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Basal cell carcinoma is the most common skin cancer, characterised by a slow growing behavior, metastasis are extremely rare, and it occurs in less than 0, 1% of all cases.Giant basal cell carcinoma is a rare form of basal cell carcinoma, more aggressive and defined as a tumor measuring more than 5 cm at its largest diameter. Only 1% of all basal cell carcinoma develops to a giant basal cell carcinoma,resulting ofpatient's negligence. Giant basal cell carcinoma is associated with higher potential of metastasis and even death, compared to ordinary basal cell carcinoma.We report a case of giant basal cell carcinoma metastaticin lung occurringin a 79 years old male patient, with a fatal evolution after one course of systemic chemotherapy.Giant basal cell carcinoma is a very rare entity, early detection of these tumors could prevent metastasis occurrence and improve the prognosis of this malignancy.The Pan African Medical Journal 2016;24

Introduction: Mutations in human epidermal growth factor receptor 2 (HER2) gene have been reported in lung adenocarcinoma, mainly in East Asian, American and Caucasian patients. There are no data available on the frequency of HER2 mutations in North African and Arab lung cancer patients. Materials and Methods: The mutational status of the HER2 gene was evaluated in 88 Moroccan lung adenocarcinoma patients. HER2 mutations in exon 20 were analyzed using conventional DNA sequencing. Results: One HER2 mutation was found in this series of 88 patients (1.1%). This patient was male and a heavy smoker. Conclusion: This study, the first to date dedicated to HER2-mutated North African lung adenocarcinoma patients, revealed that HER2 mutations are relatively infrequent in Moroccan lung adenocarcinomas and thus a probably limited interest of HER2 inhibitors.

Background. In lung adenocarcinoma, the frequency of KRAS mutations is ethnicity dependent with a higher proportion in African Americans and white Caucasians than in Asians. The prevalence of these mutations among North Africans patients is unknown. The objective of this study was to report the frequency and spectrum of KRAS mutations in a group of Moroccan lung adenocarcinoma patients. Methods. Tumor specimens from 117 Moroccan patients with lung adenocarcinoma were selected to determine frequency and spectrum of KRAS mutations. KRAS mutations in codons 12 and 13 of exon 2 were analyzed using conventional DNA sequencing. Results. The overall frequency of the KRAS mutations was 9% (11/117). In the population with KRAS mutations, there was a trend towards more male (P=0.06) and more smokers (P=0.08) compared to patients with wild type KRAS. KRAS mutations were located at codon 12 in 10 out of 11 patients (91%). The G12C mutation was the most frequent KRAS mutation (73%). Conclusion. This is the first study to date examining the frequency and spectrum of KRAS mutations in lung adenocarcinomas in North African and Arab populations. KRAS mutation frequency in Moroccan patients was comparable with the frequency observed in East-Asian population. KRAS mutations are more likely observed in males and smokers and to be transversions. Further studies, in larger numbers of patients, are needed to confirm these findings.

We are reporting a case of multifocal reversible leucoencephalopathy syndrome induced by chemotherapy based on Folfox-Bevacizumab regimen. A 44-year-old female, with no history of hypertension, received a chemotherapy based on Folfox-Bevacizumab for her metastatic colon cancer (5 FU: 325 mg/m2 d1 by intravenous infusion, Oxaliplatin 80 mg/m2 d1, and Bevacizumab: 7.5 mg/Kg d1). During the fourth cure, she presented delirium, seizures, and visual disturbances. The computed tomography (CT) of the brain showed hypodense lesions of the white matter of frontal, parietal, and occipital lobes, which were bilateral and symmetrical. The clinical table was reversible under symptomatic treatment.

Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid cells. It is usually associated with leukemia or other myeloproliferative disorders. It occurs very rarely without overt hematologic diseases. A 19-year-old man presented with left knee mass. Biopsy with pathological analysis showed lymphoma aspect. Immunostains yielded the diagnosis of GS with myeloperoxidase and CD43 positivity. There was no systemic manifestation of leukemia, and bone marrow biopsiy was negative for neoplastic infiltration. Chemotherapy by CHOP was efficient, and the patient remaind alive and healthy 40 months after the end of treatment. The case is discussed in the framework of the existing literature about the diagnosis, treatment, and prognosis of this very rare condition.

Background Basal cell carcinoma (BCC) is the most common carcinoma in the community, but the incidence of metastatic events is exceedingly low. The few reported cases most often appear in regional nodes or the lungs, and patients usually exhibit multiple concurrent organs of spread at the time of diagnosis. Methods We report a case of primary BCC located on the left forehead of a 48-year-old man, which metastasized exclusively to the bone and bone marrow, associated with hematologic disorders. A short review of the literature is included. Results Pathologic examination of the tumor located on the left forehead showed BCC. The patient underwent two surgical excisions because of local recurrence. Three years later, the patient developed a bicytopenia (anemia and thrombocytopenia). The bone marrow biopsy revealed metastasis of BCC. There were no abnormal findings in the other routine laboratory tests and radiologic investigations, except for the bone scan which showed multifocal skeletal metastases. The patient received two cycles of chemotherapy with cisplatin 75 mg/m2 before he died as a result of hemorrhagic complications and progressive disease. Conclusion Metastasis of BCC is a very rare condition that should not be overlooked. The prognosis remains very poor. We emphasize the importance of long-term follow-up of such patients.

Renal cell carcinoma (RCC) accounts for 2–3% of all adult malignant neoplasms [1]. A quarter of patients with RCC present with advanced disease, including locally invasive or metastatic cancers. Usual sites of metastases from RCC are lung (75%), soft tissue (36%), bone (20%), liver (18%), skin (8%) and central nervous system (8%) [2]. Gastric metastases are a rare event, the most frequent primaries being melanoma, carcinoma of the lung, breast and esophagus [3], and exceptionally RCC [4, 5]. Gastric metastases of RCC seem to be a late event in patients with RCC. The delay between the diagnosis of the primary tumors and the occurrence of gastric metastases seems to be longer for RCC compared to other tumors [6]. We describe the clinical course of a patient who developed gastric metastases from a clear cell carcinoma of the right kidney 5 years after the primary tumor diagnosis. Case report

Introduction Primary lymphoma of the prostate is very rare. In this paper we present a case of early stage non-Hodgkin lymphoma of the prostate managed with six cycles of rituximab-based chemotherapy, and review the related literature. Case presentation An 84-year-old man was admitted to our hospital having signs and symptoms suggestive of prostatic disease for 3 years. Histological and immunocytochemical studies of trans-urethral biopsy of the prostate showed diffuse large B-cell lymphoma. Radiological assessment of disease confirmed the diagnosis of early stage lymphoma of the prostate. The patient was managed by 6 of rituximab 375 mg/m2 on day 1, cyclophosphamide 750 mg/m2 on day 1, doxorubicin 50 mg/m2 on day 1, vincristine 1.4 mg/m2 on day 1, and prednisone 50 mg/m2 on days 1 to 5 with complete clinical and radiological response. He remained disease free, until now, 30 months after the end of chemotherapy. Conclusion According to the literature, the treatment and prognosis of primary lymphoma of the prostate is the same as that of other nodal lymphomas. Rituximab-based regimen should be considered in the management of prostatic diffuse large B-cell lymphoma.

Introduction: Epidermal growth factor receptor (EGFR) mutations in non–small-cell lung cancer predict response to tyrosine kinase inhibitors. The frequency of EGFR mutations is ethnicity-dependent, with a higher proportion in Asian populations than in whites. The prevalence of these mutations among North African patients is unknown. The objective of this study was to report the frequency and spectrum of EGFR mutations in a group of Moroccan patients with lung adenocarcinoma (AC). Methods: Tumor specimens from 137 Moroccan patients with lung AC were selected to determine frequency and spectrum of EGFR mutations. Mutation detection techniques were polymerase chain reaction amplification and sequencing of exons 18, 19, 20, and 21. Results: The overall frequency of the EGFR mutation was 21%. Mutations were mainly detected in the exon 19 (69%), followed by exon 21 (21%) and exon 20 (7%), whereas mutations in the exon 18 were rare (3%). EGFR mutation rate was significantly higher in women and in never smokers. Conclusion: Some one fifth of lung AC tumors in Moroccan patients harbor EGFR mutations. This mutation frequency is higher than that found in whites but lower than in Asian population. Further studies, in larger numbers of patients, are needed to confirm these findings.