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.

Radiation-induced osteosarcoma of the skull base after radiation therapy in a patient with nasopharyngeal carcinoma: a case report and review of the literature.

BACKGROUND: Radiation-induced osteosarcomas are a recognized complication of radiation therapy. Owing to the fact that it is rare, publications on radiation-induced osteosarcoma of the skull base are limited to a small series and some case reports. CASE PRESENTATION: We describe a rare case of a patient with a skull base radiation-induced osteosarcoma treated 11 years before with ionizing radiation for an undifferentiated carcinoma of the nasopharynx. The patient was treated with chemotherapy alone, but he died after the third cycle. CONCLUSIONS: Radiation-induced osteosarcoma of the skull base after treatment of nasopharyngeal carcinoma is a very rare but very aggressive complication with a poor prognosis. Chemotherapy gives bad results, and regular follow-up of treated patients should be considered.

Solitary intraosseous schwannoma of the base and vault of the skull: a summary review of such unusual location.

Intra-osseous schwannoma is a rare mesenchymal tumor. Although, the head and neck region is one of the most common sites for schwannomas, its location at the skull bone is uncommon and accounted for less than 0.2% in the largest series of bone tumors ever reported. Furthermore, it is most often a benign tumor, malignant transformation is exceedingly rare. Clinical presentation is non-specific, most often symptoms are associated with compression and invasion of adjacent organs. Neuro-imaging features are non-specific and the diagnosis is based on histological examination with immunohistochemical study. Surgery remains the aim of treatment. However, radiation therapy could be an interesting therapeutic option in unresectable tumors. This systemic review offers new clinicopathological data useful for better defining the diagnosis and clinicopathological behavior of schwannoma. The purpose of this work is to raise awareness among clinicians adding this clinical entity as a differential diagnosis when a mass of skull bone is identified.