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Palpebral sebaceous carcinoma (PSC) is a rare malignant disease. Despite the possibility of extraocular location, the ocular region is the most described site in the literature. This tumor is poorly known and can mimic various benign conditions, explaining the frequent diagnostic delays. We report a new observation of sebaceous carcinoma in a 59-year-old patient and a review of the literature. It mainly affects the elderly with a female predominance. Its location in the upper eyelid remains the most common site, unlike our patient who presented with a lower eyelid disease. Surgery seems to be the treatment of choice for local sebaceous cell carcinoma, the role of radiotherapy is still to be clearly defined but the studies detailed in our paper have confirmed its effectiveness in inoperable patients or patients with advanced local disease, the use of chemotherapy during or before radiotherapy remains to be clarified.

Context: Malignant melanoma of the mucous membranes of the nasopharynx is extremely rare. Despite improved diagnostic capabilities, these lesions are often diagnosed at an advanced stage and the prognosis is poor, in part related to the high rate of recurrence and metastasis. Case Presentation: We report one (01) case of relapse of a malignant mucous melanoma of the nasopharynx, four (04) years after complete conjunctival resection in a fifty (50) year old woman. Before the signs of call for epistaxis, an X-ray workup performed showed a nasopharyngeal tumor, followed by surgical resection with bilateral cervical lymph node dissection. Histology reveals a malignant melanoma without lymph node involvement. Adjuvant radiotherapy was delivered. The control by emission of positron (PET) at six (06) months after the end of adjuvant treatment did not find any lesions. Conclusion: To our knowledge, this is the first case report of a diagnosis of nasopharyngeal melanoma after four (04) years of complete remission. In view of the aggressive high rate of recurrence and metastasis, close monitoring and radiological workup at the slightest sign of calling should be required. Thus, the diagnosis will be made at an early stage which could improve the prognosis.

Background and Objectives: Medulloblastoma are a highly malignant tumor of the central nervous system, very frequent in the childhood, but remains rare in adulthood. This study aims to analyze the frequency, clinical and therapeutic aspects of adults medulloblastomas. Methods: We retrospectively analyzed the data from the record of adult’s patients treated for medulloblastoma between between January 2000 and December 2015 in in the Radiation oncology department of the Ibn Rochd University Hospital Center. Results: The average age was 27,96 years (Range: 20-53 years). The sex ratio M/F was 4 with a clear male predominance. The most common symptom was intracranial hypertension, which was present in 22 patients, followed by headaches and cerebellar syndrome which were present in 9 patients. The tumor was mostly located in the cerebellar hemispheres with an average size of 5,75 cm. One patient had pulmonary metastasis at the time of diagnosis. Twenty-four patients had a surgical resection. Complete resection was performed in 13 patients. Thus, twenty-one patients have received craniospinal irradiation with a dose of 36 Gy followed by a boost in the posterior fossa with a total dose of 54-56 Gy. Twelve patients have received Chemotherapy. Six patients are still alive. Survival rates were 50% at 3 years, 35% at 5 years, and 30% at 10 years. Conclusion: Medulloblastoma is a devastating disease with a bad prognosis. The clinical presentation is variable and the management is multidisciplinary. Radiotherapy treatment with or without Chemotherapy play an important role in the control of the disease and recurrences avoidance. Our study illustrates the importance of treatment by radiation.

Spinal ependymoma, the most common intramedullary tumour in adults, is generally located intradurally and intramedullarily. The presence of this tumor in the bulbo-medullary region is rarely documented in the medical literature.We present the case of a 33-year-old man with persistent torticollis and severe neck pain. Spinal cord magnetic resonance imaging revealed a lesion in the bulbo-medullary region. Subtotal resection of this lesion was performed, and anatomopathological and immunohistochemical analysis confirmed the diagnosis of ependymoma. Following surgery, the patient underwent post-operative radiotherapy.The standard therapeutic management of ependymoma is total tumor resection. However, the role of post-operative radiotherapy remains to be determined, although it is recommended in cases of subtotal resection. &nbsp

Ganglioneuroblastoma is a tumor belonging to the family of neuroblastic tumours. Those are tumors of the sympathetic nervous system. Ganglioneuroblastoma is very rare in adults. We report here a case of nodular ganglioneuroblastoma metastatic to the bone in a 31-year-old woman who consulted for pain in the right flank with, on the CT scan, a voluminous and heterogeneous tissue formation of lobulated contours. She underwent an adrenalectomy. A postoperative radiological assessment showed osteolytic lesions of the neck, left femoral metaphysis and bilateral iliac wings. The patient was put on palliative chemotherapy. She is currently under surveillance at 16 months of survival without new events. Ganglioneuroblastomas are considered to have intermediate metastatic potential. &nbsp

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

Yolk sac tumor is a non-seminomatous testicular germ cell tumor rarely found in adults. It is an extra-embryonic differentiated tumor. It reproduces structures evocative of the yolk sac in humans. We report the clinical case of a 37-year-old patient, with no previous history, who is followed up for a tumor of the left testicle revealed by an increase in size and induration of the testicle. The left orchiectomy, performed through an inguinal approach, allowed us to retain the diagnosis of pure yolk sac tumor on anatomical and immunohistochemical examination. The evolution was marked during the surveillance by a relapse requiring a systemic treatment.

Bevacizumab has been shown to improve progression-free survival in women with ovarian cancer in multiple clinical trials. However, serious adverse effects, such deep vein thromobosis, can occur. Phlegmasia cerulea dolens is a rare entity secondary to grave Deep Vein Thrombosis (DVT), in the lower extremities, and associated with rapidly progressive pain and marked swelling that may compromise the perfusion of the limb. This situation may lead to venous gangrene and the limb’s amputation secondary to a compartment syndrome. We present the case of a 45-year-old female who presented eight days after the fourth administration of bevacizumab for ovarian cancer treatment, a bilateral leg pain with progressive edema which also began to exhibitwith a black discoloration. Venous dopplers showed bilateral occlusions of the common femoral, saphenofemoral, superficial femoral, popliteal, posterior tibial and peroneal veins. To our knowledge, this is the first case with bevacizumab associated Phlegmasia cerulea dolens.

Lung cancer is known to be a complex multifactorial disease, involving both genetic and environmental factors. The study of the different signaling pathways and the identification of the genes involved, will contribute to further understanding the pathogenesis of the disease, thus allowing the development of appropriate targeted treatments. Recently, the link between cancer and inflammation has become more evident and inflammation has been proposed as the seventh hallmark of cancer. Previous studies have suggested that key cytokines involved in inflammation may have an important role in the etiology of lung cancer. The aim of this study was to investigate whether common variants in inflammation-related genes: IL-6, IL6-R, and IL6-ST, influence lung cancer risk in Moroccan population. Single nucleotide polymorphisms (SNPs) in IL-6, IL6-R, and IL6-ST genes were assessed in 120 controls and 120 patients with confirmed lung cancer diagnosis. Genotyping analysis was performed with the TaqMan® allelic discrimination technology. The results were analyzed using SPSS 24.0 software. Among the studied SNPs, we found a significant association for the IL-6 (rs2069840) (OR = 1.63; 95% confidence interval 1.08–2.47; p = 0.01). No significant association was observed for the remaining SNPs of IL-6R (rs2228145) and IL-6ST (rs2228044) genes. Our results suggest the IL-6 (rs2069840) polymorphism may influence the occurrence of lung cancer in Moroccan patients.

Purpose: While nasopharyngeal carcinoma (NPC) management in Morocco is still based on conventional work-ups: a head and neck computed tomography (HN-CT), thoracic and abdominal CT and bone scan, the combination of HN magnetic resonance imaging (HN-MRI) and 2-Deoxy-2-[18F] fluoro-D-glucose positron emission tomography/computed tomography ([18F] FDG PET/CT) is now widely used in the diagnostic and follow-up of this malignancy.Methods: In this prospective study, [18F] FDG PET/CT and HN-MRI outcomes of 117 NPC patients diagnosed between January 2017 and December 2018 were investigated in order to assess their usefulness in routine management of Moroccan patients with NPC. The concordance between HN-MRI and [18F] FDG PET/CT in Tumor (T) and Nodal (N) classification was assessed and the association between [18F] FDG PET/CT metabolic parameters (Tumor- maximum standardized uptake value (T-SUV max), Nodal (N-SUV max), node-to-tumor SUV ratio (NTR) and distant metastasis (M-SUV max), TNM staging system, NPC stages and patient’s survival outcomes was evaluated. Results: Our results showed a moderate concordance between T-TEP and T-MRI categories with a Cohen kappa coefficient (k) at 0.45, and a mediocre concordance between N-TEP and N-MRI (k=0.3). Metabolic parameters of the [18F] FDG PET/CT were assessed; N-SUV max values were significantly higher in patients with advanced nodal involvement, with a mean of 7.4, 9.7 and 11.0 for patients with N1, N2 and N3 nodal categories, respectively (pConclusion: Our findings provide additional evidence into the complementary roles of HN-MRI and [18F] FDG PET/CT in TNM and overall staging of NPC. To the best of our knowledge, this is the first Moroccan study to highlight N-SUV max and NTR derived from [18F] FDG-PET/CT as promising metabolic biomarkers for NPC prognosis.

Background The identification of effective prognosis biomarkers for nasopharyngeal carcinoma (NPC) is crucial to improve treatment and patient outcomes. In the present study, we have attempted to evaluate the correlation between pre-treatment plasmatic Epstein-Barr virus (EBV) DNA load and the conventional prognostic factors in Moroccan patients with NPC. Methods The present study was conducted on 121 histologically confirmed NPC patients, recruited from January 2017 to December 2018. Circulating levels of EBV DNA were measured before therapy initiation using real-time quantitative PCR. Results Overall, undifferentiated non-keratinizingcarcinoma type was the most common histological type (90.1 %), and 61.8 % of patients were diagnosed at an advanced disease stage (IV). Results of pre-treatment plasma EBV load showed that 90.9 % of patients had detectable EBV DNA, with a median plasmatic viral load of 7710 IU/ml. The correlation between pre-treatment EBV DNA load and the conventional prognostic factors showed a significant association with patients’ age (p = 0.01), tumor classification (p = 0.01), lymph node status (p = 0.003), metastasis status (p = 0.00) and overall cancer stage (p = 0.01). Unexpectedly, a significant higher level of pre-treatment EBV DNA was also found in plasma of NPC patients with a family history of cancer (p = 0.04). The risk of NPC mortality in patients with high pretreatment EBVDNA levels was significantly higher than that of those with low pre-treatment plasma EBV-DNA levels (p p Conclusions The results of the present study clearly showed a high association between pre-treatment EBV DNA load, the crucial classical prognostic factors (T, N, M and disease stage) of NPC and OS, suggesting that pre-treatment EBV DNA can be a useful prognostic biomarker in clinical decision-making and improving NPC treatment in Morocco.

To date, several studies have reported that key cytokines in the inflammatory system have important roles in the pathogenesis of cancer, notably in lung cancer. The aim of this case-control study, conducted for the first time in Moroccan population, was to investigate and to analyze the association of the following inflammatory cytokine genes Interleukin (IL)-6, Interleukin (IL)-8, Interleukin (IL)-10, Interleukin (IL)-17, Tumor Necrosis Factor-Alpha (TNFA), Macrophage migration Inhibitory Factor (MIF) and Signal Transducer and Activator of Transcription 3 (STAT3) with lung cancer risk in our patients. Firstly, the mRNA expression was assessed by a quantitative real time PCR in the peripheral blood of lung cancer patients and healthy subjects. Secondly, polymorphisms in the genes encoding cytokines were assessed in 160 lung cancer patients and 150 healthy controls. Genotyping analysis was performed with a Real-Time polymerase chain reaction using TaqMan® genotyping assays on a 7500 FAST Real-Time PCR System and Restriction Fragment Length PolymorphismPCR. Our results revealed a significant difference in mRNA expression levels of IL-6, IL-8, IL-10, IL-17 and TNFA genes in lung cancer patients compared to healthy subjects (P 0.05). Among the studied genes, we found a significant association between lung cancer risk in our patients and the following polymorphisms IL-6 (rs1800795, rs1800796), IL-8 (rs4075, rs2227306), IL-17F (rs763780, rs2397084) and MIF (rs755622). In conclusion, the results of our study suggest that IL-6, IL-8, IL-10, IL-17 and MIF cytokine genes may aggravate lung cancer risk in the Moroccan population. However, further investigations are required to confirm our findings.

Breast cancer is the most common cancer in women in the world and in Morocco. Anthracyclines and anti-HER2 therapy are major drugs in the therapeutic management of localized breast cancer. The most serious toxicity of these drugs is cardiotoxicity. Our work aims to assess the prevalence of this toxicity in the Moroccan population.We conducted a prospective longitudinal observational study between January 2017 and June 2018. All our patients were followed in The Cardio-Oncology Unit, 1st unit of its kind in Morocco, created thanks to the collaboration between the Mohammed VI Cancer Treatment Center and The Cardiology Departement of Ibn Rochd University Hospital in Casablanca. Eligible patients (n=549) had Stage I-III localized breast cancer, verified histologically, and a pre-treatment adequate cardiac function with a LVEF = 50%, measured with echocardiography, and received systemic cardiotoxic treatment (anthracycines, anti-her2 drugs). All patients received regular monitoring of cardiac function mainly by echocardiography. Cardiotoxicity was defined as a decrease in LVEF of 10 points and / or50%.A decrease in LVEF was observed in 8.4% of our patients, with 4% symptomatic heart failure. The baseline average LVEF in the cardiotoxicity group was 63.5% (50-77) versus 60.5% (60-74) in the group without cardiotoxicity. 97.1% of these patients received anthracyclines, 98% received trastuzumab against 97% and 65% in the group without cardiotoxicity respectively. Cardiotoxicity was reversible in 6.4% of patients, permanent discontinuation of cardiotoxic treatment was observed in 2.2%. A statistically significant relationship was found between cardiotoxicity and arterial hypertension (HTA) (p = 0.002), trastuzumab (p = 0.0001) and radiotherapy for left breast cancer (p = 0.023).This is one of the first observational studies in Morocco with a large number of patients, which gives us an idea of the cardiotoxicity of systemic treatments in Moroccan localized breast cancer patients. Our results join those of the literature, but are still worrying and invite us, oncologists and cardiologists, to be more vigilant with this toxicity, which influences the oncological and cardiac prognosis of our patients, especially cancer survivors.

Ocular structures represent an extremely rare sites for disseminated malignancy , which can have different origins of primary cancer. woman’s ocular metastasis should suggest primary breast cancer at first. The diagnosis of metastatic ocular disease is based on clinical and radiological arguments, they should be considered in any visual disturbance, such as exophthalmos, which is the most frequent symptom. The definitive diagnosis is based on the histological analysis. Treatment options are focused on improving the patients’ quality of life. It is a combination of local and systemic cancer treatments that can help to preserve the visual acuity .however the prognosis remains poor. In this manuscript, we present a rare case of a woman with ocular metastasis, who was traited 6 years ago for a breast cancer, while raising the clinical, paraclinical and therapeutic aspects of this location with a review of the literature.

Background As it is the case for all kinds of cancer; lung cancer is a multifactorial disease. The interaction between both Exposures to different carcinogens and individual genetic backgrounds modulate the disease risk. Cytochrome P450 family is one of the main enzymes involved in the metabolism of these carcinogens. Therefore, polymorphisms of genes encoding for the cyp450 enzymes can be responsible for the inter-individual differences in lung cancer susceptibility. In this study, we chose to focus on the Cyp2c19, as one of the crucial cyp450 enzymes associated with metabolism of a number of drugs and xenobiotics and its association with the lung cancer risk. Methods Peripheral blood from a total of 115 Moroccan patients diagnosed with lung cancer and 105 healthy subjects was collected. The genotyping of CYP2C19*2 and CYP2C19*3 polymorphisms was carried out using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technic. Results We found that the frequency of both CYP2C19*2 (GA+AA) genotype and CYP2C19*A allele were significantly more frequent in lung cancer patients than that in control subjects (24.3% vs 13.3%; p = 0.04 and 14.35% vs 7.15%; p = 0.01 respectively). We also found that the CYP2C19*3 A allele was only found in lung cancer patient with a frequency of 10% (p = 0.007). Consequently, the frequency of the CYP2C19*3 (GA + AA) genotype was also significantly more prevalent in lung cancer patients than that in controls (20% vs 0.00%; p = 0.005). We also found that smoking is associated to a higher lung cancer risk in participants carrying CYP2C19*3 or CYP2C19*2 GG genotypes (p Conclusion These findings indicate that the CYP2C19*2 and CYP2C19*3 polymorphisms are significantly associated with lung cancer in Moroccan population. In addition, that the coexistence of CYP2C19*3 with smoking increased lung cancer risk even more.