroid gland are breast and kidney. As to primary lung cancer metastasizing to the thyroid gland, only a few cases have been described in the literature. Case presentation We report a case of a 37-year-old white Arabian woman who had never smoked tobacco products for whom a malignant thyroid mass revealed a primary lung tumor. She had a surgical excision for both the thyroid and the pulmonary tumors, and received adjuvant chemotherapy. At 1 year, she is still in remission. Conclusions Our case is rare as it describes a case where the thyroid lesion was the revealing sign of an unknown lung carcinoma. Management of thyroid metastases should depend on the individual situation and surgical excision should be proposed whenever a patient’s condition is favorable.

Background Sebaceous carcinoma is a rare malignancy primarily with aggressive growth affecting the cutaneous tissues of the periocular region. Sebaceous carcinoma of the parotid gland is exceedingly rare, with only 32 cases reported in the literature. Our case brings this total to 33. Case presentation We present a case of a 57-year-old Moroccan woman with a firm, painless, slowly enlarging swelling at her left parotid area, with normal overlying skin and no palpable neck nodes. Parotidectomy with facial nerve preservation was performed, and microscopic examination showed sebaceous carcinoma. Then, she underwent adjuvant radiotherapy. With a follow up of 20 months, head and neck computed tomography revealed no recurrence. Conclusions The optimal treatment is unclear. With more cases reported, clinicopathological characteristics and histogenesis are increasingly understood. Therefore the treatment for this rare tumor continues to evolve.