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Lung cancer is known to be a complex multifactorial disease, involving both genetic and environmental factors. The study of the different signaling pathways and the identification of the genes involved, will contribute to further understanding the pathogenesis of the disease, thus allowing the development of appropriate targeted treatments. Recently, the link between cancer and inflammation has become more evident and inflammation has been proposed as the seventh hallmark of cancer. Previous studies have suggested that key cytokines involved in inflammation may have an important role in the etiology of lung cancer. The aim of this study was to investigate whether common variants in inflammation-related genes: IL-6, IL6-R, and IL6-ST, influence lung cancer risk in Moroccan population. Single nucleotide polymorphisms (SNPs) in IL-6, IL6-R, and IL6-ST genes were assessed in 120 controls and 120 patients with confirmed lung cancer diagnosis. Genotyping analysis was performed with the TaqMan® allelic discrimination technology. The results were analyzed using SPSS 24.0 software. Among the studied SNPs, we found a significant association for the IL-6 (rs2069840) (OR = 1.63; 95% confidence interval 1.08–2.47; p = 0.01). No significant association was observed for the remaining SNPs of IL-6R (rs2228145) and IL-6ST (rs2228044) genes. Our results suggest the IL-6 (rs2069840) polymorphism may influence the occurrence of lung cancer in Moroccan patients.

Breast cancer is the most common cancer in women in the world and in Morocco. Anthracyclines and anti-HER2 therapy are major drugs in the therapeutic management of localized breast cancer. The most serious toxicity of these drugs is cardiotoxicity. Our work aims to assess the prevalence of this toxicity in the Moroccan population.We conducted a prospective longitudinal observational study between January 2017 and June 2018. All our patients were followed in The Cardio-Oncology Unit, 1st unit of its kind in Morocco, created thanks to the collaboration between the Mohammed VI Cancer Treatment Center and The Cardiology Departement of Ibn Rochd University Hospital in Casablanca. Eligible patients (n=549) had Stage I-III localized breast cancer, verified histologically, and a pre-treatment adequate cardiac function with a LVEF = 50%, measured with echocardiography, and received systemic cardiotoxic treatment (anthracycines, anti-her2 drugs). All patients received regular monitoring of cardiac function mainly by echocardiography. Cardiotoxicity was defined as a decrease in LVEF of 10 points and / or50%.A decrease in LVEF was observed in 8.4% of our patients, with 4% symptomatic heart failure. The baseline average LVEF in the cardiotoxicity group was 63.5% (50-77) versus 60.5% (60-74) in the group without cardiotoxicity. 97.1% of these patients received anthracyclines, 98% received trastuzumab against 97% and 65% in the group without cardiotoxicity respectively. Cardiotoxicity was reversible in 6.4% of patients, permanent discontinuation of cardiotoxic treatment was observed in 2.2%. A statistically significant relationship was found between cardiotoxicity and arterial hypertension (HTA) (p = 0.002), trastuzumab (p = 0.0001) and radiotherapy for left breast cancer (p = 0.023).This is one of the first observational studies in Morocco with a large number of patients, which gives us an idea of the cardiotoxicity of systemic treatments in Moroccan localized breast cancer patients. Our results join those of the literature, but are still worrying and invite us, oncologists and cardiologists, to be more vigilant with this toxicity, which influences the oncological and cardiac prognosis of our patients, especially cancer survivors.

To date, several studies have reported that key cytokines in the inflammatory system have important roles in the pathogenesis of cancer, notably in lung cancer. The aim of this case-control study, conducted for the first time in Moroccan population, was to investigate and to analyze the association of the following inflammatory cytokine genes Interleukin (IL)-6, Interleukin (IL)-8, Interleukin (IL)-10, Interleukin (IL)-17, Tumor Necrosis Factor-Alpha (TNFA), Macrophage migration Inhibitory Factor (MIF) and Signal Transducer and Activator of Transcription 3 (STAT3) with lung cancer risk in our patients. Firstly, the mRNA expression was assessed by a quantitative real time PCR in the peripheral blood of lung cancer patients and healthy subjects. Secondly, polymorphisms in the genes encoding cytokines were assessed in 160 lung cancer patients and 150 healthy controls. Genotyping analysis was performed with a Real-Time polymerase chain reaction using TaqMan® genotyping assays on a 7500 FAST Real-Time PCR System and Restriction Fragment Length PolymorphismPCR. Our results revealed a significant difference in mRNA expression levels of IL-6, IL-8, IL-10, IL-17 and TNFA genes in lung cancer patients compared to healthy subjects (P 0.05). Among the studied genes, we found a significant association between lung cancer risk in our patients and the following polymorphisms IL-6 (rs1800795, rs1800796), IL-8 (rs4075, rs2227306), IL-17F (rs763780, rs2397084) and MIF (rs755622). In conclusion, the results of our study suggest that IL-6, IL-8, IL-10, IL-17 and MIF cytokine genes may aggravate lung cancer risk in the Moroccan population. However, further investigations are required to confirm our findings.

Granulosa cell tumors is classified into juvenile and adult types and comprise less than 5% of ovarian tumors in women and are much rarer in men which only 45 have been previously reported. We report here a 40-year young man with a left testicular adult type granulosa cell tumor. The tumor measured 5.5X5X4cm; Immunohistochemical stains showed the tumor diffusely positive for inhibin and vimentin. Post operative CT scans shows a lomboaortic lymphnodes treated by four cycles of chemotherapy type BEP (bleomycin, etoposide, cisplatin). The thoraco abdominal CT scans post chemotherapy shows the disappearance of the right testicular nodule and the lomboaortic lymphnodes. 2 years after treatment, the patient is alive and well with no signs of recurrence. Our report highlights one more case of this very rare tumor of the testis, which is quite problematic In terms of prognosis and management, and for this reason seems to have attracted the interest of many researchers recently.

Le lymphome non hodgkinien (LNHK) extra-ganglionnaire primitif est rare et sa localisation intramusculaire primitive est exceptionnelle puisqu'elle est observée chez moins de 0,5% des patients. Ils touchent généralement des hommes dont l'âge moyen est de 70 ans. Le traitement standard associe l'exérèse chirurgicale, la chimiothérapie et la radiothérapie. Nous rapportons un cas d'un jeune patient de 31 ans qui s'est présenté pour un syndrome pseudotumorale musculaire au niveau de la jambe droite dont l'examen anatomopathologique avait conclu un lymphome malin non hodgkinien à grandes cellules B intramusculaire. Le patient a été traité par chimiothérapie exclusive avec une rémission complète.

Les tumeurs phyllodes du sein sont des tumeurs très rares et restent exceptionnelles chez les enfants et les adolescents, leurs traitement est basé sur la chirurgie et la radiothérapie, avec un bon pronostic. Nous rapportons le cas d'une adolescente âgée de 12 ans, qui s'est présentée pour une masse du sein gauche. Le diagnoctic d'une tumeur phyllode a été retenu après bilan et histologie. Le traitement a consisté en une tumorectomie large sans traitement adjuvant ; avec une bonne évolution à un recul de deux ans.

L’angiosarcome de l’oreille est une tumeur maligne très rare, et localement très agressive. Elle représente 4-5% des sarcomes cutanés et moins de 1% de tous les sarcomes. Notre objectif est de décrire et de discuter les modalités diagnostiques et thérapeutiques de cette tumeur maligne. A travers le cas clinique d’une patiente âgée de 31 ans reçue pour une masse bourgeonnante du pavillon de l’oreille gauche. Le scanner était en faveur d’une tumeur du pavillon d’oreille avec envahissement de la parotide homolatérale. Le diagnostic histologique était en faveur d’un angiosarcome. Le traitement a consisté en une chirurgie d’exérèse complète suivie d’une radiothérapie adjuvante. Elle est en rémission compléte avec un recul d’une année.Pan African Medical Journal 2016; 24:177

Les tumeurs à cellules de la granulosa (TG) de l’ovaire sont des tumeurs rares appartenant au groupe des tumeurs des cordons sexuels et du stroma. Elles représentent 0,6 à 3 % de l’ensemble des tumeurs de l’ovaire et 5 % des tumeurs malignes On distingue deux types: le type juvénile (TGJ) qui se caractérise par son agressivité et le type adulte (TGA) qui est le type le moins agressif et le plus fréquent. Les rechutes de TG de l'ovaire surviennent généralement dans les cinq ans, elles sont rarement sous forme de métastases péritonéales ou locales. Bien que, des options de traitement y compris la chirurgie avec ou sans chimiothérapie et ou radiothérapie ont été rapportés pour le traitement des récidives des TG, il n'y a aucune prise en charge standardisée de récidive de cette maladie. Ici, nous rapportons notre stratégie thérapeutique dans la prise en charge des récidives tardives, après dix ans, de la TG sous forme de carcinose péritonéale pour deux patientes avec une revue de la littérature.The Pan African Medical Journal 2016;25

Introduction Imatinib, a tyrosine kinase inhibitor, is a major therapeutic option for the management of unresectable aggressive fibromatosis. Unfortunately, for most patients of low or very low average income countries, surgery often is the first treatment option. This is related to unavailability of chemotherapy or targeted therapy, and to a lack of financial resources or surgeons’ lack of knowledge of other therapeutic options. Case presentation In 2010, a 26-year-old Moroccan man was referred to our oncology and radiotherapy center by his surgeon for the management of a recurrent tumor of his right subscapularis muscle. Before his assessment in our center, two resections were performed by his surgeon after performing an incision biopsy and magnetic resonance imaging. Postoperative magnetic resonance imaging was performed and showed a right axillary nodule size 2.1cm regarding a collection with a residual tumor. We decided to administer imatinib 400mg daily by mouth. Clinical and magnetic resonance imaging evaluation were performed regularly and reported a stable tumor. We reported no adverse side effects to imatinib regarding Common Terminology Criteria for Adverse Events grading. Conclusions Recurrences are high during aggressive fibromatosis management. Systemic treatment with imatinib for unresectable or recurrent tumors with positive c-KIT could be the best therapeutic option. In our case report, the patient was stabilized with imatinib for 30 months and he had a very good quality of life.

Le syndrome de Stewart-Treves (SST) est une entité rare, correspondant à un angiosarcome cutané compliquant un lymphoedème chronique. Il est de mauvais pronostic. Stewart et Treves ont rapportés en 1948, les premiers cas d'angiosarcome secondaire à un traitement du cancer du sein. Ce terme s'est généralisé pour regrouper l'ensemble des cas de lymphangiosarcome sur lymphoedème d'origine congénital héréditaire ou non héréditaire, post-traumatique ou post-infectieux. Le SST sur un lymphoedème idiopathique reste exceptionnel. Nous rapportons le cas rare d'une patiente présentant un lymphoedème chronique primitif idiopathique des quatre membres évoluant depuis l'adolescence et qui a développé un SST du membre supérieur droit. Elle a subi une amputation à mi- bras vu le caractère très évolué de la tumeur.

INTRODUCTION: Few population-based cancer registries are in place in developing countries. METHODS: In order to know the burden of cancer in Moroccan population, cancer registry initiative was put in place in the Casablanca district, the biggest city of Morocco. RESULTS: The data collected covers 3.6 millions inhabitant and included Casablanca city and the administrative region. The data collected in the years 2005-07 show that the top 5 forms of cancers in women were breast (ASR: 36.4 per 100,000), cervical (15.0), thyroid (6.7), colon-rectum (5.8), and ovarian (5.3); the top 5 cancers in men were lung (25.9), prostate (13.5), bladder (8.7), colon-rectum (8.1) and non-Hodgkin lymphoma (7.2). Tumours of haematopoietic and lymphoid tissues represented 11% of all cancers (skin excluded); some presented unusual sex ratios. For breast, cervical, colorectal and thyroid cancer, respectively 57%, 42%, 28% and 60% of the cases were under 50 years of age. This was attributable to particularly low numbers of cases recorded among old people, and the young age of the general population; the observed age-specific incidences under age 50 were not higher than in western countries. Cancers at young ages were particularly common in women: 67% of the cases were under 50. Stage at diagnosis could be obtained for 82% of the breast cancer cases and was as follows: 28% local, 63% regional and 9% distant, in the absence of screening. CONCLUSION: These first population-based data have provided an invaluable resource for the national cancer control plan of Morocco, and will be useful tool to its future evaluation.

Les métastases cérébrales des cancers du col de l'utérus sont extrêmement rares. Elles sont généralement supra-tentorielles, survenant à un stade avancé de la maladie et dans un cadre de néoplasie polymétastatique. La tumeur primitive est le plus souvent un carcinome épidermoïde peu différencié. Leur pronostic reste sombre malgré toutes les options thérapeutiques. Vu la rareté de cet événement et le peu de cas publiés dans la littérature, nous rapportons l'observation clinique d'une jeune patiente de 44 ans, opérée pour un carcinome du col utérin et qui présente 14 mois plus tard des métastases cérébrales sus et sous tentorielles associées à des métastases ganglionnaires lombo-aortique, médiastinale et sus-claviculaire. Elle a bénéficié d'un traitement palliatif associant une chimiothérapie et une radiothérapie pan encéphalique. Devant l'altération rapide de l'état général, la patiente a été mise sous un traitement symptomatique et des soins de support.

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract in adults, although rectal localisation of these tumours is very rare. We report here two cases of rectal stromal tumours in a 77-year-old woman and a 65-year-old man, confirmed by histology and immunohistochemistry. Surgery for rectal GIST patients is the standard treatment and adjuvant imatinib, a tyrosine kinase inhibitor, is indicated for GISTs with a high risk of malignancy, as well as in the case of metastatic or unresectable tumours.Pan African Medical Journal 2012; 12:19