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Abstract Peutz–Jeghers syndrome is a rare but potentially life‐threating syndrome. We report here the case of a young girl who presented recurrent small bowel intussusceptions. Laparotomy exploration showed many jejunal polyps leading to jejunojejunal intussusceptions. These were removed via mini enterotomies and pathological examination concluded to Peutz–Jeghers polyps.

Amyloidosis derived from abnormal extracellular fibril deposits may contribute to multiple organ dysfunctions. The recognition of amyloidosis-associated orofacial changes may be beneficial for the early diagnosis of this systemic pathology and the underlying diseases. This retrospective study aimed to determine the characteristics of orofacial amyloidosis to aid dentists in the recognition of this disease. Seven patients consulting the Department of Oral Medicine and Oral Surgery at Sahloul Hospital from January 2010 to January 2019 and diagnosed with systemic amyloidosis were included. The median age of onset, the most commonly affected sites, the predominant oral features of amyloidosis, and its complications were presented. The results of minor salivary gland and tongue biopsies were evaluated. Macroglossia was the most frequent oral lesion and it was associated with AL amyloidosis in 5 cases. Minor salivary gland biopsy was positive in four cases. We concluded that the dentist, especially the oral pathologist, has an important role in the evaluation of the local alterations that may reflect the patients´ systemic deterioration., Competing Interests: The authors declare no competing interest., (Copyright: Raouaa Belkacem Chebil et al.)

Purpose: Effective teamwork is crucial for patient safety in healthcare. The TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) is a widely used tool for assessing teamwork perceptions. The T-TPQ has been adapted and validated for hospital setting use in several countries. This study aimed to translate and validate the T-TPQ into French for use among Tunisian healthcare professionals, enhancing teamwork assessment and patient safety initiatives., Design/methodology/approach: A rigorous process ensured cultural and linguistic adaptation of the T-TPQ, including back-translation, expert panel review, and pilot testing. 459 healthcare professionals from four hospitals in Kairouan, Tunisia participated. Confirmatory factor analysis (CFA) compared the original five-factor structure with a revised structure based on exploratory factor analysis (EFA)., Findings: Both CFA models demonstrated good fit, with no significant difference between them (∆χ 2  = 22.51, p  = 0.79). The original five-factor structure was retained due to its established theoretical foundation. The French T-TPQ exhibited strong internal consistency (α = 0.9). Two-way Random ICCs indicated fair to good test-retest reliability for all the five dimensions (0.633-0.848)., Research Limitations/implications: Several limitations should be acknowledged. The use of a questionnaire as a data collection tool is the source of a reporting bias, for fear of being identified or for reasons of "social desirability". Nevertheless, this social desirability was minimal, as Baker et al. (2010) took steps to mitigate this during the instrument's development. Additionally, for assessing attitudes and perceptions, self-reported measures are deemed more effective, whereas objective measures are advocated for behavioral assessments. Furthermore, the participants were informed of the absence of good or bad answers, the importance of answering as closely as possible, and the confidentiality. Moreover, considering the data collection period, the COVID- 19 pandemic and its potential impact on recruitment, data collection, and participant responses. Although the sample size of 459 met the recommended criteria for conducting confirmatory factor analysis, as suggested by Bentler and Chou (1987) and (Floyd and Widaman, 1995), the COVID-19 pandemic presented challenges in recruitment. The increased workload and stress on healthcare professionals, coupled with staff redeployment and research restrictions within hospitals and care units, likely hindered achieving an even larger sample size. These circumstances also necessitated adjustments to data collection methods to ensure safety and adherence to pandemic protocols. This involved incorporating online surveys option with paper-based questionnaires and implementing stricter hygiene measures during in person data collection. Furthermore, the pandemic impacted the teamwork perceptions as significantly redefined the healthcare environment, placing immense pressure on professionals due to surging patient volumes, staff shortages, and the emotional burden of caring for critically ill individuals. This heightened stress and workload likely influenced teamwork dynamics, potentially fostering both positive adaptations, such as increased cohesion and support, as well as negative consequences like communication breakdowns and decreased morale (Terregino et al. , 2023)., Practical Implications: We outline significant practical implications for leaders in health care for improving teamwork and patient safety. Or, healthcare leaders can significantly enhance teamwork and patient safety by incorporating the validated French T-TPQ into their improvement strategies. This reliable tool enables the assessment of staff perceptions regarding teamwork strengths and weaknesses, specifically in areas like communication and leadership. By identifying these crucial areas, leaders can implement targeted training programs and interventions. In fact, the existing body of research consistently demonstrates the positive impact of team training interventions, on both teamwork processes and patient outcomes. These interventions have been shown to enhance teamwork skills (Baker et al. , 2010; Thomas and Galla, 2013; Weaver et al. , 2014). In areas such as communication, leadership, situation monitoring, and mutual support, leading to decreased mortality and morbidity rates (Weaver et al. , 2014). Implementing team training programs fosters trust and collaboration around shared goals, contributing to a more effective and safer healthcare environment for both patients and professionals. Additionally, the culturally adapted T-TPQ not only benefits individual healthcare settings but also unlocks opportunities for broader research and collaboration on a global scale. By enabling cross-cultural comparisons and benchmarking, the T-TPQ can deepen our understanding of how teamwork dynamics vary across diverse healthcare environments and cultural contexts. This knowledge is invaluable for tailoring teamwork interventions and training programs to specific populations and settings, ensuring their effectiveness and cultural relevance. Moreover, integrating teamwork training into continuing professional development, interprofessional and medical education initiatives is crucial for cultivating collaborative competencies and building high-performing healthcare teams. Research has shown that interprofessional teamwork experiences significantly enhance collaborative competencies among nursing and medical students, emphasizing the importance of incorporating teamwork training early in healthcare education. This approach equips future healthcare professionals with the necessary skills to navigate complex team environments, ultimately improving patient care quality and mitigating workload issues that contribute to burnout (Simin et al. , 2010; Ceylan, 2017; Fox et al. , 2018)., Originality/value: The French version of the T-TPQ was semantically equivalent and culturally relevant with adequate test-retest reliability as compared to the English version, expanding its applicability and contributing to understanding teamwork perceptions in this context. The French T-TPQ offers a valuable tool for assessing teamwork, identifying areas for improvement, and implementing interventions to enhance teamwork and patient safety in Tunisia and potentially other French-speaking regions., (© Emerald Publishing Limited.)

Objectives: Emerging evidence points to tobacco experimentation being associated with a vast array of mental disorders, particularly anxiety and depression. We aimed to assess the prevalence of tobacco experimentation, its predictive factors and its potential links with anxiety and depressive disorders among in school adolescents in a Tunisian delegation., Methods: We carried out a cross sectional study among adolescents schooling in middle and high schools in the delegation of Nfidha, Sousse, Tunisia, during the period from January to March of the 2019-2020 school year using an anonymous questionnaire self-administered to a representative sample of 1,353 randomly selected pupils. Data were collected using the Arabic versions of the Beck Depression Inventory short form (13 items) and the Screen for Child Anxiety Related Disorders (SCARED-C) and a socio-demographic questionnaire with reference to the literature., Results: Tobacco was experimented by (17.5 %; CI 95 %: 14.8-18.8 %) of pupils. Almost three out of four pupils (73.2 %; CI 95 %: 70.8-75.6 %) reported experiencing depressive symptoms and (65 %; CI 95 %: 62.5-67.5 %) anxiety symptoms. Pupils who exhibited depressive disorder indicators were significantly more prone to experiment with tobacco (20.2 vs. 9.9 %, p<0.001; crude OR=2.301 CI 95 %: 1.74-3.58). Similarly, the prevalence of tobacco experimentation was found to be higher among pupils who reported having experienced anxiety disorders (21.0 vs. 14.5 %, p<0.001; crude OR=1.56 CI 95 %: 1.06-2.27). Being a male pupil (AOR=5.48 95 % CI: 3.62-8.31), being be enrolled in a high school (AOR=2.86, 95 % CI: 1.92-4.26), tobacco use by father and siblings (respectively AOR=1.76, 95 % CI: 1.19-2.60; AOR=2.47, 95 % CI: 1.52-4.02) and experiencing depressive disorders (AOR=2.69, 95 % CI: 1.60-4.53) were the determinants of tobacco experimentation in the multivariate analysis., Conclusions: Tobacco experimentation in adolescence has been shown to be significantly associated with anxiety and depression. National smoking prevention strategies should be reinforced with a focus on mental health disorders., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Objectives: As social media and online gaming technology have developed very rapidly over the last two decades, their paired issues are of growing concern worldwide. The aim of our study was to assess the prevalence of video game and Facebook addiction and its predictive factors among Tunisian in school adolescents., Methods: We conducted a cross-sectional study among in school adolescents in Sousse, Tunisia, over the first academic term of the 2019-2020 school year using a self-administered questionnaire to a randomly selected representative sample of 1,353 students. The valid Arabic version of the Bergen Facebook Addiction Scale (BFAS), the Video Game Addiction Scale (GAS-7), the Beck Depression Inventory Short Form (13 items) and the Screen for Child Anxiety Related Disorders (SCARED-C) were used to assess facebook addiction disorder (FAD), internet gaming disorder (IGD), depression and anxiety respectively., Results: More than one in four pupils (26.1 %; CI 95 %: 23.8-28.4 %) were identified as problematic video game users and almost a third of participants (32.5 %; CI 95 %: 30-35 %) reported FAD. IGD was significantly associated with FAD (p<0.001). Likewise, pupils exhibiting depressive symptoms as well as those with anxiety symptoms were significantly more likely to be problematic video games and Facebook users (p<0.001 for each). Being addicted to Facebook (AOR=1.83, 95 % CI: 1.18-2.81), experiencing anxiety disorders (AOR=2.43, 95 % CI: 1.52-3.88), being male (AOR=2.51, 95 % CI: 1.95-3.23) and spending more than 4 h per day surfing the net (AOR=2.55, 95 % CI: 1.65-3.96) were the determinants of IGD in the multivariate analysis. Similarly, being addicted to video games (AOR=1.82, 95 % CI: 1.21-2.73), experiencing anxiety disorders (AOR=1.85, 95 % CI: 1.20-2.86), having experienced academic failure (AOR=1.73, 95 % CI: 1.16-2.56), and spending more than 4 h per day on social media (AOR=3.75, 95 % CI: 2.38-5.90) were the predictors of FAD., Conclusions: The prevalence of problematic use of video games and Facebook is alarmingly high. Identifying risk factors can help screen high-risk adolescents. We need additional prevention measures addressing not just adolescents, but all risk factors., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Background: Breast cancer (BC) patients' diagnosis and management was affected by a global reorganization after the Coronavirus disease 2019 (COVID-19). Our study aimed to assess the impact of the pandemic on the pathological stage of newly diagnosed patients with BC compared to pre-pandemic and to identify predictive factors of tumor advanced stage., Methods: Pathological records of all consecutive newly operated BC patients between March 2020 and December 2021 were reviewed retrospectively. Clinical and pathological prognostic factors of BC were collected and compared between pre-pandemic and pandemic periods. Then, predictive factors of tumor advanced stage were identified., Results: Of the 225 cases included in the analysis, 98.7% were females and 1.3% were males. The median time from first histological diagnosis to first surgical treatment was enlarged by 42 days with a significant difference between the two periods (p = 0.002). Newly diagnosed BC patients during the COVID-19 pandemic were operated at a more advanced stage (54.1% vs 36.2%, p = 0.007), had a greater lymphovascular invasion (p = 0.002), lymph node metastasis (p = 0.015) and are more commonly of IBC NST histological type (p = 0.005). Moreover, multivariate analyses showed that the pandemic period (AOR = 2.28; p = 0.016) and the lympho-vascular invasion (p < 0.001) were independently associated with advanced stage of tumors., Conclusion: Our findings proved an increase in alarming rates of advanced stage BC associated with the COVID-19 crisis. These findings support recommendations for a quick restoration of BC screening at full capacity, with adequate prioritization strategies to mitigate harm.

Introduction: Stress exposure is a significant concern in the healthcare sector. This animal model study aims to reproduce caregivers' working conditions and determine their impact on the brain., Method: Twenty-four healthy male rats of the Wistar strain were divided into four groups. Three groups were submitted each to one stressor for 21 days, while the fourth group was used as a control. Stressors were food and water deprivation (FW), permanent illumination (PI), and forced swimming (FS). At the end of the experiment, rats were euthanized, and stress biomarkers, biological parameters, and DNA damage were measured., Results: Prooxidant biomarker rates increased in the different groups (+50 to +75%) compared to the control ( p  < 0.0001). Urinary corticosterone rates increased in all stressed animals, mainly in the PI group, with changes of up to +50% compared to the control group. Acetylcholinesterase levels decreased to -50% ( p  < 0.0001 for the three exposed groups). Total ATPase, (Na + /K + )-ATPase, and Mg 2+ -ATPase activities decreased in all stressed groups. The percentage of brain cell congestion and apoptosis was 3% for the FW group ( p  < 0.0001), 2% for the PI group (p < 0.0001), and 4% for the FS group (p < 0.0001) compared to the control (0.8%). DNA damage was observed in all exposed groups. Finally, we noticed behavioral changes and a depression-like syndrome in all stressed rats., Conclusion: Stressful conditions such as the working environment of caregivers can trigger several pathophysiological processes leading to oxidative, neurochemical, and hypothalamic-pituitary-adrenal disorders. These changes can progress to cell damage and apoptosis in the brain and trigger psychological and physical disorders., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Pujo, Fitriani, Ben Saad, Ghariani, Dghim, Mellouli, Burin, Mutricy, Houcke, Roujansky, Mansyur, Nkontcho, de Toffol, Ben Amara and Kallel.)

Sulfated polysaccharides from seaweed are highly active natural substances with valuable applications. In the present paper, attempts have been made to discuss the physicochemical and structural features of polysaccharides isolated from red marine alga Alsidium corallinum (ACPs) and their protective effect in hepatic impairments induced by tebuconazole (TEB) in male adult rats. Structural features were determined using high-performance liquid chromatography, Fourier-transformed infrared, and solid-state 1 H and 13 C-Nuclear magnetic resonance analysis. ACPs are found to be hetero-sulfated-anionic polysaccharides that contain carbohydrates, sulfate groups, and uronic acids. In vitro biological activities suggested the effective antioxidant and antimicrobial capacities of ACPs. For antioxidant testing in vivo, the biochemical analysis and plasma profiles displayed that oral administration of ACPs could mitigate blood lipid indicators, including total cholesterol, triglyceride, low and high-density lipoprotein cholesterol, and bilirubin. Liver function indexes involving alanine aminotransferase and aspartate aminotransferase showed that ACPs possessed prominent antioxidant activities. Additionally, the intervention of ACPs potentially inhibited lipid peroxidation, protein oxidation, key enzymes of lipid metabolism (<0.001), and improved antioxidant status (<0.05). Histomorphological observation confirmed that ACPs intervention could partially repair liver injuries caused by TEB. The computational results showed that A. corallinum monosaccharides bound 1JIJ, 1HD2, and 1WL4 receptors with acceptable affinities, which, together with deep embedding and molecular interactions, support the antioxidant, antimicrobial, and hypolipidemic outlined effects in the in vitro and in vivo findings. Given their prominent antioxidant effects, ACPs are promising candidates for liver diseases and must be considered in pharmaceutical applications.

Background: Papillary Thyroid Carcinoma (PTC) is the most frequent endocrine malignancy with a variety of histological presentations. Warthin-like Papillary Thyroid Carcinoma (WLPTC) is an uncommon neoplasm that is recognized as a distinct subtype of PTC in the WHO classification of thyroid tumors. In this report, we present a novel case of WLPTC in a female patient and provide an in-depth review of the available literature on its clinical, pathological, and therapeutic characteristics., Case Presentation: A 27-year-old female patient was referred for neck swelling. Ultrasound showed two suspicious thyroid nodules leading to a thyroidectomy. She was diagnosed with intermediate-risk bifocal foci of classic PTC and WLPTC, arising from a background of chronic lymphocytic thyroiditis (CLT). This pT1b(m) N1b M0 malignancy was treated with adjuvant isotopic ablation and suppressive thyroxine therapy. The 1-year outcomes were favorable., Literature Review: It covered articles published from 1995 to 2022, by searching PubMed and Google Scholar using specific terms. Out of 148 articles reviewed by two authors, 25 relevant articles were selected, including 13 case reports and 12 case series. The study included 150 cases of WLPTC. Data related to clinical presentation, imaging, histological features, management, and outcomes, were extracted. The mean age of diagnosis was 39 years, with a female predominance. The most common clinical presentation was neck swelling. Thyroid autoimmunity was positive in 71.6% of patients. Lymph node metastases were present in 28% of cases, with no reported distant metastases. Overall, the outcomes were favorable., Conclusion: WLPTC shares similar clinical and radiological presentations as classic PTC. The hallmark histological features of WLPTC are papillae lined with oncocytic tumor cells with papillary nuclear changes and lymphoid stroma. WLPTC is almost constantly associated with CLT. The management of WLPTC aligns with that of classic PTC with comparable stage and risk category, often resulting in favorable outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Missaoui, Hamza, Belabed, Mellouli, Maaloul, Charfi, Jardak, Sellami-Boudawara, Rekik and Abid.)

Inverted follicular keratosis (IFK) is a rare benign tumour of the follicular infundibulum characterized by exo-endophytic growing. Generally, the diagnosis of IFK is histopathologically made because clinical differentiation from other lesions is difficult. We present a retrospective series with thirteen patients with histologically confirmed IFK to evaluate the epidemiological, clinical and histopathologic characteristics of IFK. The mean age of the patients at the time of the excision was 53 years with extremes ranging from 19 to 82 years. The sex ratio M/F was 3.3. The lesions affected the face in nine patients mainly the moustache, followed by the scalp in three cases and the arm in one case, and 92% of the localizations are sun-exposed. The diagnosis was never clinically evoked. The lesion had a pink colour in ten cases and was pigmented in two cases and hypopigmented in one case. More than half of the lesions (53%) had a keratotic centre. Histopathological examination showed endophytic intradermal proliferation of basaloid cells with a variable degree of squamoid differentiation. Horn cysts were present in all cases. According to our series, the IFK occurs predominantly in young men, in the face and more specifically in the moustache. Dermoscopy may suggest the diagnosis of the IFK. In fact, a histopathological examination is the gold standard for the diagnosis of the IFK and helps differentiate these benign tumours from possible malignant neoplasms., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Indian Journal of Dermatology.)

Background: The tumor phenotype may change between primary and metastatic breast cancer. We compared the expression of estrogen receptor (ER), progesterone receptor (PR), and HER2 in a series of primary breast carcinomas (PBC) with their metastatic relapses and analyzed the impact of any changes on survival., Materials and Methods: It was a single-center retrospective study, collecting consecutive cases of metastatic breast carcinoma diagnosed in the pathology and medical oncology departments at Habib Bourguiba University Hospital in Sfax, Tunisia. An immunohistochemical study was used to assess ER, PR, and HER2 expression. Overall survival (OS) and post-metastasis survival (PMS) were evaluated using multivariable Cox regression analysis., Results: Our study included 68 patients. ER and PR status changed in 29.4 % and 39.7 % of cases, respectively. Conversions were mainly from positive to negative status (22 % and 23.5 % for ER and PR, respectively). Differences in HER2 status were observed in 19.6 % of cases, with loss of overexpression in 6 patients (10.7 %). Adjuvant trastuzumab therapy and PBC molecular subtype (HR-, HER2+) were associated with HER2 status discordance (p = 0.02 and 0.03, respectively). On multivariable analysis, HR-negative conversion tumors were significantly associated with a worse OS (p = 0.042) and PMS (p < 0.001), compared to HR-concordant positive tumors., Conclusion: This study establishes that HR and HER2 status discordance between primary and metastatic breast carcinoma has a prognostic impact on patient outcome. Analyzing these receptors' status in all newly diagnosed cases of metastatic breast carcinoma is strongly recommended and would provide information for changing treatment strategies., Competing Interests: Conflict of interest The authors have no conflicts of interest to disclose., (Published by Elsevier Inc.)

Background: Potato tubers from genetically modified plants overexpressing the StDREB1 or the VvWRKY2 transcription factors that exhibited improved tolerance to salt and resistance to Fusarium solani infection were characterized and evaluated for safety in a 30 day rat feeding study. Male Wistar rats were split into four groups and provided with a diet composed of 33% (w/w) of either one of the two genetically modified potatoes (GMPs), 33% of the commercial Spunta variety (Sp), or a control group fed with the basal rats' diet. The influence of the GMPs on rat behavior and overall health parameters was evaluated and compared with that of commercial potato (i.e. the Sp group) and control diet., Results: Small differences were noticed in the chemical composition of the different tubers, but all the diets were adjusted to an identical caloric level. Results showed no sign of toxic or detrimental effects on the rats' overall health as a result of these diets. The rats fed with the GMPs meal showed hematological and biochemical compositions of the plasma comparable to the control groups. No histopathological damage nor any structural disorganization, severe congestion, or acute inflammation were noticed in the rats' tissues., Conclusion: Under these study conditions, the GMP diets did not induce any apparent or significant adverse effects on rats after 30 days of dietary administration in comparison with rats fed diets with the corresponding non-transgenic diet and the standard diet group. These two GMPs were therefore considered to be as safe as their commercial comparator. © 2022 Society of Chemical Industry., (© 2022 Society of Chemical Industry.)

Background: Breast cancer is the first female cancer worldwide. Its prognosis depends mainly on pathological stage and histological grade. These classical prognostic factors are essential but may be insufficient to predict the outcome of the disease. Research focuses on identifying new prognostic factors such as CD10, which is a cell surface metalloproteinase., Objective: This study aims to evaluate CD10 expression on stromal and tumor cells in invasive breast carcinomas and its correlations with other clinicopathological factors and survival., Methods: A series of 100 cases of breast carcinoma of no special type diagnosed from 2009 to 2011, was investigated in this study. CD10 expression was detected by immunohistochemistry. Stromal CD10 expression (=10% stromal positivity was considered positive) and tumor cells expression (=1% stained carcinomatous cells) were noted. Statistical correlations were analyzed with different known prognostic parameters; survival analysis were performed using SPSS 22.0., Results: Stromal CD10 expression was seen in 60% of the cases. It showed positive correlation with high tumor grade (p=0,012) and distant metastasis (p=0,02). CD10 expression on tumor cells was observed in 10% of the cases. It was associated with high tumor grade (p=0,009), hormone receptor negativity (estrogen receptor: p<0,0001), progesterone receptor: p=0,005), triplenegative phenotype (p=0,001), and Ki67 overexpression (p=0,046). Stromal CD10 expression was significantly associated to a shorter overall survival (p=0,029) and disease-free survival (p=0,05) in univariate analysis., Conclusion: Given these results, it can be concluded that CD10 expression predict an aggressive behavior of breast cancer. This marker can be introduced as a determinant prognostic factor.

Metastasis to the nasopharynx is a rare clinical entity. Breast carcinoma is one of the primary tumors that can be responsible for a nasopharyngeal metastasis, which is an extremely rare occurrence. We report the case of a 50-year-old woman with a history of a confirmed breast carcinoma under chemotherapy who presented to our department with a unilateral hearing loss and tinnitus. Nasal endoscopy revealed a small bulging mass at the posterior wall of the nasopharynx. The biopsy of the lesion showed an infiltration of the nasopharyngeal mucosa by a mammary adenocarcinoma that was positive for estrogen and progesterone receptors and negative for human epidermal growth factor receptor 2. Computed tomography scan revealed a thickening of the nasopharyngeal mucosa, a pleural and pericardial effusion and diffused secondary bone lesions. The patient received chemotherapy. Control revealed a partial regression of the nasopharyngeal mass. The patient is still under chemotherapy., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Rosai-Dorfman-Destombes disease (RDD) is a rare histiocytic disorder affecting lymph nodes as well as extranodal sites. Although cutaneous involvement in RDD is common, primary cutaneous RDD is a distinct and not well-documented entity with unknown aetiology and non-specific clinicopathological features. We report a case of a 57-year-old patient, who presented with an indolent skin nodule in the left sub-nipple area. Surgical excision was performed. Histological examination concluded to the diagnosis of cutaneous RDD with histological features mimicking IgG4-related disease. The diagnosis of systemic RDD with cutaneous involvement was ruled out after exclusion of extracutaneous involvement. No recurrence or systemic progression was observed during follow-up. The diagnosis of primary cutaneous RDD is very uncommon and hence is challenging for pathologist and dermatologist especially with features of IgG4-related disease. Careful systemic and microscopic examinations help in establishing the appropriate diagnosis., (© 2022 The Australasian College of Dermatologists.)

Background: Breast cancer represents the most frequent cancer and cause of death in women worldwide and in Tunisia. Cyclin D1 is a gene of cell cycle regulation. It represents a potential oncogene in invasive breast cancer; however; the results are conflicting. We performed a retrospective study aiming to analyze the prognostic impact of cyclin D1 expression in patients with invasive breast carcinoma of no special type and its relation with clinical-pathological features., Methods: One hundred cases of invasive breast carcinoma of no special type diagnosed between 2009 and 2011 were included in this study. Immunohistochemical (IHC) staining was performed for cyclin D1 in all cases. Results were analyzed statistically., Results: Cyclin D1 positivity was seen in 74 cases (74%), of which 32 cases (32%) showed strong immunoreactivity. Cyclin D1 staining was statistically significantly associated with estrogen receptor (ER) and progesterone receptor (PR) positivity ( P <0.0001) and with low grade SBR ( P =0.007). None of the clinical data and other pathological features had any association with cyclin D1 expression ( P >0.05). Univariate analysis revealed that expression of cyclin D1 was not statistically associated with overall survival (OS) and disease-free survival (DFS) ( P =0.459 and P =0.564, respectively)., Conclusion: These results confirm that cyclin D1 overexpression can be employed as a beneficial prognostic marker and suggest that anti-cyclin D1 therapy may be efficient, especially for ER positive tumors., (2022 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Introduction: and importance: Papillary Thyroid carcinoma (PTC) is the most common endocrine malignancy and accounts for 1-2% of all cancer cases. Second malignancies in women diagnosed with thyroid cancer are of concern given the young average age at diagnosis. The concurrent occurrence of thyroid cancer and malignant brain tumor such as glioblastoma (GBM) was rarely seen and reported. However, the simultaneous association of these 2 conditions, namely PTC and GBM, in a neurofibromatosis type 1 (NF1) patient, has never been reported before in the literature., Case Presentation: The authors report the first case of an extremely rare association combining papillary thyroid carcinoma, glioblastoma, and a neurofibromatosis 1 in a 34-year-old female patient with primary generalized tonic-clonic seizures., Clinical Discussion: NF1 can be associated with PTC and GBM independently. In this current case, NF1 was accompanied by both PTC and GBM. With the exception of the present case, to our knowledge, there has been no previous case report in the literature in which these 3 entities were associated. The reason for the rarity of this combination of these neoplasms in patients with NF1 remains not clear, but it may be explained by the low incidence of combined occurrence of PTC and GBM., Conclusion: This is the first reported extremely rare coexistence of GBM and PTC in a female NF1 patient. Further genetic investigations could improve our understanding of this combination and change our therapeutic approaches., Competing Interests: The authors declared no potential conflicts of interests with respect to research, authorship and/or publication of the article., (© 2022 The Authors.)

Cerebellar liponeurocytoma or lipomatous medulloblastoma is a rare oncological entity. Knowledge regarding the management and outcomes of these rare tumors are still evolving. Very few cases have been described previously in the literature. The authors report a case of a middle-aged woman operated on twice, 8 years apart, with uneventful postoperative follow-ups. Radiological characteristics were revealed atypically on the computed tomography scan and magnetic resonance imaging. Histopathological study supported a cerebellar liponeurocytoma with classic immunohistochemical features. Through this report, the authors aim to describe atypical radiological and histopathological features of this rare entity with good outcome by going through a comprehensive review of the existing literature., (© 2022 The Authors.)