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1.
J Med Case Rep ; 15(1): 73, 2021 Feb 20.
Article in English | MEDLINE | ID: mdl-33608057

ABSTRACT

BACKGROUND AND AIM: Breast tuberculosis is a rare disease, even in endemic areas. The diagnosis can be challenging, as it can mimic breast cancer. We aim to report our experience and discuss diagnoses and management modalities. RESULTS: We encountered twelve cases of breast tuberculosis in our institution from 2004 to 2019. The average age of our Caucasian North African patients was 42 years old (22-63). The classic presentation was a breast lump found in half of the cases. On physical examination, we suspected breast carcinoma in seven patients. The average size of the tumors was 39 mm (15-80 mm). Nine patients had a mammogram. In five cases, there was a suspicious breast mass mimicking a malignant tumor with an average size of 33 mm (25-60 mm). A ultrasonography was performed in 6 cases and revealed a suspicious ill-circumscribed nodule in four patients with an average size of 37.5 mm (10-60 mm). Five patients had a lumpectomy, and seven women underwent drainage of the abscess and the biopsy of its hull. The association of epithelioid cell granulomas and caseous necrosis was mandatory for the histological diagnosis of tuberculosis. All of them had an antitubercular therapy. The median period of follow-up was of 43 months (3-156 months). One patient presented with a recurrent abscess of the breast. CONCLUSION: Our study found that clinical examination and radiological imaging were not specific. Positive cultures for Koch bacillus or histological confirmation are mandatory for the diagnosis. A meta-analysis of the existing cases is needed.


Subject(s)
Breast Diseases , Breast Neoplasms , Tuberculosis , Adult , Antitubercular Agents/therapeutic use , Breast/diagnostic imaging , Breast Diseases/diagnostic imaging , Breast Diseases/therapy , Breast Neoplasms/diagnostic imaging , Breast Neoplasms/therapy , Diagnosis, Differential , Female , Humans , Mammography , Tuberculosis/diagnostic imaging , Tuberculosis/drug therapy
2.
Urol Case Rep ; 35: 101544, 2021 Mar.
Article in English | MEDLINE | ID: mdl-33376676

ABSTRACT

Testicular metastases in colorectal cancer are rare, and pathogenesis still remains unclear. It tends to occur in late stage of disease and has a poor prognosis. We present a 37-year-old patient complained from abdominal pain with deterioration of performance status and weight loss. Body scan showed a recto sigmoid tumor associated with metastasis in the left liver with pelvic lymphadenopathy and hetero nodular testis. Colonoscopy showed a stenosing upper rectum tumor. Histology concluded to an adenocarcinoma. The patient had a transverse colon resection and a right orchiectomy. Histology concluded to an invasive adenocarcinoma with carcinosis, secondary testicular and hepatic metastasis.

3.
Cancer Radiother ; 24(3): 206-214, 2020 Jun.
Article in English | MEDLINE | ID: mdl-32171674

ABSTRACT

PURPOSE: The aim of this study was to extensively describe the epidemiological, clinical and therapeutic outcomes of adolescents and young adults (AYA) population with classical Hodgkin Lymphoma (cHL). Then, a comparison between AYAs and adults and between the subgroups of AYAs treated with the same adult protocol was accomplished to further inform on optimal therapy approach of choice for adolescent patients. MATERIAL AND METHODS: In this mono-centric, retrospective study, we reviewed the medical records. We analyzed 112 consecutive North Tunisian patients, including 66 AYAs (15 to 39 years) and 46 adults (≥40years) affected by cHL treated from 2000 to 2015 at Salah Azaiez Institute. Then, we performed a comparative analysis between AYA and 46 adult patients and a subgroup analysis between adolescents and young adults. All patients were treated according to the national protocol for HL, edited by the Tunisian Society of Hematology. The treatment included chemotherapy and involved-field radiotherapy (RT) at a dose of 20 or 30 Grays (Gy) for responders and 36Gy for non-responders. RESULTS: AYA patients presented with adverse features with nodular sclerosis subtype (p=3.88×10-02) and mediastinal mass involvement (p=9.40×10-04). At a median follow-up of 51 and 32 months for AYAs and adults, respectively, no statistical difference in terms of 3 and 5-years overall survival (OS) and event-free survival (EFS) was shown. Using the Kaplan-Meier method, in AYAs, the ABVD regimen has an impact on 3-years EFS (p=4.63×10-02). The 36Gy RT was associated with the best 3-years EFS (p=9.24×10-03). Besides, AYA patients with advanced-stage had the worst 3-years OS (76%) (p=2.41×10-02). Although the adolescents and young adults shared similar clinical presentation, we noted that the adolescent group had the worst 3-years EFS (48%), but the best 3-years OS (91%). We identified 15% of primary refractory patients and a rate of toxicity of 5.3% in AYA. CONCLUSION: The treatment approach used is well tolerated by adult patients. However, the AYA patients and particularly adolescent subgroup had more advanced disease at diagnosis and should be treated more intensively in dedicated units. RT dose<36Gy and ABVD chemotherapy were associated with lower EFS in this population.


Subject(s)
Hodgkin Disease/therapy , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bleomycin/administration & dosage , Cyclophosphamide/administration & dosage , Dacarbazine/administration & dosage , Disease-Free Survival , Doxorubicin/administration & dosage , Etoposide/administration & dosage , Female , Hodgkin Disease/epidemiology , Hodgkin Disease/mortality , Hodgkin Disease/pathology , Humans , Kaplan-Meier Estimate , Male , Mechlorethamine/administration & dosage , Mediastinal Neoplasms/pathology , Middle Aged , Organs at Risk/radiation effects , Prednisone/administration & dosage , Procarbazine/administration & dosage , Radiotherapy Dosage , Recurrence , Retrospective Studies , Treatment Outcome , Tunisia/epidemiology , Vinblastine/administration & dosage , Vincristine/administration & dosage , Young Adult
5.
J Eur Acad Dermatol Venereol ; 25(6): 722-6, 2011 Jun.
Article in English | MEDLINE | ID: mdl-20735519

ABSTRACT

BACKGROUND: The skin is a rare site of metastasis of the internal malignancies. On the contrary, lung cancer is a common primary malignancy of skin metastasis. The latter is either synchronous with the primary lung tumour or can reveal it. OBJECTIVE: To analyse the clinical findings and the outcome of cutaneous metastasis in patients with primary lung cancer. METHODS: Retrospective study including 12 cases of cutaneous metastasis of lung cancer diagnosed in our institution during 6years. RESULTS: Our patients included three women and nine men with a median age of 59.83years. The cutaneous metastases were unique in seven cases. They revealed the primary tumour in two cases, were discovered synchronously with the primary tumour in six cases and after the primary tumour in four cases. They appeared in patients presenting multiple metastases in 10 cases. Clinical appearance consisted on a firm nodule, sometimes ulcerated with a diameter ranging from 0.5 to 5.5cm. The tumour was sited in the thorax, the back, the abdomen; or the upper or lower limbs. Pathological examination of bronchial biopsy revealed an adenocarcinoma in eight cases, a squamous cell carcinoma in two cases and a small cell carcinoma in two cases. In spite of lung cancer therapies, the patients with metastasis to other organs with a median follow-up time of 4months died. CONCLUSION: Cutaneous metastases of lung cancer are of poor prognosis. They are most of the time associated with an advanced neoplastic process with metastasis to other organs. Median survival after skin involvement does not exceed months.


Subject(s)
Adenocarcinoma/secondary , Carcinoma, Small Cell/secondary , Carcinoma, Squamous Cell/secondary , Lung Neoplasms/pathology , Skin Neoplasms/pathology , Skin Neoplasms/secondary , Adenocarcinoma/pathology , Adult , Aged , Aged, 80 and over , Carcinoma, Small Cell/pathology , Carcinoma, Squamous Cell/pathology , Female , Humans , Male , Middle Aged , Retrospective Studies
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