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Goal: Evaluate the techniques and results obtained from the mammary Oncoplastic in the conservative treatment of breast cancer. Patients and methods: This is a retrolective descriptive study conducted during the period from 3 April 2017 to 3 April 2019, the Gynecologic Breast pole of the Oncology National Institute of Rabat. Results: Out of 105 files listed, the locations of the tumours were: 35% 37/105 QSE, QSI QSE + 21/105 or 20%, QSI 19/105 or 18%, QSI 12/105 or 11%, other maps 16/105 or 16%. The techniques were Oncoplastic: Pamectomy 10/105 or 10% Round Block 58/105 or 55%, plasty inverted T 21/105 or 20%, and other technical 16/105 or 15%. The aesthetic results and the quality of resection were correct and above all stable at 82/105 patients 78% of cases. The lymphocele 13/105 or 12% 5/105 5% lymphoedema represented early complications occurred as late complications consisted of retractile unsightly scars 15/105 or 14%, breast asymmetry 13/105 soit12% and cutaneous sclerosis 3/105 or 3%. Conclusion: The oncoplastic surgery is a part of multidisciplinary management of breast cancer. It imposes oncologic resections and reassuring cosmetic results for the patient and the practitioner.

The multidisciplinary team meeting has become a standard medical practice in oncology. However, no evaluation of this activity was carried out in Morocco. The aim of this study was to evaluate the multidisciplinary team meeting of gynecological mammary cancers in a National Tertiary Referral Center. The study was carried out by retrospective analysis of 207 cases of patients randomly selected among the 1190 cases recruited during the year 2015. Completeness and quality criteria were evaluated. The global completeness rate of passage in multidisciplinary team meeting is 38%. According to the therapeutic specialities, the completeness of passage in multidisciplinary team meeting is 68% of surgery, 35% of medical oncology and 19% of radiotherapy. As far as localizations are concerned, the completeness of passage in multidisciplinary team meeting is 43% for the breast and only 19% for the cervix. A quorum was met 100% of the cases. In 96% of cases the treatment performed is in accordance with the decision of the multidisciplinary team meeting. Eighty-four percent of cases performed multidisciplinary team meeting within less than one month. This analysis shows that the completeness of the transition to multidisciplinary team meeting has not reached the 100% planned by our institution. However, the requirements for conducting the multidisciplinary team meeting were generally met. This study shows an organizational evolution of our structure based on collective and multidisciplinary medical decision. The national obligation measure of multidisciplinary team meeting is necessary.

e13064Background: Inflammatory breast cancer (IBC) is the most aggressive breast carcinoma, with the clinical and biological characteristics of a rapidly proliferating disease. A number of molecula...

Resume Les auteurs rapportent une serie de 47 cas de cancers renaux chez l’adulte, colliges au service de chirurgie carcinologique de l’institut national d’oncologie de Rabat entre janvier 1985 et janvier 1999. Nos cas se repartissent en 16 hommes et 21 femmes (57 %) avec un âge moyen de 49 ans (29–70 ans). Le cortege de signes cliniques est variable, le motif de consultation le plus dominant etait les lombalgies unilaterales (81 %), une hematurie (25 %), une masse lombaire (10 %). L’uroscanner etait effectue chez tous les malades. La localisation la plus frequente etait polaire inferieure (53 %), la taille du processus tumoral etait entre 5 et 17 cm de diametre. Le traitement etait chirurgical chez 46 patients par une nephrectomie totale elargie avec un curage ganglionnaire de principe. Les suites operatoires ont ete simples. Un deces suite a des metastases synchrones chez un malade non operable. Le suivi moyen s’etend de 2 a 15 ans. L’apparition de metastases asynchrones est observee chez 6 patients operes apres un delai de 9 a 36 mois. La survie a 5 ans est de 100 % pour le stade PT1, 78 % pour les PT2 et de 34 % pour les PT3.

Endometrial cancer in patients with uterine congenital malformations is exceptional and there are only a few rare cases published in the literature. We report the case of a 67 years-old patient with an endometrial cancer located in the right cavity of a complete septate uterus.Pan African Medical Journal 2015; 22

The authors report a rare case of the ovarian juvenile granulosa cell tumor associated with Maffucci's syndrome (enchondromathosis + hemangiomas), no heriditary mesodermal dysplasia. Sarcomatous changes of chondromas are encountered most frequently; however other various typed neoplasma have been reported: ovarian juvenile granulosa cell tumor may occur not infrequently in female patients with Maffucci's syndrome in the first or second decades. Sarcomatous changes of choromas established prognosis of the Maffucci's syndrome.

Le neurofibrome présacré solitaire est une tumeur ectodermiquetrès rare tant par sa fréquence que par sa localisation, souvent pauci-symptomatiquejusqu’à l'atteinte de taille importante, d'accès difficile et de diagnostic erroné. L'imagerie préopératoirejoue un rôle essentieldans la prise en charge. Son diagnostic est immuno-histologique. Son traitement chirurgical est basé sur l'exérèse complète à marges saines. Nous rapportons l'observation d'une patiente de 46 ans, ayant été opérée pour suspicion de fibrome utérin sous séreux, dont l'exploration chirurgicale a confirméune tumeur rétropéritonéale et présacrée. L'IRM post opératoire a précisé ses rapports anatomiques. La reprise chirurgicalea permis l'exérèse complète de la tumeur sans lésions des organes adjacents. L'histologie et l’étude immuno-histochimique ont conclu à un neurofibrome.

PURPOSE The goal of this study is the analysis of the diagnostic and therapeutic aspects of this affection which is usually discovered at a delayed stage in our context. MATERIAL AND METHODS A retrospective study of 170 renal cancer, collected during a period of 15 years (1985-2000). Ninety-two men and 78 women were studied, their mean-age was 50 years (15-81 years). The diagnosis was relied on clinical, radiological and histological arguments. RESULTS Lumbar pain, hematuria and enormous mass were present in 85 cases (50%). The ultrasound and computed exams permitted the diagnosis and also evaluated the venous and locoregional extension. The treatment consisted on large nephrectomy practiced in 114 patients (67%), abstention in 56 cases (33%) due to the advanced stage of the tumor. The histological exam concludes to clear cell adenocarcinoma in 91.2% of cases. CONCLUSION The authors deplore the delayed diagnosis of renal cancer in our context which is responsible of a high rate of abstention (33%); and underline the interest of the early diagnosis for an adequate management.

Le cancer verruqueux de la vulve est une variante rare et bien différenciéedu carcinome épidermoïdedont les particularités diagnostiques, thérapeutiques et pronostiques méritent d’être distinguées. Il se caractérise par son importante croissance exophytique sans infiltration de la membrane basale. Son évolution est surtout locale rarement métastatique. Il est l'indication d'un traitement chirurgical exclusif avec exérèse large sans curage ganglionnaire de principe. La radiothérapie n'apporte aucun bénéfice en survie. Le pronostic est relativement bon mais grevé par les récidives locales. Nous rapportons quatre cas de carcinome verruqueux de la vulve colligés au Service de Chirurgieà l'Institut National d'Oncologie Rabat, nous discuterons à travers une revue de littérature, leurs modalités diagnostiques thérapeutiques et évolutives.

La tumeur de Buschke-Lowenstein est une affection rare appartenant au groupe des carcinomes verruqueux. Elle survient le plus souvent chez des sujets pubères en pleine activité sexuelle. Une infection par human papillomavirus (HPV) 6 et 11 est volontiers associée à ces tumeurs. Elle se caractérise par la fréquence des récidives et le risque de transformation maligne. Son traitement est difficile même si l'Noureddine Njoumi1, Mohamed Tarchouli1, Moulay Brahim Ratbi1, Mohamed Reda Elochi2, Rajae Yamoul1, Hafid Hachi1, Abdesslam Bougtab1histologie confirme la bénignité. A partir de 16 observations de TBL et d'une revue de la littérature, les auteurs soulignent les aspects épidémiologiques, cliniques, thérapeutiques et évolutifs de cette affection.

Resume Les auteurs rapportent une serie de 12 observations colligees durant une periode de 15 ans (1985–2000). L’âge moyen des malades est de (38 ans) (27–44 ans). Dix fistules ureterovaginales (84 %) sont secondaires a une radiotherapie suivie d’une intervention de Wertheim. Deux fistules ureterovaginales etaient survenues apres l’association de curietherapie–radiotherapie externe pour carcinome epidermoide du col uterin. Le diagnostic est pose sur les donnees de l’anamnese, le test d’etancheite vesicale et l’examen gynecologique sous valve. L’urographie intraveineuse montre le siege, l’etendue, le type de lesion et le retentissement sur le haut appareil. Le traitement a consiste en une uretero-ureterostomie chez 7 patientes ; une reimplantation ureterovesicale avec vessie psoique chez 3 patientes ; une endoprothese JJ chez 2 patientes. Sur le plan local, l’evolution etait favorable chez 84 % des patientes. Sur le plan general, 2 deces survenus suite a des metastases viscerales avec insuffisance renale avancee chez 2 patientes qui avaient ete perdues de vue pendant 3 a 7 ans.

Epidermoid cyst is a frequent benign tumor. It gives rise to destruction of adjoining tissues, chiefly in the skull. The pelvic epidermoid cyst is rare. We report the second case of giant pelvic epidermoid cyst with a 25-year-old girl. Ultrasound exploration and computed tomography evoked an ovarian origin. The surgery discovers an epidermoid cyst under the peritoneum. Ovaries and uterus were undamaged. We realized an evacuation of cyst, which contained lamellas of keratin. Histology allowed confirmation of diagnosis. The patient is always observed after 18 months.

Male breast cancer is rare; it constitutes 0.2–1.5% of all malignant tumours in men and 1% of all breast cancers. The goal of this retrospective study is to analyse the epidemiologic, clinic, therapeutic and evolutive profiles of this disease in 71 cases collected at the National Institute of Oncology in Rabat, Morocco, between the years 1985 and 1998.The median age was 60 years. No significant risk factor was found. The average consultation's delay was 35 months. The main clinical complaint was a mass beneath the areola in 86% of the cases, associated with ulceration in 18% of the cases. For that, the disease was diagnosed at an advanced stage. Infiltrating ductal carcinoma was the most frequent pathologic type (91.5% of cases). Management consisted especially of radical mastectomy, followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy. It was possible to follow 58 of the patients. The median of follow-up was 30 months. The evolution has been characterized by local recurrence, after a median delay of 36 months, in five cases (8.5% of all patients). Metastasis occurred, after a median delay of 12 months, in 14 cases (24% of all patients). The site of metastasis was the bone in six cases, lung in five cases, liver in one case, liver and skin in one case and pleura and skin in one case. There were three cases of death. In one case, death was related to lung metastases. In the two remaining cases, death was due to comorbid disease. Progression was observed in one case.

The authors report a series of 12 cases of ureterovaginal fistulas observed over 15 years period. Our patients had a mean age of 38 years (range 27 to 44 years old). Eighty four percent of ureterovaginal fistulas were due to radiotherapy and clopohysterectomy. Sixteen percent of ureterovaginal fistulas were due to brachy and radiotherapy. The clinical features were dominated by urine leak via the vagina with persistent micturition. Intravenous urography confirmed the diagnosis and revealed ureterohydronephrosis. Various therapeutic methods were used, in 7 patients treatment consisted of end-to-end anastomosis. We have used ureterovesical reimplantation in 3 cases and double J sent in 2 cases. The course was favourable in 84%.

Epidermoid cyst is a frequent benign tumor. It gives rise to destruction of adjoining tissues, chiefly in the skull. The pelvic epidermoid cyst is rare. We report the second case of giant pelvic epidermoid cyst with a 25-year-old girl. Ultrasound exploration and computed tomography evoked an ovarian origin. The surgery discovers an epidermoid cyst under the peritoneum. Ovaries and uterus were undamaged. We realized an evacuation of cyst, which contained lamellas of keratin. Histology allowed confirmation of diagnosis. The patient is always observed after 18 months.

The authors report a series of 47 cases observed over a 15-years period in the department of carcinological at the national oncological institute of Rabat. Patients consisted of 16 mean and 21 women (57%), with a mean age of 49 years old (range 29 to 70 years). The clinical features were polymorph, firstly loin pain (81%), hematuria is the next (25%). A lumbar mass (10%). The diagnosis was established by ultra-sonography and CT-scan in all the patients. The mean tumour diameter was 10 cm (5-17 cm), it were located in down pole in 53%. The surgical procedure consisted of radical nephrectomy and regional or hailer lymph node dissection in 46 patients. The post operative course was marked by one death due to pulmonary metastases. The mean follow-up was (2 to 15 years). Asynchronies metastases occurred in 6 patients after a mean interval (9 to 36 months). The overall 5 year survival was 100% PT1, 78% PT2, 34% PT3.

This report describes a case of primary leiomyosarcoma of the testis in a 70-year-old man. Treatment consisted in orchidectomy by the inguinal route with no adjuvant treatment. The patient developed pulmonary metastasis 14 months after surgical treatment. Few reports have been published on primary leiomyosarcoma of the testis. Most reported cases have been in small series in association with germ cell tumors. Surgical treatment is the most effective therapeutic modality. The standard surgical technique is orchidectomy by the inguinal route. Retroperitoneal lymph node dissection is not always performed. The prognosis of isolated testicular sarcoma is better than that of sarcoma associated with germ cell components.

The authors report a rare case of the ovarian juvenile granulosa cell tumor associated with Maffucci's syndrome (enchondromathosis + hemangiomas), no heriditary mesodermal dysplasia. Sarcomatous changes of chondromas are encountered most frequently; however other various typed neoplasma have been reported: ovarian juvenile granulosa cell tumor may occur not infrequently in female patients with Maffucci's syndrome in the first or second decades. Sarcomatous changes of choromas established prognosis of the Maffucci's syndrome.

Renocolic fistulas are rare lesions, generally involving the ascending and descending colon. The authors report a case of reno-sigmoid fistula occurring in a tuberculous pelvic ectopic kidney. Nephrectomy with segmental sigmoid resection was completed by antituberculous treatment for 9 months. The patient presents a good general condition with normal renal function and normal intestinal transit with a follow-up of 19 months.

Vaginal leiomyosarcoma is unfrequent. We report on a case in a 50-year-old multipara patient who had presented a posterior vaginal swelling since 6 months. The tumor was discovered at the occasion of pains and non hemorragic discharge. The histological pattern of the tumor was well-differentiated spindle cell sarcoma with pleiomorphic areas. The immunohistochemistry confirmed the smooth myogenic differentiation. The treatment consisted of posterior pelvic exenteration extended to the vagina. The patient is alive and free of disease at 20 months of fellow-up.

We report a case of sperm cell seminoma caused by trauma. The data in the literature indicate the frequency is less than 5% of all seminomas. This case was exclusively located in the gonads and was a pure form. Orchidectomy with high ligature of the cord and adjuvant radiotherapy at the dose of 25 Gy centered on the para-aortic and subdiaphragmatic chains is adequate treatment. When inguinoscrotal surgery is performed, this zone must be irradiated with 25 Gy. Prognosis is satisfactory: 5-year survival is 100% with this protocol.