Search

Singnet ring cell carcinoma of the breast is a rare and aggressive tumor. We report the case of a 44-year-old woman with signet ring cell carcinoma of breast who was treated in the gynecology and medical oncology departments of HASSAN II Hospital University in Fez. She received a neoadjuvant chemotherapy with the anthracyclines and taxanes. After she had radical mastectomy and radiotherapy. Currently she has remained in good control.

Primary Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are considered as Ewing sarcoma family of tumors (ESFT), characterized by chromosomal translocation t(11; 22) (q24; q12) leading to a chimeric transcript EWS-FLI1 in 85% of cases. It typically involves the soft tissues of the chest wall, pelvis, paravertebral region, abdominal wall, retroperitoneal region and extremities in children, adolescents and young adults. It rarely occurs in the female genital tract. We report an extremely rare case of advanced vulvar Ewing sarcoma/PNET of the vulva confirmed by Fluorescence In Situ Hybridization (FISH) in a 30-year-old woman. The patient was treated by 6 cycles of chemotherapy followed by radiotherapy with favourable outcome.

Background Limited national information is available in Morocco on the prevalence and distribution of HPV-sub-types of cervical cancer and the role of other risk factors. The aim was to determine the frequency of HPV-sub-types of cervical cancer in Morocco and investigate risk factors for this disease. Methods Between November 2009 and April 2012 a multicentre case-control study was carried out. A total of 144 cases of cervical cancer and 288 age-matched controls were included. Odds-ratios and corresponding confidence-intervals were computed by conditional logistic regression models. Results Current HPV infection was detected in 92.5% of cases and 13.9% of controls. HPV16 was the most common type for both cases and controls. Very strong associations between HPV-sub-types and cervical cancer were observed: total-HPV (OR = 39), HPV16 (OR = 49), HPV18 (OR = 31), and multiple infections (OR = 13). Education, high parity, sexual intercourse during menstruation, history of sexually transmitted infections, and husband’s multiple sexual partners were also significantly associated with cervical cancer in the multivariate analysis. Conclusions Our results could be used to establish a primary prevention program and to prioritize limited screening to women who have specific characteristics that may put them at an increased risk of cervical cancer.

Ce Corrigendum vise à rectifier l’oubli d’un nom d’auteur dans la liste d'auteurs de l’article original « Carcinome urothélial sur un calice rénal exclu révélé par une métastase cérébrale ». Pan Afr Med J. 2019;34:184.

Le carcinome urothélial est caractérisé par une symptomatologie bruyante faite d'hématurie macroscopique généralement. Nous rapportons ici le cas d'une patiente sans antécédent de tabagisme ni de carcinome urothélial connu; ce qui en fait à notre connaissance un cas unique et une première où le carcinome urothélial se révèle par une métastase cérébrale.

The cancerous teratoma of the ovary is a rare entity. We report the case of a 57-year-old woman post menauposal with malignant transformation of ovarian mature teratoma who was treated in the gynecology and medical oncology departments of CHU HASSAN II in Fez. The patient underwent bilateral adnexectomy and a total hysterectomy with omentectomy. The evolution was marked by the appearance of carcinomatosis nodules postoperatively. She received chemotherapy with platinum and taxanes .she had complete remission after 6 cycles and has remained under good control at present.

Glioblastomas are the most frequent and aggressive primary brain tumors which are expressing various evolutions, aggressiveness, and prognosis. Thus, the 2007 World Health Organization classification based solely on the histological criteria is no longer sufficient. It should be complemented by molecular analysis for a true histomolecular classification. The new 2016 WHO classification of tumors of the central nervous system uses molecular parameters in addition to histology to reclassify these tumors and reduce the interobserver variability. The aim of this study is to determine the prevalence ofIDHmutations andEGFRamplifications in the population of the northeast region of Morocco and then to compare the results with other studies.Methods.IDH1codon 132 andIDH2codon 172 were directly sequenced and the amplification of exon 20 ofEGFRgene was investigated by qPCR in 65 glioblastoma tumors diagnosed at the University Hospital of Fez between 2010 and 2014.Results. The R132HIDH1mutation was observed in 8 of 65 tumor samples (12.31%). No mutation ofIDH2was detected.EGFRamplification was identified in 17 cases (26.15%).Conclusion. A systematic search of both histological and molecular markers should be requisite for a good diagnosis and a better management of glioblastomas.

Background Astroblastoma is a controversial and an extremely rare central nervous system neoplasm. Although its histogenesis has been clarified recently, controversies exist regarding its cellular origin and validity as a distinct entity. Because of its extreme rarity and because its common features are shared with other glial neoplasms, this tumor is prone to misdiagnosis and remains challenging not only in terms of diagnosis and classification but also in the subsequent management. This case report describes a new case of astroblastoma. It discusses clinical, radiologic, pathological, and therapeutic features and differential diagnosis of this rare neoplasm, with a review of the recent literature. Case presentation We report the case of an 8-year-old Moroccan girl who presented with a 1-year history of epileptic seizure, headache, and decreased visual acuity. Cranial magnetic resonance imaging revealed a right occipito-temporal mass. A tumor resection was performed and histological examination combined with immunohistochemical study confirmed the diagnosis of low-grade astroblastoma. Conclusions Astroblastoma is a very rare primary brain tumor. Its diagnosis is often challenging because of the astroblastic aspects that can be found in astrocytic tumors, in ependymomas, and in non-neuroepithelial tumors. Considerable confusion surrounds its histogenesis and classification. The low incidence rate makes it difficult to conduct studies to examine tumor characteristics.

Background Lymphoepithelial carcinoma is a tumor mostly diagnosed in the nasopharynx, but it has also been described in a variety of nonnasopharyngeal sites. It is extremely rare in the larynx and should be distinguished from squamous cell carcinoma. Therefore, it must be known by clinicians, pathologists and oncologists. In this case report, we discuss its etiopathogeny, its epidemiological, clinical, pathological and therapeutic aspects, and its outcome. Case presentation An 81-year-old Morrocan man, smoker for 40 years, presented with a 1 year history of dysphonia, dyspnea and dysphagia. Laryngoscopy showed a mass occupying supraglottic, glottic and subglottic levels of the larynx. Cervico-thoracic computed tomography scan showed a laryngeal wall thickening with cervical lymphadenopathy. Laryngeal biopsy was performed. Microscopic analysis and immunohistochemistry confirmed the diagnosis of laryngeal lymphoepithelial carcinoma. Immunostaining for LMP1 was negative. Conclusion Laryngeal lymphoepithelial carcinoma is an extremely rare and an aggressive tumor. It is rarely associated with the EBV. It must be regarded as a distinct entity. Radiotherapy is advisable as the unique therapy for local tumor. A correct diagnosis and a close collaboration between the pathologist and clinicians is mandatory for an optimal treatment strategy.

Resume La tumeur mullerienne mixte maligne (TMMM) est une tumeur rare et agressive de l’uterus. Elle represente moins de 5 % de l’ensemble des tumeurs malignes du corps uterin. Elle se manifeste le plus souvent par des metrorragies post-menopausiques. Le diagnostic preoperatoire des TMMM est primordial afin d’optimiser le traitement chirurgical. Il repose sur le curetage biopsique de l’endometre, la biopsie des lesions exteriorisees et surtout la biopsie de l’endometre de preference guidee par l’hysteroscopie. Le traitement chirurgical est la base du traitement pour les TMMM non metastatiques. Le pronostic depend du stade chirurgical de la tumeur qui est souvent diagnostique a un stade avance. Nous rapportons trois observations a travers lesquelles nous precisons les caracteristiques epidemiologiques, anatomopathologiques, cliniques, radiologiques et la prise en charge therapeutiques des TMMM.

Introduction. Le myxome odontogene est une variete rare des tumeurs benignes des maxillaires, dont l’origine serait la portion mesenchymateuse du germe dentaire. Les manifestations cliniques et radiologiques sont variables et non specifiques et peuvent preter a confusion avec d’autres lesions radioclaires. Observation. Nous decrivons un cas de myxome odontogene du maxillaire droit tres envahissant, observe chez un jeune patient de 16 ans. Cliniquement, l’adolescent presentait une tumefaction maxillaire droite, indolore et ferme a la palpation. Une TDM du massif facial montrait un processus expansif osteolytique soufflant le maxillaire droit. Une biopsie a ete en faveur d’un myxome odontogene. Discussion. Le diagnostic s‘est base sur des arguments cliniques, radiologiques et anatomopathologiques. L’agressivite locale du myxome odontogene et son taux eleve de recidive imposent un traitement radical au-dela des limites de la lesion. La perte de substance qui en resulte implique une reparation chirurgicale ou prothetique.

Resume Nous rapportons le cas d’une jeune fille âgee de 17 ans, admise pour une prise en charge d’une masse abdomino-pelvienne. Les donnees radiologiques et biologiques ont ete en faveur d’une tumeur maligne ovarienne secretante. Tout en insistant sur la conservation de la fertilite, l’annexectomie unilaterale associe a une chimiotherapie a base de platine est le traitement adapte malgre l’association du dysgerminome a une tumeur du sac vitellin.

Le sarcome epithelioide proximal d'origine pleural revele par un epanchement pleural reste rare dans la litterature, nous rapportons le cas d'une jeune patiente, admise au service d'oncologie medicale pour prise en charge d'un sarcome epithelioide pleural proximal metastatique. A la fin du premier cycle de chimiotherapie, la patiente est decedee dans un tableau de detresse respiratoire aigue. Notre observation illustre le caractere potentiellement trompeur et agressif du sarcome epithelioide presentant un piege clinique pouvant mettre en jeu le pronostic vital et dont le diagnostic positif est strictement anatomopathologique. The Pan African Medical Journal 2016;25

We report the case of a patient of 30 years with primary choriocarcinoma of the ovary. This patient referred for abdomino-pelvic mass suspected clinically and sonographically. Exploratory laparotomy was performed with the presence of two latero-uterine mass adherents to the highly vascularised uterus and difficult to resects deep plane with a mass left hepatic bleeding. A biopsy of both masses was performed and histological examination with immunehistochemical study returned for a primary ovarian non-gestational choriocarcinoma and the patient received 4 cycles of chemotherapy after hepatic artery embolization with good clinical, biological and radiological evaluation.

Le dermatofibrosarcome de Darier et Ferrand (DFS) est une tumeur mesenchymateuse cutanee de malignite intermediaire. C'est une tumeur rare mais non exceptionnelle, representant 0,1% des tumeurs cutanees malignes. Les auteurs presentent une etude retrospective de 27 cas de DFS diagnostiques sur une duree de 7 ans (2004 a 2010) et la comparent aux donnees de la litterature. Cette etude permet d’etablir en plus des caracteristiques anatomopathologiques et immunohistochimiques, une etude epidemiologique, clinique et evolutive de ce sarcome. l’âge moyen de nos patients est de 41 ans avec une predominance masculine. Le tronc est la localisation preferentielle touche dans 52% des cas. La taille tumorale a atteint 30cm et mesure en moyenne 6,1 cm. Le diagnostic etait evoque a l'examen histologique standard et confirme par l'expression intense et diffuse du CD34. Le traitement etait chirurgical, associe a une radiotherapie dans 2 cas. L’evolution etait marquee par la transformation en un sarcome pleomorphe de haut grade dans un cas et par la survenue de recidives locales dans 2 cas. Nos resultats sont classiques et comparables aux autres series de la litterature. L'examen histologique est indispensable pour le diagnostic. L'exerese chirurgicale large est le traitement de reference. Le pronostic est conditionne par une malignite surtout locale et un fort potentiel de recidive. La transformation sarcomateuse franchement maligne metastasiante est exceptionnelle.

Introduction Vulvar lipoma is a rare tumor localization and only a few cases have been reported. The clinical characteristics of vulvar lipoma are well known. However, it is important to distinguish lipomas from liposarcomas. We report a case of vulvar lipoma and discuss its clinical features, including diagnostic aspects, with emphasis on histopathological evaluation of all excised lesions. We also report and discuss patient management and treatment outcomes. Case presentation We report the case of a 27-year-old Moroccan woman. Our patient presented with a painless and slow-growing right vulvar mass that had evolved over one year, which had suddenly become uncomfortable when walking. A physical examination revealed a single soft and pasty mass in her left labium majus, which could be mobilized under her skin towards her mons pubis. The largest dimension of the mass measured 6cm. Magnetic resonance imaging showed a homogenous hyperintense mass with a well-defined contour in her left labium majus; a fat-suppressed magnetic resonance image demonstrated a marked signal intensity decrease. The mass was completely removed surgically. A histological examination revealed a circumscribed benign tumor composed of mature adipocytes, confirming the diagnosis of vulvar lipoma. Conclusion Vulvar lipomas must be differentiated from liposarcomas, which demonstrate very similar clinical and imaging profiles. The final diagnosis should be based on histopathological evaluation. A precise diagnosis should allow for appropriate surgical treatment.

Les métastases mammaires ne représentent que 0,4 à 2% des tumeurs malignes du sein. L’origine gastrique est exceptionnellement rapportée. Encore plus rare est l’association des métastases mammaires et ovariennes provenant de l’estomac. De par leur rareté et la non spécificité des signes cliniques et radiologiques, les métastases mammaires peuvent être confondues avec un cancer primitif et être à l’origine d’un traitement mutilant non approprié. Nous rapportons le cas d’un adénocarcinome gastrique métastatique au niveau mammaire et ovarien chez une patiente jeune de 32 ans et enceinte de 32 Semaines d’aménorrhée, qui est à notre connaissance le premier cas rapporté au cours de la grossesse. A travers notre cas, nous soulignons les caractéristiques épidémiologiques, diagnostiques, thérapeutiques et pronostiques de cette entité très rare, dont la connaissance est nécessaire afin d’éviter les erreurs diagnostic et les prise en charge non adaptée qui peut suivre.Key words: Métastase mammaire, cancer gastrique, diagnostic, grossesse

La metaplasie osteoide de l'endometre (MOE) est une entite rare correspondant a la presence de tissu osseux dans l'endometre, elle est le plus souvent diagnostiquee dans un contexte d'infertilite secondaire faisant suite a une grossesse interrompue. Meme si plusieurs facteurs de risque sont repertories, sa physiopathologie reste mal connue et sa traduction clinique est tres variable. Nous rapportons un cas de MOE apparu suite a un curetage pour retention placentaire en post-partum. Le diagnostic a ete suspecte par l'hysteroscopie et confirme par l'etude anatomopathologique. A notre connaissance c'est le premier cas decrit suite a un accouchement a terme. A travers notre cas et a la lumiere d'une revue de la litterature nous insistons sur les caracteristiques epidemiologiques, physiopathologiques, cliniques et para cliniques de cette entite rare, dont la connaissance est primordiale pour un diagnostic sur et par consequent un traitement adapte permettant souvent de recuperer la fertilite de la patiente. Key words : Metaplasie-osteoide, endometre, grossesse a terme, diagnostic, hysteroscopie

Endometrial stromal nodules are rare. They represent less than a quarter of endometrial stromal tumors. Clement and Scully described as variants of endometrial stromal nodules two types of tumor ressembling ovarian sex cord tumors. Type I is tumor that resembles focally an ovarian sex cord tumor which can be abbreviated ESTSCLE, or endometrial stromal tumors with sex cord-like elements and type II; uterine tumors with more than 40% sex cord-like differentiation so called UTROSCT for uterine tumor resembling ovarian sex cord tumor. Uterine tumours with sex cord-like differentiation are very rare with only 50 cases reported in the literature so far. The diagnostic is based on microscopic findings. Immunohistochemical tests to elucidate their nature yield variable and polyphenotypic with coexpression of markers of epithelial, myoid and sex cord lineage as well as hormone receptors. We report an additional case of an endometrial stromal tumors with sex cord-like elements in a 48-year-old woman presenting with abnormal mass. Pan African Medical Journal 2013; 14:51

Splenic metastasis from colorectal cancers is a very rare occurrence. Few cases have been reported in the literature. We report herein an additionnal case of metachronous splenic metastasis from adenocarcinoma of the sigmoid colon, 3 years after the diagnosis of the primary tumor. A 62-year old woman presented for regular follow-up after colectomy for sigmoid colon adenocarcinoma. A computed tomography-scan found two splenic metastatic nodules for which splenectomy had been performed. The histological analysis of the resected spleen showed a well-differentiated metastatic adenocarcinoma from colon. The patient recovered well after surgery, and 10 months after, she had no signs of the disease.

Eccrine carcinoma is an extremely rare malignancy of the skin with few well documented cases reported in the literature. It is frequently found on the lower extremities, and it equally affects both sexes in the sixth and seventh decade. In our case, we present a 46- year-old female with a recurring exophytic tumor on the right lower extremity, without local extension. The initial tumor was biopsied, excised and diagnosed as an eccrine carcinoma. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/3568051328673318.

Le dermatofibrosarcome de Darier et Ferrand (DFS) est une tumeur mésenchymateuse cutanée de malignité intermédiaire. C'est une tumeur rare mais non exceptionnelle, représentant 0,1% des tumeurs cutanées malignes. Les auteurs présentent une étude rétrospective de 27 cas de DFS diagnostiqués sur une durée de 7 ans (2004 à 2010) et la comparent aux données de la littérature. Cette étude permet d’établir en plus des caractéristiques anatomopathologiques et immunohistochimiques, une étude épidémiologique, clinique et évolutive de ce sarcome. l’âge moyen de nos patients est de 41 ans avec une prédominance masculine. Le tronc est la localisation préférentielle touché dans 52% des cas. La taille tumorale a atteint 30cm et mesure en moyenne 6,1 cm. Le diagnostic était évoqué à l'examen histologique standard et confirmé par l'expression intense et diffuse du CD34. Le traitement était chirurgical, associé à une radiothérapie dans 2 cas. L’évolution était marquée par la transformation en un sarcome pléomorphe de haut grade dans un cas et par la survenue de récidives locales dans 2 cas. Nos résultats sont classiques et comparables aux autres séries de la littérature. L'examen histologique est indispensable pour le diagnostic. L'exérèse chirurgicale large est le traitement de référence. Le pronostic est conditionné par une malignité surtout locale et un fort potentiel de récidive. La transformation sarcomateuse franchement maligne métastasiante est exceptionnelle.

Introduction A granular cell tumor involving the breast parenchyma was first described by Abrikossoff in 1931. Localization of this lesion to the breast is very rare, accounting for between 5% and 15% of all granular cell tumor cases. We present this case because of the rarity of this tumor. It is frequently confused with breast carcinoma on clinical and radiological examination, and its diagnosis can therefore be challenging for clinicians, radiologists and pathologists. Case presentation We report the case of a 32-year-old Moroccan woman who presented with a palpable mass in her right breast. Mammography and ultrasound examination revealed a heterogeneous, irregular and poorly limited mass, located at the union of the outer quadrants of her right breast. The mass was in contact with her latissimus dorsi and suspicious for malignancy. A histological examination combined with immunohistochemical study revealed it to be a granular cell tumor. Conclusion Although a granular cell tumor of the breast is a rare breast neoplasm, it should be considered in the differential diagnosis of benign and malignant lesions. Pathologists should bear in mind a granular cell tumor when examining material containing cells with abundant granular cytoplasm to avoid misdiagnosing breast carcinoma, which could lead to unnecessary surgery.