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1.
Maroc Medical. 2011; 33 (3): 190-196
in French | IMEMR | ID: emr-162264

ABSTRACT

The hormonotherapy constitutes since many years a major element of the palliative treatment of cancer prostate. It is effective at the beginning of the treatment, but a hormono resistance a ppears ofter few months. We led a prospective study spread out over 20 months, for 6 cases. Our object was to detect Cancer prostate that is beyond the hormonal control and study - thanks to biopsies - the interesting possible histological modifications both in the normal and cancerous prostatic tissue. Our study included 6 patients with a mean age of 72 years and 6 months. At the time of the exhast 3 patients were presented with neuroendocrine differentiation. The other 3 patients were without neuroendocrine differentiation, and had at the time of diagnosis an osseous metastases. Their initiale average PSA was of 83,40ng/ ml, and of 161,23 ng/ml in exhust. The group with neuroendocine differentiations these values were of 21,95 ng/ml and 37,55 ng/wa respectively. The average time of exhust in neuroendocine differentiation was of 19 months, against 17 mouths for the group without neuroendocrine diffrentiation. Severad histological tranformations were reported in the hormonal exhust of cancer porstate, the most known were: reduction of tumoral volume, capsular invasion, as well as a smaller percentage of positive marginal resection, compared with cancer that ever treated by hormonotherapy. Certain authers also noted an increase of Gleason score in the hormono-resistant prostate. Lastly, the paramete which draws more the attention of authers was that the neuroendocrine differentiation type may be concidered as a mechanisme implied in the exhust. In our study, half of the cases in exhust presented with a neuroendocrine differentiation, that would be concideved as a prognostic factor according to certain authers, wheras others are nof convinced by its prognostic implication. The study of the histological modifications in hormono-resistant cancer of the prostate is of an main interest for the anatomopathologists, as well as for the urologists and the oncologists so as not to interpret the observed histological images incorrectly, which could establish a based prognosis and inadequate therapeutic care. The implication of these transformations remain still vague and several studies will be necessary in order to clear up the various persistent points of shade


Subject(s)
Humans , Male , Middle Aged , Aged , Aged, 80 and over , Prostatic Neoplasms/therapy , Prostate-Specific Antigen , Neoplasm Metastasis , Prospective Studies
2.
Maroc Medical. 2010; 32 (1): 39-43
in French | IMEMR | ID: emr-133554

ABSTRACT

It is a rare tumor characterized by a good prognosis even in metastatic cases. Its etiopathogenesis is still controversial and the anatomopathological progress permits for the best comprehension of these tumors. It's a case revealed by an abdominal pain witch the diagnosis was done by a histological study aided by an immunohistochemistry analysis of the excised tumnor. This pathology represents 0.7 to 2.7% of all cases of the exocrine tumors of the pancreas, with a female predominance and the average age is 22 years old. The clinical picture is not specific and may be discovered by chance. The diagnosis is based on histological study. It shows a tumoral proliferation of a pseudopapillary shape composed of small sized cells adherent to the fibrovascular axes. The differential diagnosis between these tumors and essentially the neuroendocirne tumors is based on the immunohistochemistry analysis. The treatment is essentially surgical with a good prognosis even with metastatic cases. The diagnosis of solid pseudo-papillary tumor of the pancreas bases on histological study aided by an immunohistochemistry analysis. Its good prognosis justifies a surgical radical treatment. The visible increase of its incidence is the likely consequence of a better knowledge of this pathology

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