Breast adenoid cystic carcinoma: a rare case report and review of the literature

Background: Primary adenoid cystic carcinoma [ACC] of the breast is a rare subtype of invasive breast cancer. It has a particular interest because of its excellent prognosis conversely to other triple-negative breast cancers that are associated with poor prognosis. The place of chemotherapy and radiotherapy remains controversial and there is no consensus on optimal management of the ACC of the breast

Case Report: A 50-year-old woman, presented with a palpable right breast lump. Core biopsy of the lump revealed an adenoid cystic carcinoma. A lumpectomy with axillary lymph node dissection was performed and completed by a mastectomy because of the positive surgical margins. The histopathological examination revealed an adenoid cystic carcinoma, with negah expression of hormone receptors and human epidermal growth factor receptor 2 HER2 and with no lymph node involvement. The patient underwent adjuvant sequential chemotherapy with anthracycline and taxane followed by radiotherapy. We discuss diagnosis, prognostic, and treatment options for ACC of the breast in light of exista literature

Conclusion: Adenoid cystic carcinoma of the breast iss rare variant of triple negative breast cancer with excelled prognosis. Surgical treatment is the mainstay with nc clear consensus for radiotherapy and chemotherapy

[Information needs of Moroccan elderly cancer patients]

Background: Announcing cancer to a patient is not a simple task. Usually doctors fail to inform patients about the diagnosis and it is more likely in older people .The need of information in cancerous elderly is not well established. In developed countries, there is evidence that the majority of old patients are demanding exhaustive information about their disease, treatment and prognosis

Aim: In developing countries where social and cultural issues are different, perception of cancer in elderly is not well studied. Therefore we conducted a prospective study on Moroccan elderly cancerous need of information about their disease

Methods: This is a prospective descriptive study, Conducted in the National Institute of Oncology of Morocco, cancerous patients older than 70 were included. A questionnaire was given to participants. Demographics, disease characteristics, social, economical and cultural features were recorded

Results: One hundred and fifty patients responded to the questionnaire. Mean age was 73. 72.7% of patients were diagnosed in advanced stages. Illiteracy was found in 76%. 87.3% of patients did not have health insurance. All patients were Muslim, practicing in 97%. 57% ignored diagnosis. 80% didn't want to know further information about prognosis and treatment side effects. Family protection from information was found in 70%

Conclusion: Moroccan elderly affected with cancer are less demanding of details about their illness.Illiteracy and cultural background may play a major role, Relatives overprotection is also influencing

[Dietary risk factors of undifferenced nasopharyngeal carcinoma: a case-control study]

The incidence of nasopharyngeal carcinoma [NPC] is relatively high in Maghreb countries. This cancer is a model of multifactorial oncogenesis, but the role of food as risk factor in ethiopathogenesis of this tumor is not negligible. To identify the association between risk of NPC and some dietary factors in Morocco. It is a case-control study including all new cases of NPC in our department between December 2009 and May 2010. Frequency consummation of foods was compared between cases and controls matched for age, sex and socio economic level. A high frequency consummation of a food was defined as consumption once or more by a week. Some traditional foods in Moroccan cooking like Harissa [hot red pepper], Qadid [mutton dried and salted], Khlii [dried meat, salted, spiced cooked and preserved in a mixture of oil and rendered beef fat] and Smen [rancid butter] were analyzed in this study. A conditional logistic regression was used to identify the association between dietary factors and the risk of NPC. Cases were more likely to have high frequency consumption of Harissa, Smen and Black Pepper, and less frequency consumption of fruits and vegetables. There was significant association between the risk of NPC and the frequency consumption of Qadid, khlii and cooking with olive oil. Some of these risk factors [Harissa, Black pepper] were found in 3 North African studies. This study indicates the involvement of dietary factors, and thus the lifestyle in the development of NPC and the need of biochemical analysis of food specimens to search for the carcinogenic agents

Endometrial stromal sarcoma: prognostic factors and impact of adjuvant therapy in early stages

Endometrial stromal sarcomas [ESS] are rare uterine neoplasms. Surgery remains the cornerstone of treatment for early stages and consists of an abdominal hysterectomy with bilateral salpingo-oopherectomy. Despite appropriate surgical treatment, relapse rates are high [18% to 45%] and the value of adjuvant therapies is not clear. We evaluated prognostic factors and the impact of adjuvant treatment on localized ESS [stages I and II]. Retrospective, case-control study conducted at the National Institute of Oncology in Rabat, Morocco over 10 years from 2000 to 2009. Twenty-one cases of localized ESS were included in the analysis. Standard surgery was performed in 71.4% of our patients. Myometrial invasion was noted in 57.1% of cases. Mitotic activity was considered high in five patients. Adjuvant treatment was given to 52.3% of patients: endocrine therapy in five patients and radiotherapy in six. Survival was significantly longer in the group of patients who underwent standard surgical treatment [P=.0007], in the absence of deep myometrial invasion [P=.0248] in cases with a low mitotic index [P<.0001] and in patients who received adjuvant therapy [hormone or radiotherapy] [P=.0048]. In a multivariate analysis independent risk factors for monitoring were inadequate surgical treatment and absence of adjuvant treatment. Myometrial invasion and mitotic index appear to be important prognostic factors. The reference surgery is hysterectomy with bilateral salpingo-oopherectomy. Lymph node dissection does not appear to provide a benefit. Finally adjuvant treatment may carry a significant survival benefit