Promising Results of an Exclusive Radiotherapy Treatment of an Inoperable Giant Eyelid Sebaceous Carcinoma.

Eyelid sebaceous carcinoma is a rare malignant tumor. Surgical excision is generally the standard curative treatment. However, in cases where surgery is not possible due to locally advanced tumors, definitive radiotherapy can be considered an option. A 71-year-old man presented with a history of eyelid sebaceous carcinoma dating back two years. The tumor, measuring 93 x 55 x 56 mm and located on the right upper eyelid, was not surgically resected. He was then treated with intensity-modulated radiotherapy, receiving a total dose of 70 Gy in 35 fractions. After 24 months, the patient shows no local recurrence.

Radiotherapy for parotid cancer: 10 years of experience in a single center.

<b><br>Introduction:</b> We report our experience in the treatment of parotid cancers by radiotherapy delivered with curative intent over a period of 10 years.</br> <b><br>Aim:</b> The aim of this study was to evaluate the therapeutic results and prognostic factors.</br> <b><br>Materials and methods:</b> This is a retrospective study of patients with parotid cancer treated with radiotherapy between 2008 and 2017 at the National Institute of Oncology in Rabat. Patients who received adjuvant or exclusive radiotherapy were included in this study. We performed a multivariate analysis for the factors related to locoregional control and overall survival.</br> <b><br>Results:</b> Initially, 74 patients (45 men and 29 women), at a median age of 57 years. were identified. At the time of diagnosis, 10 (13.6%), 36 (48.6%), and 28 (37.8%) patients were in stage II, III, and IVab, respectively. Sixty patients received adjuvant radiotherapy after parotidectomy and 14 patients received exclusive radiotherapy for an unresectable tumor. At 5 years, the rate of locoregional control and overall survival were 68.2% and 53.7%, respectively. Surgical resection and negative margins were significantly correlated with locoregional control. Lymph node involvement, unresectable tumors, high-grade histological types, and cystic adenoid carcinoma were significantly correlated with poor overall survival.</br> <b><br>Conclusions:</b> Acceptable long-term results are obtained with surgery combined with radiotherapy. Surgical resection remains essential for parotid cancer, given the disappointing results of treatment with radiotherapy alone.</br>.

Hypofractionated Regional Nodal Irradiation for Women With Node-Positive Breast Cancer.

PURPOSE: To evaluate the effect of hypofractionated radiation therapy (HFRT) of the breast/chest wall and regional nodes on overall survival (OS), disease-free survival (DFS), locoregional control and on treatment-related toxicity in patients with breast cancer and nodal involvement. METHODS AND MATERIALS: Two hundred fifty-seven patients treated between October 2009 and June 2011 with hypofractionated locoregional radiation therapy (42 Gy in 15 fractions) were retrospectively reviewed, 51 (19.8%) after breast-conserving surgery and 206 (80.2%) after radical surgery. Patients treated with breast-conserving surgery received a boost dose to the tumor bed (delivered by photons, electrons, or interstitial high-dose-rate brachytherapy). Two hundred fifty-six (99.6%) patients underwent chemotherapy, 209 (81.3%) had hormonal treatment, and 65 (25.3%) had anti-HER2 targeted therapy. RESULTS: The median follow-up time was 64 months (range, 11-88 months). The rates of 5-year OS, DFS, locoregional recurrence (LRR)-free survival, and distant metastasis (DM)-free survival were 86.6%, 84.4%, 93.9%, and 83.1%, respectively. In multivariate analysis (MVA), lymph node ratio >65%, lymphovascular invasion, and negative hormone receptor status predicted for OS, DSF, and DM. T3 to 4 stage was also associated with worse DFS and DM. Finally, for LRR the independent prognostic factors on MVA were N2 to 3 stage and grade 3. Hyperpigmentation was observed in 19.2% of patients, telangiectasia in 12.3%, and fibrosis in 30.7%. Grade ≥2 lymphedema was recorded in 5.8% of cases. During the study follow-up, no cardiac or symptomatic pneumonitis was observed, nor were plexopathy or rib fractures. CONCLUSION: According to the findings from this retrospective study, HFRT seems to be an acceptable alternative for patients with breast cancer who need regional nodal irradiation. However, prospective randomized trials are necessary to confirm these preliminary results.

Extra-axial ependymoma of the cerebral convexity: A very rare intracranial adult tumor.

Background Ependymomas are rare adult tumors that originate from the ventricular system or the ependymal surface of the central canal. Extra-axial supratentorial ependymomas are extremely rare, and only five cases have been reported to date in the English literature. Case presentation A 46-year-old previously healthy male presented with a gradual painless loss of vision in the right eye. Cerebral MRI showed a right parietal-occipital lesion resembling an atypical meningioma. Surgical resection was performed, and immunohistochemical staining results concluded that it was a very uncommon location of a grade 3 ependymoma. Favorable outcome was observed one year after completion of postoperative radiotherapy. Conclusion Clinical and imaging aspects are misleading in rare brain tumors, and immunohistochemistry is essential to re-address diagnosis.

Associated factors with psychological distress in Moroccan breast cancer patients: A cross-sectional study.

OBJECTIVES: To estimate the prevalence of psychological distress (PD) in Moroccan breast cancer patients, and to determine clinical and social demographic factors associated with PD. METHODS: It was a cross-sectional study where we included all female breast cancer patients that did not have other malignancies. Judgment criteria were based on the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). Threshold values of 15 and 3 were fixed to detect patients on PD by the HADS and the DT, respectively. We analyzed data by calculation of Cronbach's alpha coefficient for the reliability of measurements, and by simple and multiple logistic regressions. RESULTS: 446 women were enrolled. Cronbach's alpha coefficient was 0.801, 0.669 and 0.639 respectively for the HADS, HAD-A and HAD-D questionnaires. 120 patients (26.9%) had a HADS global score ≥15. HAD-A and HAD-D sub-scores were ≥11 in 25 (5.6%) and 30 (6.7%) patients respectively. In multivariate analysis, adjusted for the education level, marital status, taking analgesic and/or anxiolytic treatment, and current treatment type; we found that the occurrence of a distant metastasis [OR = 14.427 p < 0.001], lack of social family support [OR = 4.631 p < 0.001], living a difficult emotional [OR = 2533 p = 0.034] and/or financial [OR = 2.09 p = 0.037] situation, and younger (<50 years) age [OR = 2.398 p = 0.002], were independent associated factors with PD as assessed by the HADS. CONCLUSIONS: Social family support, emotional and financial difficulties should be investigated in all Moroccan breast cancer patients, especially among younger ones, in order to detect those at risk of PD and offer them appropriate support.

Primary Kaposi's sarcoma of the nasal cavity: a case report and review of the literature.

BACKGROUND: Kaposi sarcoma is a neoplastic vascular disorder. It usually present on the skin of the upper and lower extremities, rarely in the mucosa of the head and neck. The most common sites reported are within the oral cavity, particularly on the palate. Other mucosal sites are rare. We present an unusual case where the primary manifestation of the Kaposi's sarcoma was in the nasal mucosa. CASE PRESENTATION: A 56-year-old female of Mediterranean descent presented with a 1 year history of swelling on the left side of her nose, nasal obstruction and occasional minor epistaxes. Physical examination showed a firm and bulging polypoid mass which filled the left nasal cavity without cutaneous lesions. Computed tomography (CT) demonstrated a tumor, measuring 77 mm in diameter, occupying the left nasal cavity causing erosion of nasal septum and extending posteriorly to the left choana and nasopharynx. There was bilateral cervical lymphadenopathy. Patient treated with chemotherapy alone. She was in a complete response after the first cycle. The patient received no further treatment. She needs a regular medical checkups that include a review of a patient's medical history and a complete physical exam. She is in excellent local control over 12 months. CONCLUSIONS: A review of the literature revealed that only seven cases of primary Kaposi sarcoma of the nasal cavity have previously been published and only two of them presented in a patient not associated with the acquired immunodeficiency syndrome. Here, we report the third case where the primary manifestation of the Kaposi sarcoma was in the nasal cavity in a patient with an adequate immune system.

Primary non-Hodgkin lymphoma of the vulva in an immunocompetent patient.

The primary non-Hodgkin lymphoma of the vulva is a very rare pathological entity. We report a case of 37-year-old patient that presented a germinating ulcerating tumor in the small right vulva. The histology objectified a B lymphoma with a positive CD20 reaction. The patient underwent three typical chemotherapy sessions by rituximab-cyclophosphamide, doxorubicin, vincristine, and prednisone, followed by external radiotherapy on the pelvis and bilateral inguinal lymph nodes areas with an excellent answer and survival without particular events within 36 months of recession. Through this case report, we discuss the diagnostic features of this pathological entity, considering diagnosis and treatment are different compared to other tumors that are commonly found in the vulva.

Epidemiologic profile of pediatric brain tumors in Morocco.

INTRODUCTION: Brain tumors are the most common solid tumors diagnosed among children below 15 years worldwide. However, little is known about the profile of pediatric brain tumors in Africa. The purpose of this study was to further elaborate the epidemiological profile of pediatric brain tumors in Africa, specifically Morocco. METHODS: A retrospective review was conducted of all patients with primary brain tumors in the age group 0-19 years, from 2003 to 2007, from multiple centers in two cities of Rabat and Casablanca, Morocco. Only patients with histopathological confirmation were included (n = 542). Descriptive epidemiologic profiles were created for the patients by age, sex, and histological subtypes of brain tumors. RESULTS: Overall medulloblastoma was the most common brain tumor (34.5%), followed by pilocytic astrocytoma (17.3%) and diffuse astrocytoma grade 2 (12.5%). Brain tumors occurred most commonly in 5-9-year age group followed by 10-14-year age group with the former being more common among males and the latter being more common among females. We also found medulloblastoma to be the most common brain tumor in the 0-14-year-olds. CONCLUSIONS: In this rare study focused on pediatric brain tumors in Morocco, most of the findings were consistent with past studies from other parts of the world. However, we found medulloblastoma to be the most common pediatric brain tumor followed by astrocytoma.