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4.
Tunis Med ; 86(2): 155-9, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18444533

ABSTRACT

AIM: The objective of this study is to determine the clinicopathologic characteristics; incidence and prognosis value of synchronous bilateral breast carcinoma (SBBC). METHODS: This is a retrospective study done in Salah Azaiz Institute of Tunis about 30 patients with synchronous bilateral breast carcinomas diagnosed and treated over a 21-years period going from 1977 to 1997. The definition of synchronous breast lesions is the developpement of the contralateral breast cancer within 6 months. RESULTS: Median age was 49 years. The incidence of SBBC was 0.52%. History family was noted in 3% of our population. Mean tumor size was 40 mm (15-145). Breast conserving therapy was done in 16% of cases (9 patients). Five-year overall survival was 40%. Five year survival rates were 72 and 17% for stage II and III, respectively. Main prognostic factors for survival were lymph node involvement (P=0.004) and disease stage (P=0.02). CONCLUSION: Synchronous bilateral breast carcinoma is a rare entity, with a problem of definition concerning the delay of bilaterlisation. Their prognosis is similar to that of unilateral breast carcinoma patients of equal stage. Hence, breast conserving therapy can be used s fely if indicated.


Subject(s)
Breast Neoplasms/pathology , Carcinoma/pathology , Adult , Aged , Breast Neoplasms/mortality , Breast Neoplasms/surgery , Carcinoma/mortality , Carcinoma/surgery , Female , Humans , Mastectomy, Segmental , Middle Aged , Prognosis , Retrospective Studies
6.
Tunis Med ; 85(7): 604-6, 2007 Jul.
Article in French | MEDLINE | ID: mdl-18064996

ABSTRACT

BACKGROUND: Carcinoïdes tumours are a rare type of ovarian tumours which anatomoclinical behaviour differs a little from epithelial type. AIM: Report of three new cases. CASE REPORT: We report 3 observations of ovarian carcinoid tumours in patients aged 50, 23 and 28 years. All our patients were operated in emergency for twisting of appendix in two patients and for acute peritonitis in the third one. Treatment was a one-sided salpingo-oophorectomy. The diagnosis of carcinoid tumour was retained on to the definitive histological exam then the patients were re operated to complete the resection.


Subject(s)
Carcinoid Tumor/pathology , Ovarian Neoplasms/pathology , Adult , Carcinoid Tumor/surgery , Female , Humans , Middle Aged , Ovarian Neoplasms/surgery
7.
Tunis Med ; 85(10): 891-5, 2007 Oct.
Article in English | MEDLINE | ID: mdl-18236815

ABSTRACT

BACKGROUND: Fibroadenoma is a frequent benign breast tumor affecting young woman. The incidence of a carcinoma within adenofibromas is estimated at 0.1 to 0.3%. AIM: The purpose of this study was to evaluate the outcome of patients with breast carcinoma arising within adenofibroma and to determine the clinical characteristics and the prognosis of this rare entity. OBSERVATIONS: We retrospectively report on four cases of carcinomas arising in mammary fibroadenomas. The mean age was 41 years (26-53). In two cases, fibroadenomas was complex, containing cysts, adenosis and apocrine metaplasia. The adjacent parenchyma contained fibrocystic dystrophy lesions associated in one case to intralobular neoplasia lesions. The treatment consisted of a conservative treatment in two cases and a mastectomy plus axillary node dissection in the two others. Radiotherapy was indicated in all cases and chemotherapy done in three cases. All patients are alive with a mean follow up of 4.25 years (3-7) without any sign of recurrence. CONCLUSION: Every benign mammary nodule must necessarily be verified surgically to avoid misdiagnosing any carcinomatous area because at this stage its prognosis is better.


Subject(s)
Adenofibroma/pathology , Breast Neoplasms/pathology , Carcinoma/pathology , Cell Transformation, Neoplastic/pathology , Adult , Breast Cyst/pathology , Carcinoma in Situ/pathology , Carcinoma, Ductal, Breast/pathology , Carcinoma, Lobular/pathology , Chemotherapy, Adjuvant , Disease-Free Survival , Female , Follow-Up Studies , Humans , Lymph Node Excision , Mastectomy , Metaplasia , Middle Aged , Radiotherapy, Adjuvant , Retrospective Studies
8.
Am J Surg ; 192(2): 141-7, 2006 Aug.
Article in English | MEDLINE | ID: mdl-16860620

ABSTRACT

BACKGROUND: Phyllodes tumors (PTs) of the breast are rare, and their prognosis and treatment are still subject of discussion. The purpose of this study is to clarify therapeutic aspects and prognostic factors of this disease. PATIENTS AND METHODS: We retrospectively reviewed the medical records of 106 patients who had histologically confirmed PTs collected over a period of 10 years. RESULTS: The mean age was 39.5 years (14-71 years). The mean tumoral size was 83 mm (15-250). According to criteria of Azzopardi and Salvadori, tumors were classified into 3 groups: benign (62 cases, 58.4%), borderline (16 cases, 15%), and malignant (28 cases, 26.4%). Eighty-two patients (77.4%) were treated conservatively (62 benign, 11 borderline, and 9 malignant) and 24 (22.6%) by radical surgery (5 borderline and 19 malignant). For malignant PTs treated by enucleation or local excision with or without reexcision of the tumor bed, the 5-year overall and disease-free survivals were 28.5% and 15.6% versus 72.7% and 73.6% when the surgery was radical (mastectomy with or without axillary dissection) (P = .12 and P = .0022). For the other histotypes, this difference disappeared. The rate of recurrence was 12.2% (13) after a mean follow-up of 39 months (5 benign, 2 borderline, and 5 malignant). The treatment of recurrences consisted of radical mastectomy (8 cases), simple mastectomy (2 cases), and local excision in 3 cases. Eight patients developed metastases, 2 of whom after recurrences. The 5-year overall and disease-free survivals were 86.54% and 78%, respectively. In univariate analysis, age and recurrences are not of prognostic value for survival, whereas tumor size, histotype, necrosis, cytonuclear atypia, tumor margins, and number of mitosis were significant prognostic factors for survival. In a multivariate study, only cytonuclear atypia remained an independent predictor for survival. CONCLUSION: According to our results, we recommend for malignant PT a simple mastectomy, whereas for borderline and benign PT, treatment is based rather on wide excision passing in healthy tissue.


Subject(s)
Breast Neoplasms/diagnosis , Mastectomy/methods , Phyllodes Tumor/diagnosis , Adolescent , Adult , Aged , Breast Neoplasms/epidemiology , Breast Neoplasms/surgery , Diagnosis, Differential , Disease-Free Survival , Female , Follow-Up Studies , Humans , Mammography , Middle Aged , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/surgery , Neoplasm Staging , Phyllodes Tumor/epidemiology , Phyllodes Tumor/surgery , Prognosis , Retrospective Studies , Survival Rate , Ultrasonography, Mammary
9.
Tunis Med ; 84(2): 122-4, 2006 Feb.
Article in French | MEDLINE | ID: mdl-16755978

ABSTRACT

Dermatofibrosarcoma protuberans is a superficial mesenchymal cutaneous tumor of essentially local malinancy, located more often in the trunk and extremities. This tumor is usually diagnosed after multiple recurrences. We report two cases of rare mammary localisations of dermatofibrosarcoma protuberans in 2 patients aged 39 and 43 years respectively, the two lesions sized 35 x 45 mm were treated by wide excision and reconstruction with a dorsal flap; in the second case.


Subject(s)
Breast Neoplasms/pathology , Dermatofibrosarcoma/pathology , Skin Neoplasms/pathology , Adult , Breast Neoplasms/surgery , Dermatofibrosarcoma/surgery , Female , Humans , Skin Neoplasms/surgery , Surgical Flaps
10.
Am J Obstet Gynecol ; 194(1): 43-8, 2006 Jan.
Article in English | MEDLINE | ID: mdl-16389008

ABSTRACT

OBJECTIVE: The purpose of this study was to evaluate the outcome of patients with cervical adenocarcinoma and to determine the characteristics and the prognostic factors of this entity. STUDY DESIGN: This retrospective study was done in the Department of Surgical Oncology of the Salah Azaiz Institute of Tunis with 79 cases of invasive adenocarcinoma of the uterine cervix that were collected from 1990 to 1999. Survival was analyzed according to the Kaplan-Meier method. Univariate analysis of prognostic factors was performed with the test of log rank. Cox regression model was used in multivariate analysis of prognostic factors. RESULTS: Mean age was 50 years, and metrorrhagia was mostly revealing in 73% of the cases. Early stages (I, IIa, IIb with 1/3 proximal parametrial invasion) and "pure" type adenocarcinoma were found in 78% and 87% of the cases, respectively. Treatment consisted of a radiosurgical combination in 52 cases; exclusive radiotherapy was practiced with 17 patients. The 5 year-overall and disease-free survival percentages were, respectively, 68% and 72.4%. Poor prognostic factors were age >50 years, tumor size >4 cm, advanced stage, tumor grade, and lymph nodes and lymph-vascular space involvement. With the use of multivariate analysis, only stage and lymph node metastases remained significant prognostic factors. CONCLUSION: This report shows survival and prognostic factors that are similar to those found in previous studies, but unlike the Western countries, our results demonstrate a high rate of early stages and no increase in frequency of cervical adenocarcinoma.


Subject(s)
Adenocarcinoma/complications , Adenocarcinoma/pathology , Uterine Cervical Neoplasms/complications , Uterine Cervical Neoplasms/pathology , Adenocarcinoma/radiotherapy , Adenocarcinoma/surgery , Adult , Aged , Combined Modality Therapy , Female , Humans , Leukorrhea/etiology , Lymphatic Metastasis , Metrorrhagia/etiology , Middle Aged , Multivariate Analysis , Neoplasm Invasiveness , Neoplasm Recurrence, Local , Neoplasm Staging , Prognosis , Proportional Hazards Models , Retrospective Studies , Risk Factors , Survival Analysis , Uterine Cervical Neoplasms/radiotherapy , Uterine Cervical Neoplasms/surgery
11.
Tunis Med ; 84(9): 592-4, 2006 Sep.
Article in French | MEDLINE | ID: mdl-17263211

ABSTRACT

Hydatid disease is a wide spread disease. It is endemic in Tunisia. Man is contaminated by digestif way and by living with dogs. The disease affects usually liver and lung. Other localisations are rare. Hydatid cyst of the ovary is uncommon and clinically they present like malignant tumour of ovary. We present 7 cases of hydatid cyst of the ovary and we discuss the characteristics of this site of the hydatic disease.


Subject(s)
Echinococcosis/diagnosis , Ovarian Diseases/parasitology , Adult , Aged , Echinococcosis/surgery , Female , Humans , Middle Aged , Ovarian Diseases/surgery
12.
Bull Cancer ; 92(3): 281-5, 2005 Mar.
Article in French | MEDLINE | ID: mdl-15820923

ABSTRACT

Male breast cancer is rare compared to its female counterpart representing less than 1% of cancer in men. The objective of our retrospective study is to report the epidemiologic and clinical profile and to analyse the therapeutic results and prognostic factors in a Tunisian population collected during a period of 20 years at a single institution. We collected from 1979 to 1999, all the histological confirmed male breast cancers treated at our institution. We analyse the following data: age, clinical presentation and features, therapeutic protocol, results and prognostic factors. Survival was done with the Kaplan-Meier method and comparison with the log-rank test. 123 cases of male breast carcinoma were collected with a median age of 65 years. Most patients (62.2%) have an advanced T4 disease with bilateral lesions in 4 cases. Infiltrating ductal carcinoma represent 91% of all tumours. 85% of tumours expressed hormonal receptor. The treatment consisted in a radical mastectomy in 93 cases (84%) followed by radiotherapy, chemotherapy and in many cases by hormonotherapy. After a median follow up of 26 month, 22 patients presented loco regional recurrence and 41 metastases. Estimated 5-year survival rate was 62%. The presence of metastasis, nodal involvement, advanced disease, and grade affected survival. Male breast cancer represent at our institution 1 % of the male cancers treated comparable to the literature data. T4 tumours represent a higher rate, the treatment approach is the standard applicable in breast cancer; prognostic factors are the classical one like breast cancer in women.


Subject(s)
Breast Neoplasms, Male/epidemiology , Adult , Aged , Aged, 80 and over , Breast Neoplasms, Male/mortality , Breast Neoplasms, Male/pathology , Breast Neoplasms, Male/therapy , Humans , Male , Middle Aged , Retrospective Studies , Tunisia/epidemiology
13.
Tunis Med ; 80(2): 105-7, 2002 Feb.
Article in French | MEDLINE | ID: mdl-12080554

ABSTRACT

The sarcoma of the penis is a very rare tumor more exceptional is the Leiomyosarcoma of the penis for which the diagnosis required an immunohistochemical study. The prognosis for this tumor is poor. We report a case, which arise to a 53 year-old-man in this instance we did a review of the medical literature.


Subject(s)
Leiomyosarcoma/pathology , Penile Neoplasms/pathology , Diagnosis, Differential , Humans , Immunohistochemistry , Leiomyosarcoma/diagnosis , Male , Middle Aged , Penile Neoplasms/diagnosis , Prognosis
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