Search

Bevacizumab has been shown to improve progression-free survival in women with ovarian cancer in multiple clinical trials. However, serious adverse effects, such deep vein thromobosis, can occur. Phlegmasia cerulea dolens is a rare entity secondary to grave Deep Vein Thrombosis (DVT), in the lower extremities, and associated with rapidly progressive pain and marked swelling that may compromise the perfusion of the limb. This situation may lead to venous gangrene and the limb’s amputation secondary to a compartment syndrome. We present the case of a 45-year-old female who presented eight days after the fourth administration of bevacizumab for ovarian cancer treatment, a bilateral leg pain with progressive edema which also began to exhibitwith a black discoloration. Venous dopplers showed bilateral occlusions of the common femoral, saphenofemoral, superficial femoral, popliteal, posterior tibial and peroneal veins. To our knowledge, this is the first case with bevacizumab associated Phlegmasia cerulea dolens.

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.

Background The identification of effective prognosis biomarkers for nasopharyngeal carcinoma (NPC) is crucial to improve treatment and patient outcomes. In the present study, we have attempted to evaluate the correlation between pre-treatment plasmatic Epstein-Barr virus (EBV) DNA load and the conventional prognostic factors in Moroccan patients with NPC. Methods The present study was conducted on 121 histologically confirmed NPC patients, recruited from January 2017 to December 2018. Circulating levels of EBV DNA were measured before therapy initiation using real-time quantitative PCR. Results Overall, undifferentiated non-keratinizingcarcinoma type was the most common histological type (90.1 %), and 61.8 % of patients were diagnosed at an advanced disease stage (IV). Results of pre-treatment plasma EBV load showed that 90.9 % of patients had detectable EBV DNA, with a median plasmatic viral load of 7710 IU/ml. The correlation between pre-treatment EBV DNA load and the conventional prognostic factors showed a significant association with patients’ age (p = 0.01), tumor classification (p = 0.01), lymph node status (p = 0.003), metastasis status (p = 0.00) and overall cancer stage (p = 0.01). Unexpectedly, a significant higher level of pre-treatment EBV DNA was also found in plasma of NPC patients with a family history of cancer (p = 0.04). The risk of NPC mortality in patients with high pretreatment EBVDNA levels was significantly higher than that of those with low pre-treatment plasma EBV-DNA levels (p p Conclusions The results of the present study clearly showed a high association between pre-treatment EBV DNA load, the crucial classical prognostic factors (T, N, M and disease stage) of NPC and OS, suggesting that pre-treatment EBV DNA can be a useful prognostic biomarker in clinical decision-making and improving NPC treatment in Morocco.

Background As it is the case for all kinds of cancer; lung cancer is a multifactorial disease. The interaction between both Exposures to different carcinogens and individual genetic backgrounds modulate the disease risk. Cytochrome P450 family is one of the main enzymes involved in the metabolism of these carcinogens. Therefore, polymorphisms of genes encoding for the cyp450 enzymes can be responsible for the inter-individual differences in lung cancer susceptibility. In this study, we chose to focus on the Cyp2c19, as one of the crucial cyp450 enzymes associated with metabolism of a number of drugs and xenobiotics and its association with the lung cancer risk. Methods Peripheral blood from a total of 115 Moroccan patients diagnosed with lung cancer and 105 healthy subjects was collected. The genotyping of CYP2C19*2 and CYP2C19*3 polymorphisms was carried out using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technic. Results We found that the frequency of both CYP2C19*2 (GA+AA) genotype and CYP2C19*A allele were significantly more frequent in lung cancer patients than that in control subjects (24.3% vs 13.3%; p = 0.04 and 14.35% vs 7.15%; p = 0.01 respectively). We also found that the CYP2C19*3 A allele was only found in lung cancer patient with a frequency of 10% (p = 0.007). Consequently, the frequency of the CYP2C19*3 (GA + AA) genotype was also significantly more prevalent in lung cancer patients than that in controls (20% vs 0.00%; p = 0.005). We also found that smoking is associated to a higher lung cancer risk in participants carrying CYP2C19*3 or CYP2C19*2 GG genotypes (p Conclusion These findings indicate that the CYP2C19*2 and CYP2C19*3 polymorphisms are significantly associated with lung cancer in Moroccan population. In addition, that the coexistence of CYP2C19*3 with smoking increased lung cancer risk even more.

Mycosis fungoid (MF) is a non-Hodgkin's T-cell lymphoma determined by primary cutaneous involvement. It is a slow-progressing chronic indolent disease characterized by atypical T-cells with a cerebral nucleus. Management of this disease depends on the stage and is based essentially on the systemic treatment. Radiotherapy intervenes in case of localized or extended tumor, indeed, the radiosensibility of this tumor, like any other hematological affection, makes it possible to obtain a high rate of response. Clinical case: we report the observation of a 46-year-old patient followed since 2012 for mycosis fungoid revealed by a papullo-squamous lesion located at the level of the right lumbar fossa. The diagnosis was confirmed by cutaneous biopsy, showing the presence of T lymphocytes expressing CD2, CD3, CD4, CCR4, CD45RO markers. Initial assessment included a thoraco-abdominal pelvic CT, which was normal, an accelerated sedimentation rate at the 1st hour, a high C reactive protein (CRP), the electrolytic, renal, hepatic status and the hemogram were normal. Patient received 6 courses of chemotherapy according to the COPP protocol with a decrease in the size of the lesion estimated at 40%. A norm fractionated radiation therapy was delivered at the dose of 36Gy. The evolution was marked by a complete remission, maintained after 6 months of the treatment. Mycosis fungoid is a rare disease, whose management must be discussed in a multidisciplinary team. Radiotherapy remains an interesting option for all stages, but has to be validated in largest studies.

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 tres rares et restent exceptionnelles chez les enfants et les adolescents, leurs traitement est base sur la chirurgie et la radiotherapie, avec un bon pronostic. Nous rapportons le cas d'une adolescente âgee de 12 ans, qui s'est presentee pour une masse du sein gauche. Le diagnoctic d'une tumeur phyllode a ete retenu apres bilan et histologie. Le traitement a consiste en une tumorectomie large sans traitement adjuvant ; avec une bonne evolution a un recul de deux ans. Phyllodes tumors of the breast are very rare and are exceptional in children and adolescents; their treatment is based on surgery and radiotherapy, with a good prognosis. We report the case of a 12-year old teenage girl presenting with a mass in the left breast. The diagnosis of a phyllodes tumor was confirmed on the basis of clinical, imaging and histological examinations. Treatment consisted of a large tumorectomy without adjuvant therapy, with good evolution during a 2-year follow-up.

The cutaneous apocrine carcinomas are malignant tumors rare adnexal, slowly and preferably located in the axillary growth. A girl aged 24 with no particular medical history was addressed to a right axillary mass slowly evolving for two years, associated with pain in the right upper limb. The echo mammogram had shown a mass in the axilla and supraclavicular and axillary MRI had objectified mass axillary measuring 171mm. Pathological examination with immunostaining was in favor of apocrine carcinoma. The cutaneous apocrine carcinomas are well-known in the mammary glands, but it is difficult to morphologically distinguish between breast cancer and apocrine carcinoma. Pan African Medical Journal 2016; 2

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

Le cancer broncho-pulmonaire (CBP) de la femme enceinte est une entité rare, d'évolution péjorative. Cette situation devient de plus en plus fréquente, du fait de l'augmentation du tabagisme chez la femme. La transmission tumorale trans-placentaire avec atteinte fétale est décrite surtout chez les femmes non traitées. Le traitement est multidisciplinaire et n'est pas bien codifié. Nous rapportons le cas d'une patiente de 23 ans chez qui le diagnostic d'un carcinome bronchique à petites cellules a été fait au cours de sa grossesse. Elle avait bénéficié d'une chimiothérapie pendant la grossesse, bien tolérée. L'évaluation radiologique a objectivé une stabilisation du processus pulmonaire. Le traitement a été complété par une association radio-chimiothérapie concomitante après l'accouchement.

Background: Breast cancer is the leading cancer among women. The management depends largely on the knowledge of prognostic factors. The aim of our study is to evaluate the overexpression of Her-2/neu in patients with invasive breast carcinoma in Morocco, and to study the association between this overexpression and otherprognostic factors of breast cancer, such as age, tumor size, tumor grade, hormone receptors, vascular space invasion and lymph node status. Methods: This is a transversal study in which we included patients with invasive breast carcinomas treated at University Hospital Ibn Rochd of Casablanca in radiotherapy-oncology departement between January 2008 and December 2010, having had surgery first. Univariate analysis (Chi 2 test and Student’s test) and multivariate (logistic regression) were performed to study this association. Results: The overexpression of Her-2/neu was found in 29.2% of cases. In univariate analysis, Her-2 positive status was significantly correlated with high-grade tumors and large, to a lymph node, vascular space invasion and negative ER/PR. Age alone does not appear as a factor associated with positive Her-2/neu status. In multivariate analysis, the overexpression of Her 2 was significantly associated only with vascular space invasion, high tumor grade and the negativity of estrogen receptors. Conclusion: In our series, only the high grade, the vascular space invasion and the negative hormone receptors are independent factors associated with overexpression of Her 2/neu. Age does not appear as a factor associated with positive Her-2/neu status.

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.