Lymphedema after breast cancer

Lymphedema is one of the most significant survivorship issues after the surgical treatment of breast cancer and in this population it has been documented to have significant quality of life consequences. It is the result of obstruction or disruption of the lymphatic system, which can occur as a consequence of tumors, surgery, trauma, and radiation therapy, and this is lead to the accumulation of fluid in the interstitial tissues. We report the case of a patient referred in our department after breast surgery (Patey intervention) for adjuvant chemotherapy. The patient received adjuvant chemotherapy and adjuvant radiotherapy. She developed one year after completion of the treatment a swelling in the right arm, and hand, with a temporary indentation of the skin after finger pression (pitting edema). An ultra sound exam was performed and deep vein thrombosis was excluded. The patient was referred to a physical therapist for management of her lymphedema. Cancer related lymphedema is a common post treatment complication. In breast cancer patients, lymphedema has been described as an often underdiagnosed, and undertreated condition. Also, early detection of lymphedema increases the likelihood of successful treatment. Patients must be informed and conservative surgery like sentinel lymph nodes technique should be performed to reduce the risk.Pan African Medical Journal 2016; 2

La problématique du coût des nouvelles thérapeutiques en oncologie: qu’en-est-il du Maroc?

Le cancer est un problème majeur de santé public en Afrique. Les progrès réalisé dans le traitement des cancers ces dix dernières années est indéniable. L'émergence des thérapies ciblés en oncologie a permit de modifier l'histoire naturelle de certains cancers réputés de mauvais pronostic. En dépit de leurs efficacité, ces thérapeutiques pose un problème majeur de coût qui les rend inaccessible à la majorité des patients dans les pays en voie développement. Au Maroc, le cancer est reconnu comme a une affection de longue durée et les patients bénéficient de ce fait d'une couverture médicale totale. L'implication de la société civile a permis aussi d'améliorer la prise en charge ainsi qu'un accès plus élargi aux médicaments innovants pour les patients les plus démunis.Pan African Medical Journal 2016; 2

Métastase vésicale d’un adénocarcinome gastrique en bague à chaton

Bien que le cancer primitif de la vessie représente le deuxième cancer urologique après le cancer de la  prostate, les métastases vésicales sont rares et le primitif gastrique reste exceptionnel. On rapporte le cas d’un patient âgé de 46 ans, avec des épigatsralgies chroniques, qui présentait une hématurie totale avec des signes irritatifs urinaires. La cystoscopie a montré une vessie inflammatoire sans lésion tumorale décelable. La biopsie vésicale avec une étude anatomopathologique a été en faveur d’un adénocarcinome peu différencié à cellules indépendantes. Le scanner thoraco-abdomino-pelvien a montré un épaississement vésical et gastrique. La fibroscopie oeso-gastroduodénale a montré une tumeur bourgeonnante ulcérée fundique qui a été biopsiée. L’étude anatomo-pathologique a montré un adénocarcinome gastrique à cellules indépendantes mucipares. Le patient a eu 6 cures de chimiothérapie palliative de première ligne type EOX à base  d’Epirubicine, Oxaliplatine, et Capécitabine, avec une légère régression tumorale puis une chimiothérapie de maintenance à base de Capécitabine.Key words: Métastase vésicale, adénocarcinome gastrique, cellules en bague à chato

La dermatomyosite paranéoplasique révélant un carcinome indifférencié du nasopharynx: à propos d’un cas

La dermatomyosite (DM) est une maladie inflammatoire d'origine inconnue qui se manifeste sous forme de myopathie associée à lésions cutanées typiques. L'association DM et cancer est fréquente (18 a 32% selon les séries). Décrite pour la première fois par Stertz en 1916 en association avec un cancer gastrique. Tous les types histologiques et toutes les localisations de cancers observés danss la population générale peuvent être associés à la DM. Son association avec le carcinome nasopharyngé (NPC) est peu décrite et de l'ordre d'un cas pour 1000 cas de cancer nasopharyngé. Nous rapportons une observation de dermatomyosite révélant un cancer du nasopharynx localement avance.Pan African Medical Journal 2016; 2

Complementary medicine use among Moroccan patients with cancer: A descriptive study

tter inform his patients

Obstructive jaundice secondary to pancreatic head adenocarcinoma in a young teenage boy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Pancreatic adenocarcinoma is extremely rare in childhood. We report a case of metastatic pancreatic adenocarcinoma in a 13-year-old boy, revealed by jaundice.</p> <p>Case presentation</p> <p>A 13-year-old Moroccan boy was admitted with obstructive jaundice to the children's Hospital of Rabat, Department of Pediatric Oncology. Laboratory study results showed a high level of total and conjugated bilirubin. Computerized tomography of the abdomen showed a dilatation of the intra-hepatic and extra-hepatic bile ducts with a tissular heterogeneous tumor of the head of the pancreas and five hepatic lesions. Biopsy of a liver lesion was performed, and a histopathological examination of the sample confirmed the diagnosis of metastatic ductal adenocarcinoma of the pancreas. Our patient underwent a palliative biliary derivation. After that, chemotherapy was administered (5-fluorouracil and epirubicin), however no significant response to treatment was noted and our patient died six months after diagnosis.</p> <p>Conclusion</p> <p>Malignant pancreatic tumors, especially ductal carcinomas, are exceedingly rare in the pediatric age group and their clinical features and treatment usually go unappreciated by most pediatric oncologists and surgeons.</p

Pathological complete response in advanced gastric stromal tumor after imatinib mesylate therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Gastrointestinal stromal tumors are a rare neoplasm exhibiting, in most cases, mutations of <it>c-kit</it>. Imatinib mesylate is the standard treatment for patients who have advanced gastrointestinal stromal tumors. Although the response rate in patients treated with imatinib mesylate in prospective clinical studies is above 50%, a complete response is very rare. We report the case of a patient with a gastric gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Case presentation</p> <p>We report the case of a 54-year-old Arab woman with a gastrointestinal stromal tumor who had a pathological complete response after neoadjuvant treatment with imatinib mesylate.</p> <p>Conclusion</p> <p>The pathological examination of our patient documented a complete pathological response after imatinib therapy. Recently, it has been confirmed that the kinase genotype of <it>KIT </it>and <it>platelet-derived growth factor receptor α </it>can accurately predict a good response to imatinib mesylate therapy. We propose that this patient had a mutation conferring high sensitivity to imatinib mesylate.</p

Cutaneous metastasis to the face from lung adenocarcinoma

Cutaneous metastases in the facial region occur in less than 0.5% of patients with metastatic cancer, and they usually originate from malignant melanoma. In this report, we describe an unusual case of lung adenocarcinoma metastasizing to his face at the time of initial diagnosis. The patient was 64-year-old man, a heavy smoker; he was referred to our department with a short history of dyspnea, pleuritic pain and loss of weight, as well as a nodule on his left cheek which was noticed simultaneously with the respiratory symptoms. His general condition was good. A chest X-ray revealed a left upper lobe mass with. Bronchoscopy with biopsy revealed a primitive adenocarcinoma of the lung. The patient underwent computed tomography (CT) scans of brain and abdomen, and chest. Radiological exams revealed a left upper lobe tumor with hepatic metastasis. The patient underwent excision biopsy of the facial lesion. Subsequent histological sections showed infiltration by lung adenocarcinoma confirmed by immunochemistry; TTF1 and CK7 positives. A palliative chemotherapy was initiated, the patient survived 6 months.The Pan African Medical Journal 2016;2