Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation: a case report.

Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation is a very extremely rare tumor and only few cases have been reported in the literature. Here we report a case of a 37-year-old woman who presented with a pain and a palpable mass in the right flank. The abdominal computed tomography (CT) scan found a renal tumor and the patient underwent a right radical nephrectomy with adrenal gland resection. After the histological examination of the specimen completed by immunohistochemical and molecular study, a diagnosis of chromophobe renal cell carcinoma with liposarcomatous dedifferentiation was made. The patient received adjuvant chemotherapy. Afterwards, she developed bone metastasis and died 13 months after the surgery. Chromophobe renal cell carcinoma with liposarcomatous dedifferentiation is a rare tumor associated with a poor prognosis and a metastatic potential.

Ki-67 proliferation index to further stratify invasive breast cancer molecular subtypes: Northern African comparative cohort-study with external TCGA-BRCA and METABRIC validation.

Introduction: breast cancer (BC) is a malignancy with very high incidence and mortality in Africa, especially in Western Africa, where more than 25 thousand deaths are registered every year. Not all BC have the same prognosis, and being able to personalize treatment and predict aggressiveness is of crucial importance. The purpose of our study is to explore further subdivisions associated with prognosis, beyond breast cancer molecular classification that is routinely established in pathology departments. Methods: we conducted a 5-year retrospective cohort study on 1266 invasive BC of Moroccan patients, collected at the Pathology Department of Ibn-Rochd University Hospital in Casablanca, and followed at King Mohammed VI National Centre for the Treatment of Cancers. We elaborated an Estimation-Maximization Clustering, based on the main BC biomarkers: Ki-67, HER2, estrogen and progesterone receptors, evaluated by immunohistochemistry. Two independent datasets (TCGA-BRCA and Metabric) were also analyzed to assess the external reproducibility of the results. Results: each molecular subgroup could be partitioned into two further subdivisions: Cluster1, with average Ki-67 of 16.26% (±11.9) across all molecular subgroups and higher frequency within luminal BC, and Cluster2, with average Ki-67 of 68.8%(±18) across all molecular subgroups and higher frequency in HER2 as well as in triple-negative BC. Overall survival of the two Clusters was significantly different, with 5-year rates of 52 and 37 months for Custer1 and Cluster2, respectively (p=0.000001). Moreover, mortality rates within the same molecular subgroup, especially in luminal B HER2-, varied remarkably depending on Cluster membership (6% for C1 and 18% for C2 after 1 year of follow-up). Two different algorithms to evaluate the prognostic importance, variable selection using random forests (VSURF) and Minimal depth, ranked the subdivision proposed as one of the 4 most influential features being able to predict patient survival better than several histoprognostic features, both in the Moroccan and in the external datasets. Conclusion: our results highlight a new refinement of the BC molecular classification and provide a simple and improved way to classify tumors that could be applied in low to middle-income countries. This is the first study of its kind addressed in an African context.

Giant fibrous polyp issuing from the uterine cervix: A case report.

Fibrous uterine polyps are very common in women during or after menopause, and less often seen in women of child-bearing age, with a maximum of frequency between 40, and 49 years. They can have various locations in the uterus depending on the patient's age, mostly the body, and fundus. We report a rare case of cervical localization of a pedicled fibrous polyp issuing from the cervix, in a 44-year-old female patient with 3 living children and a history of miscarriage, who had been presenting breakthrough bleeding, and pelvic pain for 3 months. It is essential to remind young radiologists of the different presentations of fibrous polyps, how to explore them better and when to fear malignancy and thus insist in a histologic study, in order to help clinicians to choose the most adequate treatment option.

Solid pseudopapillary tumor of the pancreas: a rare entity in children.

Solid pseudopapillary tumors (SPTs) constitute 0.2 to 2.7% of non-endocrine primary tumors of the pancreas and comprise the majority (70%) of pediatric pancreatic neoplasms. These tumors are of unclear pathogenesis, low malignancy and favorable prognosis. Surgical resection offers an excellent chance for longterm survival, even in the presence of distant metastasis. The objective of this study is to review our experience in the management of SPT in a 12 years old girl at the pediatric hospital of the University hospital of Casablanca, in Morocco and provide an update on current management in pediatric population.

Primary Malignant Deciduoid Mesothelioma: A Challenging Diagnosis.

Primary malignant deciduoid mesothelioma is a rare subtype of epithelioid mesothelioma that was first described in the peritoneum in young women without a history of asbestos exposure. It was thought to be a distinct clinicopathologic entity with ominous prognosis; recent studies have better characterized this entity. On morphology, primary malignant deciduoid mesothelioma is characterized by cytomorphologic features resembling decidualized tissue. Pleomorphism is variable. The immunoprofile is similar to other epithelioid mesotheliomas. The prognosis is the same as other epithelioid mesotheliomas and seems to depend on histological grade.

Lead poisoning in children: a case report.

Lead colic is a rare cause of abdominal pain. The diagnosis of lead poisoning is most often mentioned in at risk populations (children, psychotic). We report the case of a 2 year old child that was presented for acute abdomen. Abdominal plain radiograph showed multiple intra-colonic metallic particles and suggested lead poisoning diagnosis. Anamnesis found a notion of pica and consumption of peeling paint. Elevated blood lead levels (BLL) confirmed the diagnosis. The lead poisoning is a public health problem especially in children, but its manifestation by a lead colic is rare and could simulate an acute abdomen table.