Search

Backgraound Oligometastatic disease is an intermediate stage between locally advanced disease and multi-metastatic disease. We report the experience of the Mohamed VI Center for the Treatment of Cancers in the management of oligometastatic prostate cancers in a retrospective series from 2016 to 2019.  Method We collected cases of de novo metastatic prostate adenocarcinoma judged to be oligometastatic and having benefited from radiotherapy on the prostate. The primary endpoints were: progression-free survival and overall survival at 2 and 3 years. The proportions were compared by the CHI 2 test with a significance level of 0.05. The Kaplan Meier model was used to compare survivals.  Result We had recruited 37 patients with a median age of 70 years. The initial PSA was between 11 ng/ml and 1635 ng/ml with an average of 160 ng/ml. The Gleason score was between 8 and 10 in 46 % of patients. A secondary bone location was present in 100% of cases and no patient had a visceral metastasis. The vertebral seat was the most common secondary bone site (55%). The maximum number of metastatic sites was 3. The median follow-up is 38 months. Overall survival at 24 months and 36 months, respectively, was 92% and 86%. The 2- year and 3-year progression-free survival was 84% and 79%, respectively. There was no statistically significant difference in either overall survival or progression-free survival between patients who received radiation to the prostate alone and those who received radiation to the prostate plus the pelvis (p = 0.86). No significant difference was observed in terms of survival between the patients who received in addition to local radiotherapy and primary palliative chemotherapy and those who received only local radiotherapy. The low statistical power of our sample did not allow us to obtain a significant difference between patients irradiated in hypofractionated and those irradiated in conventional fractionation.  Conclusion The limit of our study lies in the small size of our sample but also in its retrospective nature. Prostate radiation therapy remains a treatment option for de novo oligometastatic prostate cancer.

Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are mostly observed in the gastrointestinal tract, pancreas, and lungs. NETs in the oral and maxillofacial region are extremely rare. We report a case of a 67-year-old man with an NET in the mandible. The patient did not show any symptoms except for remarkable jugular swelling. The lesion appeared as a radiolucent honeycomb abnormality with bone destruction on panoramic radiography. The histopathologic diagnosis following a biopsy was NET. Contrast-enhanced computed tomography (CT), 18Ffluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT), showed tumor mass of the soft parts of the right mandible with bone lysis without lymph node, visceral or bone hypermetabolism . He had three chemotherapy cures with good clinical and radiological response followed by concomitant radio chemotherapy 60Gy.The evolution was marked by a febrile grade IV aplasia leading to the death of the patient. Neuroendocrine carcinomas of mandible are unusual. Their prognosis is overall bleak. The morphological characteristics, the clinical aspects and the therapeutic management of these tumors are comparable to the neuroendocrine tumors of the lung.

Neuroendocrine tumors (NETs) arise from neuroendocrine cells and are mostly observed in the gastrointestinal tract, pancreas, and lungs. NETs in the oral and maxillofacial region are extremely rare. We report a case of a 67-year-old man with an NET in the mandible. The patient did not show any symptoms except for remarkable jugular swelling. The lesion appeared as a radiolucent honeycomb abnormality with bone destruction on panoramic radiography. The histopathologic diagnosis following a biopsy was NET. Contrast-enhanced computed tomography (CT), 18Ffluorodeoxyglucose positron emission computed tomography (18F-FDG PET/CT), showed tumor mass of the soft parts of the right mandible with bone lysis without lymph node, visceral or bone hypermetabolism . He had three chemotherapy cures with good clinical and radiological response followed by concomitant radio chemotherapy 60Gy.The evolution was marked by a febrile grade IV aplasia leading to the death of the patient. Neuroendocrine carcinomas of mandible are unusual. Their prognosis is overall bleak. The morphological characteristics, the clinical aspects and the therapeutic management of these tumors are comparable to the neuroendocrine tumors of the lung.

 Background Kidney cancer in adults has a high metastatic potential with poor survival rates. Pronostic factors would improve the choice of a therapeutic method. We decided to revisit epidemiology and evaluate survival factors in kidney metastatic carcinomas in a Moroccan setting.  Method: Retrospective data collect from 2017 to 2020 of all adults patients presenting with metastatic kidney carcinomas. Epidemiology and survival rates were analysed using SPSS.  Results: We included 79 patients, predominantly over 60yo and male. Metastases were observed in lungs (73.4%), lymph nodes (39.2%), livers (31.6%), bones (35.4%) and peritoneum (17.8%). Metastases were concurrent to the primitive tumor in 59.5%. Histology was predominantly clear cell renal carcinoma. According to IMDC score, 77% of patients had an intermediate score. Global survival was 29%, better for patients with an intermediate score (p=0.009) as well as progression free survival (p=0.001). In multivariate analysis, only the OMS performance status (p=0.008) and height (0.02) were associated with survival.  Conclusion Thé IMDC score is a suitable tool to classify patients with metastatic kidney cancers, in order to guide therapeutic choices.&nbsp