A rare case of small cell carcinoma of the ovary, hypercalcemic type.

Small cell carcinoma of ovary, hypercalcemic type (SCCOHT) is an unusual malignant tumor that most commonly affects young women. Unfortunately, it has a very poor prognosis. We describe here an unusual case of a Moroccan young woman with a left ovarian mass and a symptomatic hypercalcemia. Morphologically, there are some malignant tumors that resemble SCCOHT; thus, it is very challenging to diagnose, and immunohistochemistry has a great contribution in it. Hopefully, molecular tools and new therapies will improve the management of these cases in the near future.

Assessment of deep learning algorithms to predict histopathological diagnosis of breast cancer: first Moroccan prospective study on a private dataset.

OBJECTIVE: Breast cancer is a critical public health issue and a leading cause of cancer-related deaths among women worldwide. Its early diagnosis and detection can effectively help in increasing the chances of survival rate. For this reason, the diagnosis and classification of breast cancer using Deep learning algorithms have attracted a lot of attention. Therefore, our study aimed to design a computational approach based on deep convolutional neural networks for an efficient classification of breast cancer histopathological images by using our own created dataset. We collected overall 328 digital slides, from 116 of surgical breast specimens diagnosed with invasive breast carcinoma of non-specific type, and referred to the histopathology department of the National Institute of Oncology in Rabat, Morocco. We used two models of deep neural network architectures in order to accurately classify the images into one of three categories: normal tissue-benign lesions, in situ carcinoma or invasive carcinoma. RESULTS: Both Resnet50 and Xception models achieved comparable results, with a small advantage to Xception extracted features. We reported high degrees of overall correct classification accuracy (88%), and sensitivity (95%) for detection of carcinoma cases, which is important for diagnostic pathology workflow in order to assist pathologists for diagnosing breast cancer with precision. The results of the present study showed that the designed classification model has a good generalization performance in predicting diagnosis of breast cancer, in spite of the limited size of the data. To our knowledge, this approach can be highly compared with other common methods in the automated analysis of breast cancer images reported in literature.

[Spindle cell carcinoma of the breast : diagnostic difficulties]. / Carcinome à cellules fusiformes du sein : difficultés diagnostiques.

The metaplastic breast cancers are rare lesions, accounting for less than 1 % of all breast malignancies. According to the WHO classification (2012), the spindle cell carcinoma of the breast figures among variants of metaplastic carcinomas. The average age at diagnosis is 53 years, and the usual course is fast. Their prognosis is more pejorative than the classic invasive ductal carcinoma. The differential diagnosis arises with sarcomas, especially phyllodes sarcomas but also with other primary breast sarcomas which remain rare. The distinction of this entity is important for further management of patients which is similar to that of conventional infiltrating carcinoma.

Les carcinomes métaplasiques du sein sont des lésions rares, représentant moins de 1 % des tumeurs malignes du sein. Selon la classification de l'Organisation mondiale de la Santé (OMS) des tumeurs du sein de 2012, le carcinome à cellules fusiformes figure parmi les variantes des carcinomes métaplasiques. L'âge moyen au moment du diagnostic est de 53 ans et l'évolution habituelle est rapide. Leur pronostic semble être plus péjoratif que celui du carcinome infiltrant non spécifique. Le diagnostic différentiel se pose avec les sarcomes notamment les tumeurs phyllodes malignes, mais également avec les autres sarcomes primitifs mammaires qui restent plus rares. La distinction de cette entité est importante pour la prise en charge ultérieure des patients qui rejoint celle des carcinomes infiltrant classiques. Nous rapportons le cas d'une patiente âgée de 42 ans qui présente un carcinome à cellules fusiformes du sein tout en soulevant les problématiques diagnostiques histopathologiques face à cette entité rare.

Invasive Lobular Carcinoma of the Breast with Extracellular Mucin: Case Report of a New Variant of Lobular Carcinoma of the Breast.

Invasive carcinoma of no special type (NST) or ductal carcinoma is the largest group of invasive breast cancers. Invasive lobular carcinoma (ILC) is the second most common histological type; it comprises 5%-15% of all invasive breast cancers. Historically, lobular neoplasia and invasive lobular carcinoma may produce intracellular mucin that pushes the nucleus to one side, creating the characteristic signet ring cell morphology. The extracellular mucin secretion is essentially described in mucinous breast carcinoma. Mucinous differentiation can be seen in small areas of NST carcinoma, but recently a few cases of invasive lobular carcinoma with extracellular mucin are reported in the literature. It is important for pathologists to recognize this new entity because it mimics a NST carcinoma, as such a diagnosis may require a different approach in clinical management and surveillance. We report a new case of ILC with extracellular mucin and a review of the literature.

Unusual evolution of leiomyosarcoma of the rectum: a case report and review of the literature.

BACKGROUND: Leiomyosarcoma of the rectum is a rare entity that comprises less than 0.1 % of all rectal malignancies. Given the uncommon nature of this tumor and the controversy about its treatment we report one case and review the literature in an attempt to report a particular evolution and to discuss the most appropriate treatment. CASE PRESENTATION: This case report describes the presentation of leiomyosarcoma of the rectum. A 30-year-old man from the north of Morocco presented with rectorrhagia and constipation. On physical examination we found a mass in his rectum approximately 6 cm from his anal margin. Pelvic magnetic resonance imaging showed a rectal mass with a parietal attachment that invaded the fascia and his perirectal tissue. Before any treatment he defecated spontaneously the tumor. On histopathological examination a diagnosis of leiomyosarcoma was made. An anterior resection of his rectum was performed with adjuvant radiotherapy at a dose of 50 Gy. After 1 year of surveillance, he has not presented any clinical symptoms and pelvic magnetic resonance imaging was normal. Unfortunately, histological analysis of a superficial biopsy of a rectal leiomyosarcoma may not be reflective of the entire tumor mass, and a diagnosis is based essentially on postoperative pathological examination. The optimal treatment modality in patients with rectal leiomyosarcomas is controversial. Prognosis is also poor; tumor size, histological grade, mitotic index, and local staging are the most known prognosis factors. CONCLUSION: The prognosis of rectal leiomyosarcoma is poor; more investigations are necessary to understand the progression of these tumors and to define an optimal treatment modality.

Metastatic desmoplastic small round cell tumor controlled by an anthracycline-based regimen: review of the role of chemotherapy.

Desmoplastic small round cell tumors (DSRCT) are rare and aggressive malignant neoplasms that usually occur in young males. They usually present intraabdominally with widespread peritoneal involvement at diagnosis and are sometimes associated with lymphadenopathies and liver metastases. Intraabdominal DSRCT is usually disseminated; no curative outcome has yet been achieved. We report a case of metastatic intraabdominal DSRCT controlled by an anthracycline-based regimen. A literature review of the treatment options, mainly chemotherapy, available for this unusual neoplasm, will be discussed. In patients with unresectable or metastatic disease, symptom control is most important because treatment modalities minimally impact survival. Palliative chemotherapy (mainly monotherapy) is preferable.