The value of surgery in the treatment of gestational choriocarcinoma: A case report.

INTRODUCTION AND IMPORTANCE: Gestational choriocarcinoma is a rare malignant trophoblastic tumor; it is characterized by its high metastatic potential and chemosensitivity. Hysterectomy also has a role in the management of this tumor. CASE PRESENTATION: We report a rare case of gestational choriocarcinoma in a young woman initially classified as low risk (FIGO2), treated by surgery after chemoresistance to different chemotherapy protocols, marked by an excellent clinical and biochemical improvement. CLINICAL DISCUSSION: Gestational choriocarcinoma is a malignant tumor of the villous trophoblast, devoid of placental villi and vesicles.Despite the excellence of chemotherapy, surgery has a significant place in the treatment of gestational trophoblastic tumors. The most common modality of surgical treatment is total hysterectomy. Ovarian metastases are rare; the ovaries may be preserved depending on the age of the patients. CONCLUSION: The progress of recent years lies in the clarification of the therapeutic strategies used in the treatment of gestational trophoblastic tumors, in particular choriocarcinoma.

Unilateral ovarian metastasis from renal clear cell carcinoma.

INTRODUCTION AND IMPORTANCE: Ovarian metastases of renal origin are rarely reported in the literature and pose a diagnostic problem because they are usually diagnosed at a distance from the primary cancer. PRESENTATION OF CASE: We report a case of unilateral ovarian metastasis from clear cell renal cell carcinoma fifteen years after nephrectomy in a fifty-six-year-old patient who underwent surgery for an abdominopelvic mass. CLINICAL DISCUSSION: The diagnosis of ovarian metastases can be made at the same time as the diagnosis of the primary cancer or at a distance from it, with an interval ranging from a few months to years later. In the case of our patient, the ovarian metastasis was diagnosed fifteen years after the nephrectomy. CONCLUSION: Ovarian metastases are exceptional secondary localizations of renal cancer, they can be unilateral or bilateral, and are usually discovered several years after the renal tumor.

Extensive Paget's disease of the nipple: Case report.

INTRODUCTION AND IMPORTANCE: Paget's disease of the nipple is a rare form of ductal carcinoma in situ. It is often associated with an underlying breast cancer or, more rarely, may be isolated with no associated breast neoplasm. PRESENTATION OF CASE: We report the case of a patient with extensive Paget's disease of the nipple without associated breast lesions, treated by mastectomy with coverage by a dorsalis major flap. CLINICAL DISCUSSION: The association of Paget's disease of the nipple with breast cancer is the most frequent situation, requiring a complete radiological work-up of the breast. The diagnosis is confirmed by anatomopathological examination combined with immunohistochemistry, the treatment of Paget's disease of the nipple remains controversial, with conservative or radical treatment depending on the extent of the disease and the presence or absence of associated breast cancer. CONCLUSION: Paget's disease of the nipple is a rare form of breast cancer. Treatment relies mainly on surgery, which can be either conservative or radical.

Prevalence of Polyomaviruses and Herpesviruses in Moroccan Breast Cancer.

Breast cancer (BC) is the most frequently diagnosed cancer and the leading cause of cancer death in women worldwide, accounting for 24.5% of total new cancer cases and 15.5% of total cancer deaths. Similarly, BC is the most common cancer among Moroccan women, comprising a noteworthy percentage of 40% of all cancers in women. Globally, 15% of cancers are attributable to infections; among them, viruses play a significant role. The present study aimed to explore the presence of a wide range of viral DNA in samples recovered from 76 Moroccan patients with BC and 12 controls using Luminex technology. The explored viruses were as follows: 10 polyomaviruses (PyVs): BKV, KIV, JCV, MCV, WUV, TSV, HPyV6, HPyV7, HPyV9, and SV40; and 5 Herpesviruses (HHVs): CMV, EBV1, EBV2, HSV1, and HSV2. Our results revealed the presence of PyVs DNA in both control (16.7%) and BC tissues (18.4%). Nonetheless, HHV DNA was detected exclusively in BC tissues (23.7%), with a predominance of Epstein-Barr virus (EBV) (21%). In conclusion, our study highlights the presence of EBV in human BC tissues, which may play an important role in its development and/or progression. Further investigations are needed to confirm the presence/co-presence of these viruses in BC.

Atypical adnexal mass misdiagnosed as an ovarian tumor revealing a bilateral tubal cancer. Case report.

INTRODUCTION AND IMPORTANCE: Primary epithelial cancers of the tube are a rare entity. They represent less than 2 % of gynecological tumors and are dominated by adenocarcinoma. Due to its proximity to the uterus and the ovary, the diagnosis of tubal cancer is very difficult to confirm, frequently misdiagnosed as a benign ovarian or tubal pathology. This may explain the underestimation of this cancer. PRESENTATION OF CASE: We report a case of a 47 years old patient diagnosed with a pelvic mass, the patient had an hysterectomy with omentectomy revealing a bilateral tubal adenocarcinoma after the histopathological examination. CLINICAL DISCUSSION: Tubal adenocarcinoma is a more common pathology in postmenopausal women. The treatment is similar to that for ovarian cancer. Symptoms and the serum CA-125 level may be helpful indicators but are neither specific nor always found. Therefore, careful intraoperative assessment of the adnexa is necessary. CONCLUSION: Despite the refinement of diagnostic tools available to clinicians, it is still difficult to diagnose the tumor beforehand. Nonetheless, the diagnosis of tubal cancer must be suspected in the context of a differential diagnosis of an adnexal mass. Abdomino-pelvic ultrasound is the key examination in the diagnostic process and the discovery of a suspicious adnexal mass leads to the performance of a pelvic MRI and, if necessary, to surgical exploration. The therapeutic principles follow those of ovarian cancer. Efforts should be focused on the creation of regional and international registries of tubal cancer cases in order to achieve greater statistical power in future studies.

The Biological Significance of Long noncoding RNAs Dysregulation and their Mechanism of Regulating Signaling Pathways in Cervical Cancer.

Despite the remarkable decrease in cervical cancer incidence due to the availability of the HPV vaccine and implementation of screening programs for early detection in developed countries, this cancer remains a major health problem globally, especially in developing countries where most of the cases and mortality occur. Therefore, more understanding of molecular mechanisms of cervical cancer development might lead to the discovery of more effective diagnosis and treatment options. Research on long noncoding RNAs (lncRNAs) demonstrates the important roles of these molecules in many physiological processes and diseases, especially cancer. In the present review, we discussed the significance of lncRNAs altered expression in cervical cancer, highlighting their roles in regulating highly conserved signaling pathways, such as mitogen-activated protein kinase (MAPK), Wnt/ß-catenin, Notch, and phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) pathways and their association with the progression of cervical cancer in order to bring more insight and understanding of this disease and their potential implications in cancer diagnosis and therapy.

Detection of hypermethylation BRCA1/2 gene promoter in breast tumours among Moroccan women.

BACKGROUND: The promoter region is a key element of gene expression regulation. In mammals, most of the genes present, at the level of their promoter, a large number of islands CpG. Age also is seen as another factor for developing breast cell cancer reaching the tumour stage. AIM: This study aimed to explore the hypermethylation of the BRCA1/2 promoter gene in women breast cancer and correlation with age and tumour stage. MATERIALS AND METHODS: Fifty biopsies were derived from Moroccan women treated for breast carcinoma, the DNA extracted was treated by bisulphite and the targeted BRCA1/2 Amplicons were amplified by specific methylation primers (MSP). RESULTS: The result shows that 62% of the samples were BRCA1 methylated in addition and negative result for BRCA2, these positive epigenetic factor were remarkable in women over 47 years and at the stage of malignant tumour. CONCLUSION: These results show that half of the methylated samples are positive with a majority of over 47 years old, and confirms that age might be an additional factor for breast cancer development.

Intraperitoneal migration of an intrauterine device (IUD): A case report.

INTRODUCTION: The IUD is one of the most widely used reversible, long-term contraceptive methods in the world. About 80% of IUDs are found in the peritoneal cavity after uterine perforation. CASE REPORT: A 27-year-old female patient presented with chronic pelvic pain with minimal metrorrhagia for 8 months on IUD. On examination, there was no IUD thread. Pelvic ultrasound showed a hypoechoic, heterogeneous, poorly limited formation measuring 3 × 2.68 cm. Abdominal-pelvic CT scan showed hyperdense supravesical material surrounded by a hypo-dense, well-limited collection measuring 26 × 25 mm. Laparoscopy showed an anterior peritoneal collection above the bladder containing the IUD, a uterus, adnexa, and a bladder without abnormality. The IUD was removed after incision of the collection and aspiration of the pus. DISCUSSION: The IUD is one of the most widely used long-term reversible contraceptive methods in the world. But like any foreign body, it can present complications, notably migration after uterine perforation, which remains rare, and even rarer peritoneal localization. The clinical diagnosis is not always obvious, and additional examinations are necessary to locate the device, including endovaginal ultrasound, a CT scan or magnetic resonance imaging.WHO recommends surgical removal of the migrated IUD by minimally invasive methods, including hysteroscopy, cystoscopy, colonoscopy, or laparoscopy, depending on the location of the IUD. CONCLUSION: IUDs are effective contraceptive measures, and the majority of patients with uterine perforation by IUD migration are asymptomatic. Diagnosis is based on a thorough gynecologic analysis and appropriate radiologic imaging.

Diagnostic Value of MicroRNA 21 in Endometrial Cancer and Benign Lesions and its Differential Expression with Clinicopathological Parameters.

BACKGROUND: Endometrial cancer is one of the most common malignancies among women worldwide. Although this cancer is often diagnosed at early stages, the need for biomarkers of diagnosis remains a necessity to overcome conventional invasive procedures of diagnosis. OBJECTIVE: In our study, we aim to investigate the diagnostic value of microRNA-21 in endometrial cancer and its relation to clinicopathological features. METHODS: We used RT-qPCR to measure the expression of microRNA-21 in 71 tumor tissues, 53 adjacent tissues, and 54 benign lesions. RESULTS: Our results show that microRNA-21 is a potential biomarker for endometrial cancer with an area under the receiver operating characteristic curve of 0.925 (95% CI = 0.863 - 0.964, P<0.0001). The sensitivity was 84.51% (95% CI = 74.0 - 92.0) and specificity was 86.79% (95% CI = 74.7 - 94.5). For discrimination between benign lesions and controls the AUC was 0,881 with a sensitivity of 100% (95% CI = 93.4 - 100.0) and specificity of 66.04% (95% CI = 51.7 - 78.5), and for discriminating benign lesions from tumors the AUC was 0,750 with a sensitivity of 54.93% (95% CI = 42.7 - 66.8) and specificity of 90.74% (95% CI = 79.7 - 96.9). We also found that tumors with elevated microRNA-21 expression are of advanced FIGO stage, high histological grades, and have cervical invasion, myometrial invasion and distant metastasis. CONCLUSION: Our findings support the important role of miR-21 as a biomarker to diagnose endometrial cancer. Further studies on minimally invasive/noninvasive samples such as serum, blood, and urine are necessary to provide a better alternative to current diagnosis methods.

Tuberculosis of the breast: analysis of 17 cases.

Tuberculosis constitutes a major public health problem in the world. Certain extra-pulmonary locations of tuberculosis disease are very exceptional. Amongst these, tuberculosis of the breast is rare even in countries where this infection is endemic. This form of tuberculosis is characterized by clinical and radiological polymorphisms and might mimic other diseases, especially breast cancer. This retrospective study is entailing seventeen patients treated in the Onco-Gynecology Department of the Mohammed VI Cancer Treatment Center, in the Ibn Rochd University Hospital of Casablanca, for breast tuberculosis, over a period of three years. We report the epidemiological, clinical and paraclinical aspects and we specify the treatment and evolution of the patients.

Oncogenic Human Papillomavirus involvement in epithelial ovarian carcinoma among women in Morocco.

Epithelial Ovarian cancer (EOC) although rare is the most lethal gynecological cancer in women worldwide. Despite its high prevalence few studies have been performed to evaluate the prevalence and determinants of HPV infection worldwide. The aim of the present study was to investigate the presence of HPV-DNA in Moroccan patients with EOC using PCR among women in Casablanca, and to examine the prevalence of some HPV genotypes in Moroccan population. We performed a study of HPV detection on Fresh biopsies of 70 epithelial ovarian cancer patients. PCR was realized using the MY09/11 and GP5+/6+ primers. Genotyping of HPV was performed by PCR typespecific for HPV 6, 11, 16, 18, 31, and 33.Data was statistically analyzed using SPSS software. Hence, the mean age was 48.9 years (range,21-76 years). Serous adeno carcinoma (75.71%) and stage III of the disease represent the majority of cases. eight patients were HPV positive (11.42%).Results of HPV genotyping revealed predominance of two genotypes: HPV 16 (87.5%) and HPV 31(12.5).No co-infection identified. Approximately 75% of positive cases had a serous cystadeno carcinoma and more than 62,5% had FIGO advanced stage (III or IV).Our study showed that high-risk HPV infection could play a major role among patients with EOC in Morocco.

Prevalence of mucosal and cutaneous human papillomavirus in Moroccan breast cancer.

BACKGROUND: Due to recent technical improvements and some encouraging new results, there has been a resurgence of interest in the possibility that a substantial proportion of breast cancers (BCs) may be caused by viral infections, including Human papillomavirus (HPV). The aim of this study was to determine the prevalence of mucosal and cutaneous HPV in tumours from Moroccan BC patients. MATERIALS AND METHODS: Frozen tumours from 76 BC cases and 12 controls were evaluated for the presence of 62 HPV-types using highly sensitive assays that combine multiplex polymerase chain reaction and bead-based Luminex technology. RESULTS: HPV DNA was found in 25.0% of BC tumours and only 8.3% of controls. Beta and gamma HPV types were found in 10.5% and 6.6% of BC tumours, respectively. High-risk mucosal types HPV16 and 18 were not detected in the subjects, but other probable/possible high-risk or high-risk -HPV types (HPV51, 52, 58, 59, and 66) were found in 5.3% of BC tumours. Statistical analysis showed no significant difference between, controls, BC cases and the inflammatory status (p > 0.05). CONCLUSION: HPV DNA was found 3 times as frequently in the BC tumours as in the controls. However, this difference requires confirmation in a larger sample.