The Prognosis and Predictive Value of Estrogen Negative/Progesterone Positive (ER-/PR+) Phenotype: Experience of 1159 Primary Breast Cancer from a Single Institute.

Breast cancer is a serious worldwide public health problem and is currently the most common cancer overall. Its endocrine therapy is related to the expression of the steroid hormones, estrogen receptor (ER), and progesterone receptor (PR). Breast cancers can be presented under multiple profiles of steroid hormones: ER(-)/PR(+), ER(+)/PR(-), double-positive/negative ER, and PR. 2-8% of all breast cancers express only PR (ER-/PR+) which is an abnormal phenotype, with less known about their behaviors and outcomes. Our study was performed on a large and well-characterized database of primary breast cancer from 2012 to 2019, up to 1159 cases. These cases were divided according to ER and PR expression, as we put all of our focus on ER-negative/PR-positive group, more specifically ER-/PR+/HER2+ and ER-/PR+/HER2- gene expressions, to highlight their features and find a pattern that links HR (hormone receptors) profiles and breast cancer subtypes. Out of the informative cases, 94 patients (8%) had ER-/PR+ breast cancers, while 676 (58.4%) had ER+/PR+, 88 (7.6%) had ER+/PR-, and 164 (14.2%) had ER-/PR- tumors. The ER-/PR+ group was statistically correlated with a high risk of recurrence and death in midway between the double-negative and double-positive HR. According to HER2 status, a low DFS was observed in patients ER-/PR+/HER2-, which is closer to the DFS of TNBC cases but worse than ER+/PR any. On the other side, the ER-/PR+/HER2+ showed also a poorer DFS closer to the HER2+ subgroup in between TNBC and ER+/PR any. The clinicopathological features of the ER-/PR+/HER2- and ER-/PR+ HER2+ have distinguished the patients into two groups with a difference in some clinicopathological characteristics: both groups had closer OS estimation, which was worse than ER-/PR any and better than TNBC and HER2. The ER-/PR+/HER2- seems to increase the risk of recurrence than ER-/PR+/HER2+ when compared to ER+/PR any. On the other hand, the ER-/PR+/HER2+ seems to increase the risk of death more than ER-/PR+/HER2- in comparison with ER+/PR any. Our results support that ER-/PR+ tumors really exist and are rare and clinically and biologically distinct subtypes of breast cancer. In addition, our analysis, which was based on dividing the groups according to HER2 expression, has revealed the existence of two distinct groups; this gave the ER-/PR+ subgroup a heterogeneity characterization. Moreover, this breast cancer subtype should not be treated as a luminal tumor but rather according to the HER2 expression status.

Cancer du sein triple négatif chez la femme enceinte : le pronostic est-il si mauvais dans le contexte africain ?

Le cancer du sein triple négatif est un groupe de carcinome du sein caractérisé par le manque d'expression des récepteurs hormonaux aux oestrogènes et à la progestérone (RE, RP) et HER2. Cette forme se caractérise également par son agressivité, un faible taux de survie et l'absence de thérapies ciblées. Dans cemanuscrit, nous en rapportons deux cas de survenant chez des femmes enceintes ayant bénéficié d'une chirurgie basée sur des mastectomies plus curage axillaire suivie d'une chimiothérapie et radiothérapie adjuvantes. Les deux évolutions ont été marquées par la survenue de métastases cérébrales. À travers ces cas, nous décrivons en mettant un accent sur les caractéristiquesclinique et le mauvais pronostic du cancer du sein triple négatif pendant la grossesse. Nous soumettons également une brève revue de la littérature sur cette situation pendant la grossesse

[Choriocarcinoma: a hidden face of pemphigoid gestationis]. / Le choriocarcinome: une face cachée de la pemphigoïde gestationnelle.

Gestationis pemphigoid is an autoimmune subepidermal blistering dermatosis occurring predominantly in pregnancy, more seldom in early puerperium, and exceptionally in post-abortion. The association of gestationis pemphigoid with choriocarcinoma is extremely rare. We report this association in a patient of 35 years in which the diagnosis of gestationis pemphigoid was made on clinical, histological and immunological criteria, and the one of choriocarcinoma was made on clinical, biological radiological and histological criteria. Through this article, we put the item on this association reported for the first time in post-abortion.

Giant pelvic retroperitoneal epidermoid cyst: a rare case report.

Epidermoid cyst is a frequent benign cutaneous tumor. The pelvic localization does not occur very often. The literature that taps into such cases is very limited in scope. Here is a report of a 27-year-old woman with a giant pelvic retroperitoneal epidermoid cyst. The use of ultrasound exploration and computed tomography has indicated ovarian origins. The surgery also revealed a retroperitoneal epidermoid cyst, uterus and ovaries were all intact. The evacuation of a cyst was found to contain lamellas of keratin. Histology permitted us to confirm the diagnosis. The patient was faring well after two years of followup.

Endometrial stromal nodule: report of a case.

Endometrial stromal nodule (ESN) is the least common of the endometrial stromal tumors. They are rare neoplasms which are diagnosed in most instances by light microscopy. Although such nodules are benign, hysterectomy has been considered the treatment of choice to determine the margins of the tumor required for diagnosis and to differentiate it from invasive stromal sarcoma Whose prognosis is totally different. We report a case of a 45 years old woman, with presurgical diagnosis of adnexal mass or uterine tumor. She underwent a total abdominal hysterectomy. Pathologic examination revealed an endometrial stromal nodule. Through this observation, we insist on the fact that the ESNs are rare and benign entities which must be differentiated from the other invasive malignant stromal tumors; this can change the final prognosis.

Depistage de streptocoque du groupe B au cours du troisieme trimestre de grossesse au CHU Hassan II de Fes

Objectif : Determiner le taux de portage maternel du streptocoque du groupe B (SGB) a terme et rechercher les eventuels facteurs predictifs de ce portage. Patientes et methodes : un prelevement vaginal et un anal ont ete realises de maniere prospective chez 240 parturientes lors de l'entree en salle d'accouchement sur une periode de 12 mois. Resultats : Le taux de portage etait de 23;3. Aucun des facteurs de risque etudies (age; niveau d'etude; nulliparite; antecedent d'interruption volontaire de grossesse; de fausse couche spontanee; de grossesse extra-uterine; de mort foetale in utero; de pyelonephrite gravidique; de menace d'accouchement premature; de diabete gestationnel et de grossesse gemellaire) n'etait statistiquement predictif du portage maternel du SGB. Tous les SGB isoles etaient sensibles a la penicilline G. Conclusion : Il parait souhaitable d'instaurer une politique de depistage systematique a proximite du terme chez toutes les femmes enceintes

[Isolated torsion of the fallopian tube: about two cases]. / Torsion tubaire isoliée: à propos de deux observations.

Isolated torsion of the fallopian tube is extremely rare and difficult to diagnose, requires a coelioscopy, or a laparotomy in centers which do not have coelioscpie; often carried out too tardily, to allow the conservation of the horn. We report two observations of isolated torsion of the fallopian tube and we recall through the two clinical cases the diagnostic difficulties, the useful complementary examinations, the treatment and the causes of this pathology which must be systematically evoked in front of any acute abdominal syndrome in order to hope for an early surgical treatment and if possible conservative.

[Clinical case of the month. Krugenberg tumor in pregnancy]. / Le cas clinique du mois. Tumeur de Krukenberg et grossesse: a propos d'un cas.

The authors report the observation of a bilateral ovarian tumor in a pregnant woman. The lesion corresponded to a metastasis from a sigmoïd adenocarcinoma.

Uterine Inversion : a Case Report

The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However; extrinsic factors such as oxytocic arrests after a prolonged labour; umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity; uterine hypotonia; various placental localizations; fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage; shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home

[Vulval tuberculosis: a rare case report]. / Tuberculose vulvaire: à propos d'un cas rare.

The authors report an observation of a rare case of vulvar tuberculosis in its hypertrophic form it is observed in a 16-years-old girl. The diagnosis was retained on a beam of arguments anamnestic, clinical, histological and evolutionary. A medical treatment based on antibacillar was founded supplemented of a surgical reduction for aesthetic concern.

[Angiosarcoma of the breast: a case report]. / L'angiosarcome du sein: à propos d'un cas.

We report a breast's angiosarcoma case admitted at the maternity hospital Souissi of Rabat in 1997. We discussed epidemiologic, diagnostic and therapeutic aspects of this type of tumor insisting on the difficulties of diagnosis.

[Paratesticular malignant mesothelioma. Presentation of a case]. / Mésothéliome malin paratesticulaire. Présentation d'un cas.

We report a case of malignant mesothelioma of tunica vaginalis in a 65-year-old man. The clinical course was marked by local relapse and distant metastases. Based on a review of the literature, the authors discuss the clinical, epidemiological and therapeutic aspects.

[Non Hodgkin's malignant lymphoma of the uterine cervix. Apropos of a case]. / Lymphome malin non hodgkinien du col utérin. A propos de 1 cas.

The authors report a case of a 61-year-old woman presenting a primary cervical non Hodgkin's lymphoma, FIGO stage IIIA and Ann Arbor stage IE. The patient was successfully treated by combination of multiple drug therapy and pelvic external radiation therapy. Twenty-eight months later, the patient is in good general health and complete remission.

[Primary angiosarcoma of the breast. Apropos of 2 cases]. / Les angiosarcomes primitifs du sein. A propos de 2 cas.

We report here 2 cases of breast angiosarcoma observed at Centre Val-d' Aurelle of Montpellier over a period of 14 years (1980 to 1994). Based on a review of literature, we analyze the epidemiological, pathological, clinical, diagnostic and treatment aspects of this rare type of breast cancer. The difficulties of histological diagnosis are underlined. Mastectomy is the treatment of reference. Breast angiosarcoma has the worst prognosis of all mammary malignancies, with a mean survival of 24 months. The low histologic grade and an early diagnosis are the most important factors of good prognosis. The benefit of irradiation and chemotherapy as adjuvant therapy remains to be demonstrated.

[Radiation-induced sarcoma]. / Les sarcomes radio-induits.

Based upon the literature, we discuss epidemiological, histopathological, clinical and treatment aspects of postirradiation sarcomas. The risk of postirradiation sarcoma is very low and negligible in comparison with the beneficial effect of radiotherapy, and it should not be a major factor influencing treatment decision in patients with cancer. The radical surgical approach of postirradiation sarcoma is the treatment which offers the best chance for cure.

[Struma ovarii. A case report]. / Goitre ovarien. A propos d'un cas.

Struma ovarii is a rare ovarian tumor composed entirely or in part of thyroid tissue. Pathogenesis is unclear. Diagnosis rests on the histologic study. A case is reported. Specific features of struma ovarii are discussed based on a review of the literature. The treatment is surgical and the outcome generally favorable.

[Anorectal malignant melanomas. Apropos of 5 cases. Review of the literature]. / Les mélanomes malins anorectaux. A propos de 5 cas: revue de la littérature.

This study reports five cases of anorectal melanoma treated at Centre Val d'Aurelle-Paul Lamarque in Montpellier. There follows a discussion based upon the literature of epidemiological, clinical, histopathological and therapeutic aspects. Surgery is the treatment of choice but there is major controversy regarding the best method. The decisive prognostic factor appears to be the stage of the disease rather than the type of treatment. The role of radiotherapy, adjuvant chemotherapy and immunotherapy remains to be evaluated.

Tuberculoma of pineal area. Case report.

A case of pineal area tuberculoma revealed by grand mal seizures and deterioration of vision is presented. A surgical biopsy and chemotherapy produced good results. This unusual site of tuberculoma demonstrates the usefulness of a direct approach to pineal area masses. It also confirms the effectivity of chemotherapy for tuberculoma.