The prognostic significance of pathological features in Her-2 overexpressing breast carcinomas: A single institution experience in southern Tunisia.

BACKGROUND: Breast cancer is the most frequent malignant neoplasm affecting Tunisian women. It represents 25 to 35% of all female cancers. There is no published study about the features of Her-2 overexpressing breast carcinomas in North African women. OBJECTIVE: The aim of this study is to assess the prognostic significance of pathological features in a cohort of a Her-2 overexpressing breast carcinoma originating from the region of south Tunisia. METHODS: This study investigated a series of 100 patients followed from January 2006 to December 2011 for a Her-2 positive invasive breast carcinoma. Pathological features included in this study were: histological type, histological grade, tumor size, vascular invasion, perineural invasion, mitotic index, lymph nodes stage, positive lymph node capsular effraction, inflammatory infiltrates, nipple involvement and hormone receptors status. RESULTS: Multivariate analysis showed that pT stage, pN stage, capsular effraction, vascular invasion, perineural invasion and Nipple involvement were independent prognostic factors for overall survival and disease free survival in patients free from distant metastasis at diagnosis. For patients with synchronous metastasis, there is no independent pathologic prognostic factor for survival. CONCLUSIONS: Our study demonstrates that pathological features are important prognostic factors for non metastatic Her-2 overexpressing breast carcinomas. This supports the idea that HER2-positive disease is a heterogeneous entity. We believe that these findings reinforce the need to identify molecular predictors of benefit and resistance to anti-Her-2 based therapies.

[Scleredema of Buschke. A case report]. / Scleroedeme de Buschke. A propos d'une observation.

Scleredema of Buschke is a rare disease whose aetiology remains unknown. It is characterised by symetric skin induration of the upper part of the body which usually resolve spontaneously. It can be associated with extra-cutaneous symptoms. We report a new case in a 55 year old women.

[Pemphgoid gestationis. A report of 30 cases]. / La pemphigoïde gravidique. A propos de 30 cas.

Pemphigoid gestationis is an acute autoimmune subepidermal bullous dermatosis which occurs during pregnancy and post partum. It is a rare disease which incidence vary from 1/1700 to 1/60000 pregnancy. It occurs in young woman aged between 20 to 40 years. The authors try throughout a retrospective study of 30 cases of pemphigoid gestationis to drave the epidemiological and clinical profile and the immunopathological characteristics of this affection.

[Nevus lipomatosus cutaneous superficialis: a clinico-pathological study of 13 cases]. / Naevus lipomateux cutane superficiel : étude anatomoclinique de 13 cas.

Nevus lipomatosus cutaneous superficialis (NLCS) is a rare hamartomatous skin lesion histologically characterised by the presence of mature fat tissue within the dermis. Clinically, two types of NLCS can be distinguished: a multiple type of Hoffmann-Zurhelle and a solitary type. We report a retrospective study of 13 cases of NLCS seen in the Anatomopathological department of La Rabta hospital of Tunis during a period of 12 years (1992-2004). Two clinical forms were distinguished: the solitary form (11 cases) consisting of a unique papulo-nodular lesion and the multiple form (2 cases). Histologically, the tumor consisted in all cases on mature fat tissue.

Lupus erythematosus in children: a report of six cases.

The clinical features of childhood discoid lupus erythematosus (DLE) are similar to those of adult DLE in presentation and chronic course. However, children have a particularly high levels of transition to systemic disease. Systemic lupus erythematosus (SLE) is the most common rheumatic disease associated with significant morbidity and mortality in children. This is a retrospective study reporting all cases of childhood lupus erythematosus observed in the dermatology department of Habib Thameur Hospital over a 14-year period. From 1989 to 2003, six cases of childhood lupus erythematosus are included, three patients with discoid lupus erythematosus (2 girls, 1 boy), and three patients with systemic lupus erythematosus (2 boys, 1 girl). The mean age of onset was 12 years (range 10-16 years). Skin manifestations were localized in sun exposed areas in both discoid and systemic lupus erythematosus. Photosensitivity was noted in all cases. The diagnosis was confirmed by histopathologic examination, direct immunofluorescence, and immunologic findings. Treatment included sun avoidance, oral hydroxychloroquine, and topical and systemic steroids. An average follow-up time was 18.1 months (1-96 months). The severity of onset of SLE is usually greater in children than adults. We note that lupus erythematosus is not a static disease and progression from DLE to SLE is possible.