Brain metastasis from male breast cancer treated 12 years ago

Male breast cancer is an uncommon disease that has been the focus of limited researches. Its etiology is unclear, but hormonal levels may play a role in the development of this disease. Our case is a 84 year old patient treated for breast cancer 12 years ago, it was an infiltrating ductal carcinoma classified pT2 N0 M0 with hormone receptor positive (HR +), treated with surgery, adjuvant chemotherapy, radiation therapy and 5 years of endocrinotherapy (tamoxifen 20mg 1 tablet daily continuously). Clinical control of our patient was normal within 11 years and 10 months. A month ago, the patient had headache and vomiting complicated by the sudden onset of left hemiplegia. The brain MRI showed a huge right temporal process with a shift of the midline structures (figure). A biopsy was also performed and demonstrated a cerebral relapsed breast primitive with the same disease profile (HR positive and HER2 negative). Brain metastases traditionally occur in 10-16% of metastatic breast cancer patients and are associated with a bad prognosis. The development of brain metastases has been associated with young age, and tumors that are estrogen receptor negative, HER2 positive or of the basal phenotype. However, we can also have brain metastases of a primary breast cancer in elderly patients even with pathological and immunohistochemistry different profiles regardless of gender.Pan African Medical Journal 2016; 2

Maxillofacial metastasis from breast cancer

Metastatic tumors to paranasal sinuses are exclusively rare. In this paper, we report acase of breast  carcinoma metastasizing to the right maxilla. The metastasis occurred 5 years after radical mastectomy and presented as a primary sinonasalmass. The diagnosis was confirmed with histopathologic  andimmunohistochemical examination however the patient died before starting any specific treatment  because of tumor bleeding.Key words: Breast cancer, maxillofacial, metastasi

Gastrointestinal stromal tumors: real-life experience of a Moroccan center

Introduction : Les tumeurs stromales gastro-intestinales (GIST) sont des tumeurs mésenchymateuses rares qui ont connu récemment beaucoup de progrès tant sur le plan diagnostique que thérapeutique. Matériel et Méthodes : Notre expérience porte sur 23 cas de GIST colligés à l’hôpital militaire Moulay Ismail de Meknès sur une période de 6 ans (depuis janvier 2011 jusqu’à décembre 2016). Résultats : L’âge moyen de nos patients était de 54,2 ans (de 28 à 73 ans) avec une prédominance masculine plus marquée (16 hommes/7 femmes). Les épigastralgies constituaient le principal mode de révélation de la maladie (73,9 %). La localisation gastrique était la plus fréquente (69,6 %). A l’endoscopie digestive, Il s’agissait le plus souvent d’une masse sous muqueuse (21,7 %). Le type cellulaire fusiforme était prédominant (73,9 %). La tumeur était localisée dans 47,8 % des cas, localement avancée dans 8,7 % des cas et métastatique dans 43,5 % des cas. Le traitement a consisté en une résection chirurgicale carcinologique complète dans 65,2 % des cas. Le traitement médical à base d’imatinib était préconisé chez 20 cas dont 12 cas en situation adjuvante et les autres en situation métastatique. Avec un recul moyen de 3 ans, une rémission complète a été obtenue dans 52,2 % des cas. Conclusion : Les GIST sont des tumeurs rares au Maroc. Elles sont souvent localisées dans l’estomac. La chirurgie dans les GIST localisées doit être macroscopiquement complète. L’imatinib est un traitement « à la carte ». Une étude multicentrique à l’échelle nationale permettrait une analyse plus approfondie du profil des GIST au Maroc.Introduction: Gastrointestinal stromal tumors (GIST) are rare mesenchymal tumors that have recently undergone much progress both diagnostically and therapeutically. Material and methods: Our experience concerns 23 cases of GIST collected at the Moulay Ismail military hospital in Meknes over a period of 6 years (from January 2011 to December 2016). Results: The average age of our patients was 54.2 years (28 to 73 years) with a higher male predominance (16 men / 7 women). Epigastralgia were the main mode of disclosure of the disease (73.9%). Gastric localization was the most common (69.6%). Digestive endoscopy most often showed a submucosal mass (21.7%). The fusiform cell type was predominant (73.9 %). The tumor was localized in 47.8% of cases, locally advanced in 8.7 % of cases and metastatic in 43.5% of cases. Therapeutic management consisted of complete surgical resection in 65.2% of cases. Medical treatment with imatinib was recommended in 20 cases including 12 cases in adjuvant situation and the others in metastatic situation. With a mean follow-up of 3 years, complete remission was obtained in 52.2% of cases. Conclusion: GIST are rare tumors in Morocco. They are often located in the stomach. Surgery in localized GIST should be macroscopically complete. Imatinib is an “at card” treatment. A multicenter nationwide would allow further analysis of GIST profile in Morocco

Unusual toxicity of bevacizumab (Avastin®): Hyperlipemia?

Le bevacizumab (Avastin®) est un anticorps monoclonal exerçant une activité antiangiogénique. Son utilisation apporte un gain en survie dans plusieurs localisations tumorales en phase métastatique dont le cancer du sein, le cancer colorectal, le cancer du rein et le cancer bronchique non à petites cellules. Ce traitement est pourvoyeur de toxicités spécifiques comme l’hypertension artérielle, la protéinurie, les perforations digestives ou les évènements thromboemboliques artériels. Nous rapporterons une série de 7 cas d’hyperlipémies apparues (5 cas) ou s’étant aggravées (2 cas) lors d’un traitement par bevacizumab. Tous nos malades ont évolué favorablement par les mesures hygiéno-diététiques, associées ou non à un traitement médical par statines.Bevacizumab (Avastin®) is an antibody humanized monoclonal neutralizing anti-VEGF (anti-growth factor vascular endothelial) exerting anti-angiogenic activity. It has shown its impact on relapse-free survival of patients treated for metastatic tumors including breast cancer, colorectal cancer, kidney cancer and no small cell lung cancer. This treatment is a provider of specific toxicities such as hypertension, proteinuria, gastrointestinal perforation or arterial thromboembolic events. We report a series of seven cases who received this therapy including 5 patients who had no dyslipidemia before treatment and 2 cases who had increased their initial lipid profile. All the patients were placed under Lifestyle and diet, associated or not to medical treatment by statins. The evolution was favorable in all cases

Small or Non-Small Cell Lung Cancer Based Therapy for Treatment of Large Cell Neuroendocrine Cancer of The Lung? University of Cincinnati Experience

Large cell neuroendocrine cancer (LCNEC) of the lung exhibits morphological and immunohistochemical characteristics of both neuroendocrine and large cell carcinomas. No defined optimal therapy has been described for this subset of patients and the question of whether these patients should be treated with non-small cell lung cancer (NSCLC) treatment protocols, according to the National Comprehensive Cancer Network (NCCN) guidelines, or with small cell lung cancer (SCLC) due to histological and clinical similarities is still uncertain. We conducted a retrospective review of patients identified with diagnosis of LCNEC of the lung at the University of Cincinnati Cancer Center from the year 2002 to 2012 to determine which treatment approach resulted in improved outcomes in this rare category of disease. Patients who received chemotherapy whether NSCLC (group A) or SCLC (group B) protocols did not show significant changes in OS (P=0.911). Meanwhile, patients who underwent surgery (group C) had better OS compared to groups A and B (P= 0.027 and 0.024, respectively). This analysis reveals that outcomes for SCLC or NSCLC treatment strategies in LCNEC patients did not result in survival advantages and future research should be addressing it as a separate entity