Survival After Pelvic Exenteration for Cervical Cancer.

BACKGROUND: The purpose of this work was to identify the results of pelvic exenteration for recurrent, persistent or locally advanced cervical cancer in terms of survival performed for 41 patients in Salah Azaiez Institute. PATIENTS AND METHODS: We conducted a retrospective unicentric study. The association between PE and OS was estimated using the method of Kaplan-Meier using SPSS ver 24. RESULTS: Median age at the time of intervention was 53.9 years old. FIGO stage IIB was the most frequent (46.3%). Eighteen patients had pelvic exenteration after neoadjuvant treatment. Resection margins were free of tumor in 83.3% of cases. Twenty-three patients underwent pelvic exenteration for recurrence of cervical cancer treated. The median time of recurrence was 23.4 months. Free resection margins were obtained in 69.5% of cases. Postoperative complications were noted in 61% of patients. Two deaths were seen in the early postoperative period. After a median follow-up of 40.5 months, 24.4% of recurrences were noted. Overall survival at 5 years was 51% and recurrence-free survival at one year was 39%. Prognostic factors which impact overall and recurrence-free survival were the size of recurrence and resection margins after exenteration. The time between the end of initial treatment and recurrence was the only predictive factor of recurrence after pelvic exenteration. CONCLUSION: Pelvic exenteration remains a curative treatment of cervical cancer in certain indications despite high morbidity. A rigorous preoperative selection of candidate may reduce the morbidity and improve the survival of patients.

A Single Liver Metastasis From Adenoid Cystic Carcinoma of the Parotid Gland: Case Report.

Adenoid cystic carcinoma is an uncommon malignant neoplasm of the salivary gland. Liver metastasis from salivary gland cancer is a rare situation. In this article, we report the case of a 29-year-old woman treated 5 years previously for adenoid cystic carcinoma of the parotid gland by surgery and radiotherapy, who presented for a large hypervascularized hepatic metastasis of 20 cm. After 3-cycle chemotherapy stability, hepatic surgery was successfully performed. The patient maintained disease-free period of 12 months after the surgical treatment. This rare case represents a therapeutic challenge for oncologists and surgeons. Through this case and a review of the literature, we try to better detail the management of this uncommon entity.

Costal chondrosarcoma mimicking a breast cancer: Case report and review of literature.

INTRODUCTION: Chondrosarcoma (CS) was the third most common primary bone malignancy. Frequently chondrosarcoma was occurring in long bones or in the pelvis. Their localization in the rib is rare. CASE PRESENTATION: A 45-year-old male presented to our institution with a lump in the left breast. A physical exam revealed a large, fixed 10 cm mass occupied the entire right breast. Clinical presentation had supposed initially as a sarcoma of the breast. Preoperative unenhanced CT imaging showed well-defined round heterogeneous soft tissue density with hypo dense areas. A core-needle biopsy was taken, which was suggestive of chondrosarcoma grade II. The whole tumor was excised en-bloc along with 4th, 5th and 6th ribs. Reconstruction of the defect was undertaken with polypropylene plate and ipsilateral pedicle latissimus dorsi muscle flap was placed on the alloplastic mesh. The patient had an uneventful postoperative course and was discharged on the 10th postoperative day. No adjuvant treatment was administrated. CONCLUSION: En-bloc resection with appropriate margins and thanks to the evolution of reconstructive surgical techniques used to ensure preservation of respiratory mechanics. All this procedure represents the cornerstone and the only curative option.