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Purpose: the aim of this study was to rapport the experience of Military Teaching Hospital Mohammed V and specifically the radiotherapy department in the management of high risk prostate cancer. Materials and Methods: This is a retrospective descriptive and analytical study, involving 149 patients followed for high risk prostate cancer proven histologically, in the radiotherapy department of HMIMV in Rabat between April 2009 and December 2018. All patients with low or intermediate risk prostate cancer were excluded. Results: The mean age is 68.1 years ± 6.4; screening is performed in 29.5% of cases. Urinary signs were the most frequent symptoms (obstructive syndrome 16.7%, irritative 37.5%), the initial median PSA 22ng / ml [11.1- 40]; histological evidence was obtained by prostate biopsy in 87.24% of cases. Evaluation of locoregional extension by pelvic MRI was performed in 99.3% of patients. Treatment: 132 patients (88.59%) benefited from a combination of external beam radiotherapy and androgen deprivation therapy (LH-RH analogues) for long duration (2 to 3 years), 17 patients (11.41%) underwent radical prostatectomy coupled with ilio-obturator dissection (in 14 patients); all these patients received postoperative radiotherapy (adjuvant or salvage) ± hormone therapy. Evolution: With a follow-up of 117 months, 14 of our patients (9.39%) presented a recurrence: 2 biochemical relapses (1.34%), 5 locoregional relapses (3.35%) and 7 systemic relapses (4.69%); The univariate and multivariate analyzes made it possible to retain the level of PSA Nadir (P = 0.022) and lymph node invasion (P = 0.049) as predictors of relapse. Conclusion: High risk prostate cancer is a group at high risk of specific mortality linked to progression after treatment. Hence the interest of a multidisciplinary consultation meeting management to define the optimal therapeutic strategy for these patients.

Endometrial cancer is the most common gynecological cancer in developed countries. It mainly concerns postmenopausal women. The objective of our work is to report the experience of the radiotherapy oncology department of the oncology-hematology hospital (HOH) of the Mohammed IV University Hospital of Marrakesh in the management of endometrial cancer. We retrospectively analyzed 85 cases of endometrial cancer treated by radiotherapy (external radiotherapy and /or brachytherapy) in our institution between 2014 and 2019. The data collected from our patients concerned the epidemiological, clinical, therapeutic and evolutionary aspects of this cancer. The median age of the patients was 58 years [37, 82], 88% were postmenopausal. The average consultation time was 08 months. The master symptom was post-menopauseal bleeding in 85% of the patients. Pathological examination showed endometrioid adenocarcinoma in 83% of cases. After workup, 51% of patients were stage I (IA 17%, IB 35%), 25% stage II, 23% stage III (IIIA 3%, IIIB 9% and IIIC 10%) and 1% stage IVA according to the classification of the International Federation of Obstetric Gynecology (FIGO). After surgery, 77% of patients received external beam radiation therapy. The dose delivered was between 46 and 50 Gray (Gy) over a mean spread of 42 days associated with concomitant chemotherapy in 16% of cases. Intravaginal brachytherapy was delivered to 98% of patients. It represented the only adjuvant treatment in 27% of cases, after external radiotherapy in 73% of cases. Adjuvant chemotherapy was received in 36% of patients. After a mean follow-up of 3 years, 82% of patients were still followed in a situation of good control of their disease, 8% of cases of local recurrence and 10% of distant metastasis.

Introduction : Le chordome est une tumeur osseuse primitive, rare qui nait à partir de la notochorde foetale et siège essentiellement au niveau sacrococygien et sphénooccipital. Le chordome extra-axial en est une entité exceptionnelle.Observation : une femme âgée de 50 ans, présentait une tuméfaction cervicale gauche compressive avec détresse respiratoire aigue. La cervicotomie exploratrice a objectivé une masse latero et retortrachéal inextirpable au contact du lobe thyroïdien gauche et refoulant l’axe jugulocarotidien homolatéral.Conclusion : Le chordome extra-axial est une tumeur maligne de bas grade, à croissance lente, mais localement invasive, posant parfois le problème de diagnostic positif et de prise en charge.Mots clés : : Chordome ; extra-axial ; latérotrachéalIntroduction : Chordomas are rare primitive bone tumor, which develop from vestigial remnants of the fetal notochord. Most chordomas arise in the sacrococcygeal and spheno-occipital region. Extranotochordal chordomas are extremely unusual.Case report : A 50 year women suffering from a left compressive cervical mass with a acute respiratory detress. in cervicotomy, it was an inextirpable tumor in contact with the left thyroid lobe and deplacing the ipsilateral jugulocarotidien axis.Discussion and Conclusion : The extra axial chordoma is a low grade malignant slowly growing neoplasms and locally invasive. Sometimes, it poses the problem of positive diagnosis and management.Keyswords : Chordoma; extranotochordal; laterotracheal

Introduction : C’est une tumeur très rare qui ne représente que 0,25% des tumeurs malignes du sein. Son diagnostic repose sur la présence exclusive au niveau du sein d’une composante sarcomateuse ostéogénique et l’absence de toute composante épithéliale confirmée par une étude immunohistochimique et ultrastructurale. Aux stades localisés, son traitement repose essentiellement sur la chirurgie. La place des traitements adjuvants (radiothérapie et chimiothérapie) reste à définir. Pour les formes métastatiques la chimiothérapie palliative est recommandée. Observation : Il s’git d’une patiente âgée de 45 ans, sans antécédents pathologiques particuliers, présentant un ostéosarcome primitif du sein gauche confirmé par une étude immunohistochimique et un bilan d’extension correcte, métastatique d’emblée avec une évolution fatale sous chimiothérapie palliative. Discussion : Nous allons discuter les facteurs de risque de l’ostéosarcome primitif du sein, ses circonstances de diagnostic, ses critères diagnostiques qui sont bien codifiés, ainsi que ses aspects histologiques, thérapeutiques et évolutifs, avec une revue exhaustive de la littérature. Conclusion : C’est une pathologie très agressive qui nécessite un diagnostic précoce, une prise en charge thérapeutique adéquate et rapide pour assurer un bon contrôle locorégional et général et améliorer le pronostic qui reste malgré tout très péjoratif., Maroc Médical, Vol. 34, No 3 (2012)