Epidemiology and survival analysis of gastrointestinal stromal tumors in lebanon: real-life study from a hospital tumor registry 2000-2015

Background: We report, to our knowledge, one of the largest studies concerning gastrointestinal stromal tumors [GIST] in the Middle East. We also present a survival analysis of GIST in our 15-year real-life experience

Methods: We studied demographic, epidemiologic and survival characteristics of 70 patients with confirmed GIST in a cross-sectional study between 2000 and 2015

Results: The .median age of our patients was 62 +/-12.8 years [range, 25-84] with a male to female ratio of 1.7. The gastric and the small intestine GIST were the most frequent primary sites. The majority of our patients had localized disease at diagnosis [81.4%]. Metastasis m limited to the abdominal cavity and lymph node spreadinc occurred in 14.3%. After a median follow up of 838 dap [range 48-4309 days] with only two patients reporte dead, two and five-year overall survival rates were 98% and 95% respectively. Median overall survival was not reached

Conclusion: In the light of our results, molecular profili of Lebanese patients with GIST would be of interest t detect the particularities responsible for the increase! overall survival and lymph node spreading

Gastric Adenocarcinoma Secondary to Primary Gastric Diffuse Large B-cell Lymphoma

Despite the decreasing incidence and mortality from gastric cancer, it remains a major health problem worldwide. Ninety percent of cases are adenocarcinomas. Here, we report a case of gastric adenocarcinoma developed after successful treatment of prior primary gastric diffuse large B-cell lymphoma (DLBCL). Our patient was an elderly man with primary gastric DLBCL in whom complete remission was achieved after R-CHOP (cyclophosphamide, adriamycin, vincristine, prednisolone plus rituximab) chemotherapy. Helicobacter pylori infection persisted despite adequate treatment leading to sustained chronic gastritis. The mean time to diagnose metachronous gastric carcinoma was seven years. We believe that a combination of many risk factors, of which chronic H. pylori infection the most important, led to the development of gastric carcinoma following primary gastric lymphoma. In summary, patients who have been successfully treated for primary gastric lymphoma should be followed up at regular short intervals. H. pylori infection should be diagnosed promptly and treated aggressively.

Brucellosis: A lymphoma-like presentation

Brucellosis is one of the most common zoonotic infections worldwide caused by gram negative bacilli of the genus Brucella. It is transmitted to humans by contact with infected animals or derived food products such as unpasteurized milk. Brucellosis' clinical presentation varies widely from multi-systemic involvement to asymptomatic infection. We present the case of a 52-year-old Lebanese male who was admitted to our hospital with a 3-week history of fever (up to 40 °C), chills, night sweats and abdominal pain. Abdominal CT scan revealed the presence of several mesenteric lymphadenopathies and some retroperitoneal lymphadenopathies. Blood cultures came back positive for Brucella melitensis, and a follow-up CT of the abdomen done after treatment revealed complete resolution of the lymphadenopathies. To our knowledge, this is the first case in the literature of brucellosis presenting as retroperitoneal and mesenteric lymphadenopathies. In endemic areas, the diagnosis of brucellosis should always be raised in front of any long duration fever even in the absence of a typical clinical presentation.

Brucellosis: A lymphoma-like presentation

Brucellosis is one of the most common zoonotic infections worldwide caused by gram negative bacilli of the genus Brucella. It is transmitted to humans by contact with infected animals or derived food products such as unpasteurized milk. Brucellosis' clinical presentation varies widely from multi-systemic involvement to asymptomatic infection. We present the case of a 52-year-old Lebanese male who was admitted to our hospital with a 3-week history of fever (up to 40 °C), chills, night sweats and abdominal pain. Abdominal CT scan revealed the presence of several mesenteric lymphadenopathies and some retroperitoneal lymphadenopathies. Blood cultures came back positive for Brucella melitensis, and a follow-up CT of the abdomen done after treatment revealed complete resolution of the lymphadenopathies. To our knowledge, this is the first case in the literature of brucellosis presenting as retroperitoneal and mesenteric lymphadenopathies. In endemic areas, the diagnosis of brucellosis should always be raised in front of any long duration fever even in the absence of a typical clinical presentation.

Management of metastatic colorectal cancer current treatments and new therapies

Colorectal cancer represents 8% of metastatic cancers. For decades, the gold standard therapy has been infusional chemotherapy with 5-Fluorouracil [5-FU] associated to folinic acid. The discovery of irinotecan, oxaliplatin and oral forms of 5-FU in the nineties is considered a milestone in the treatment of this disease. Since 2004, targeted therapy with monoclonal antibodies including anti-EGFR and angiogenesis inhibitors showed superiority in terms of mortality compared to conventional therapy. Metastatic colorectal cancer, however, remains an incurable disease. We present the current treatments of metastatic colorectal cancer, the clinical development of these emerging treatments, and their position in the Lebanese health care system

[Insertion des chambres a catheter implantables sous guidage echographique et scopique. Etude prospective portant sur 120 cas]

We compare our results of a prospective study, on 120 totally implantable venous access ports [TIVAP] inserted at angiographic unit, under ultrasound and fluoroscopic guidance, with those of the literature. The 120 AP data, placed under ultrasound and fluoroscopic control for chemotherapy treatment, were prospectively analyzed. The detailed technique of insertion is noted. Data related to the technical success rate and to complications were classified into major, minor, early or late, according to the recommendations of the interventional radiology society. The technical success rate is 100% with no major complication noted. Eight [6.6%] TIVAP were withdrawn because of infection in 4 cases [3.3%], and end of treatment in the other four. The withdrawals took place in chemotherapy clinics. Three [2.5%] are classified as early infections, within two months of the procedure, two of which were associated to wound non-healing. Four patients [3.3%] presented early minor complications [hematoma surrounding TIVAP insertion site]. Our results correspond to previously published data. The insertion of AP at the angiographic unit under ultrasound and fluoroscopic control has lower risk of complications and a success rate higher than that being inserted following anatomical location. Collaboration with a specialized care nurses team is of paramount importance