Neuroendocrine carcinoma of the cervix: About a rare case and literature review

INTRODUCTION

Neuroendocrine carcinomas of the uterine cervix are rare carcinomas, accounting for only 0.9-1.5 % of cervical tumors. Given their rarity and the absence of randomized trials, the diagnostic and therapeutic management of these tumors is complicated and is essentially modeled on that of pulmonary neuroendocrine tumors.

PRESENTATION OF CASE

We report a new case of large-cell neuroendocrine carcinoma of the uterine cervix, and review the various aspects of this rare entity.

DISCUSSION

Neuroendocrine carcinoma is a rare and aggressive malignant tumor, It differs from squamous cell carcinoma in its higher recurrence rate and delayed diagnosis. On the other hand, association with human papillomavirus (HPV) 16 and 18 is a common risk factor for both carcinomas.

CONCLUSION

To improve the survival of patients with large-cell neuroendocrine carcinomas of the uterine cervix, it is imperative to conduct multicenter clinical trials aimed at defining an effective, standardized treatment.

Paget disease of de Vulva: About a rare case and a literature review

INTRODUCTION

Paget disease of de Vulva (PDV) is a rare neoplastic intraepithelial pathology. In the majority of cases, neoplastic proliferation remains intraepithelial and the prognosis is favorable. The standard treatment for Paget disease is surgical excision. We report the observation of a patient with extensive and recurrent vulvar Paget's disease which we treated with surgery.

PRESENTATION OF CASE

A 39-year-old single woman presented with itchy heterogeneous erythematous vulvar lesions suggestive of Paget disease. A biopsy confirmed the diagnosis of non-invasive Paget disease. Surgical excision of the lesions was realized, with the anatomopathological examination confirming the diagnosis.

DISCUSSION

MPV is often diagnosed late due to the absence of specific symptoms in its initial phase. Clinically, it manifests as an erythematous lesion or eczema. Immunohistochemistry plays a crucial role in the diagnosis of VPM, helping to distinguish the disease from other vulvar conditions. Vulvar MPV has recently been subdivided into two subtypes: type 1, which concerns primary vulvar lesions, and type 2, which concerns associated primary non-cutaneous adenocarcinomatous proliferations or pagetoid intraepithelial urothelial carcinomas. Surgery is considered the gold standard treatment for MPV.

CONCLUSION

PDV is a complex disease requiring appropriate diagnosis and management, with surgery as the main treatment, but other less invasive therapeutic options may be considered on a case-by-case basis. Prognostic factors play an important role in the choice of treatment and disease progression.

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.

Primary pelvic hydatidosis: About two cases

INTRODUCTION AND IMPORTANCE

Primary pelvic hydatidosis in women is a rare or even exceptional entity; its diagnosis is often late.

CASE PRESENTATION

We report two cases of pelvic hydatid cyst with a clinical picture simulating an ovarian tumor, dignosticated at the Mohamed VI Center for the treatment of gynecomammary cancers in Casablanca.

CLINICAL DISCUSSION

Pelvic hydatidosis is rare; its incidence is between 0.30 and 5.27% of hydatid localizations. Its diagnosis is exceptionally made preoperatively; the patient is most often consulted for pelvic pain, which reveals the presence of an abdominopelvic mass. Pelvic ultrasound is the first-line examination. Serology is necessary only in doubtful cases. Treatment is essentially surgical and must take into consideration the desire for pregnancy in women of childbearing age.

CONCLUSION

The vital and gynaecological prognosis is at stake and early diagnosis is necessary. This diagnosis should always be evoked when there are signs of pelvic damage, despite the rarity of hydatid cysts in this location. However, prevention remains the best solution to this scourge, especially in endemic areas.

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.

Ovarian Sertoli-Leydig tumor: A tricky tumor case report

INTRODUCTION AND IMPORTANCE

Ovarian Sertoli-Leydig cell tumors (SLCT) are a rare sex cord-stromal tumors, accounting for <0,2 % of all ovarian malignancies. As these tumors are found at an early stage in young women, the whole management dilemma is finding the right balance between a treatment efficient enough to prevent recurrences but that still enables fertility-sparing.

CASE PRESENTATION

We report the case of a 17 years old patient hospitalized in the oncology and gynecology ward of the university hospital Ibn Rochd in Casablanca, presenting a moderately differentiated Sertoli-Leydig cell tumor in the right ovary, our aim is to analyze the clinical, radiological and histological characteristics of this rare tumor that can be tricky to diagnose and review the different management therapies available and the challenges they present.

CLINICAL DISCUSSION

Ovarian Sertoli-Leydig cell tumors (SLCT) are rare sex cord-stromal tumors that should not be misdiagnosed. The prognosis of patients with grade 1 SLCT is excellent without adjuvant chemotherapy. Intermediate and poorly differentiated SLCTs require a more aggressive management. Complete surgical staging and adjuvant chemotherapy should be considered.

CONCLUSION

Our case reaffirms that in the presence of a pelvic tumor syndrome and signs of virilization, SLCT should be suspected. The treatment is essentially surgical, if diagnosed early on, we can offer an effective treatment that preserves their fertility. Efforts should be focused on the creation of regional and international registries of SLCT cases in order to achieve greater statistical power in future studies.

Squamous cell carcinoma of the breast: About a case

Squamous cell carcinoma of the breast is a rare metaplastic breast tumor whose histogenesis is controversial. Its prevalence is estimated between 0.06 % and 0.2 % of all breast neoplasms. The histogenesis remains obscure. The clinical aspects are not specific. Squamous cell carcinoma is characterized by a rapid evolution and by an uncodified treatment. The objective of our work, by reporting a new case of primary squamous cell carcinoma of the breast, is to specify through a literature review some characteristics of this particular form of breast cancer.

Squamous cell carcinoma of the breast is a rare tumor belonging to the heterogeneous group of metaplastic carcinomas. The clinical and radiological presentations are not specific. The prognosis.

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Squamous cell carcinoma of the breast is a rare tumor belonging to the heterogeneous group of metaplastic carcinomas.

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These tumors could arise from a breast dermoid cyst, a chronic breast abscess, or from a phyllodes cystosarcoma.

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The majority of these tumors do not express hormone receptors, as does Her 2 amplification.

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Neoadjuvant chemotherapy is not justified to consider conservative treatment since its results are poor.

Primary neuroendocrine tumors of the breast: About a case and of the review of the literature

primary neuroendocrine carcinomas of the breast represent a minority and are currently included in the latest WHO classification of breast tumors. Their morphological and immunohistochemical features (chromogranin and synaptophysin expression) allow the retain the diagnosis.

we report a case of primary neuroendocrine carcinoma of the breast in 50 years old Moroccan women who presented nodule 4,2 cm palpable and mobile of the left breast. Lumpectomy axillary lymph node resection was performed. a histopathological examination disclosed the diagnosis of primary breast neuroendocrine tumors with negative surgical margins and positive lymph nodes (13 N+/19 N). The tumor cells were positive for neuroendocrine markers, a highKi67 proliferation index and the membrane expression of the invasive tumor cells to the anti-HER2 antibody was 2, a FISH done which was equivocal. Our patient received 6 courses of chemotherapythen radiotherapy; currently she received adjuvant hormonal treatment with Tamoxifene.

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The morphological and immunohistochemical features (Chromogranin and Synaptophysin expression) allow to retain the diagnosis.

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Studies, including larger series, are needed in order to understand the biological behavior of these tumors.

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Surgical treatment (mastectomy with axillary dissection and metastasectomy), remains the first line treatment in primary neuroendocrine tumors

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The chemotherapy protocol is not standardized: Primary neuroendocrine tumors of the breast are treated by some as adenocarcinoma of the breast and by others as neuroendocrine carcinoma

Primary clear cell adenocarcinoma of the vagina not associated with diethylstilbestrol: A case report

Primary vaginal cancers are rare and clear cell adenocarcinoma is a malignant tumor that is all the more rare when the woman has not been exposed in utero to synthetic diethylstilboestrol (DES). We report the case of a 60-year-old woman with a history of balanced essential hypertension and partial mastectomy for neoplasia, who presented with a recurrent left inguinal adenopathy. Clinical examination revealed a 3 cm bulging lesion of the anterior vaginal wall in the lower third with indurated left inguinal adenopathy. Biopsy of the nodule showed an invasive clear cell adenocarcinoma. The extension bialn is negative and the multidisciplinary decision is to perform a partial colpectomy with bilateral inguinal curage. The patient is currently undergoing radiochemotherapy. This is a rare case with a poor prognosis. A poor response to adjuvant therapy with a high frequency of distant metastases is reported in the literature. Due to the rarity of this pathology, individual experience based on case reports is the main source of information. The most effective mode of treatment therefore remains unknown and depends on patient-specific factors such as tumor size, surgeon and oncologist team experiences.

Botryoid rhabdomyosarcoma of the uterine cervix: Report case

Rhabdomyosarcoma of the cervix is among the rare histological types of cervical cancers, which are usually seen in young girls or women in the general active period. The usual circumstances of diagnosis are dominated by recurrent metrorrhagia. At the initial stage, the lesions may be asymptomatic or take on the appearance of a benign polyp. In the case reported here, the clinical symptomatology was recurrent metrorrhagia with a cervical implanted polyp occurring 28 months after resection of a benign polyp. RMS is one of the malignant tumors of mesenchymal origin. Typically, it is a malignant tumor proliferation of cells with morphological and/or phenotypic striated muscle differentiation. The characteristic cells of this tumor are rhabdomyoblasts rhabdomyosarcomas are classified into three histological subtypes: embryonal, alveolar, and anaplastic. Within embryonal RMS, it is possible to distinguish between botryoid, leiomyomatous and anaplastic forms. Botryoid and leiomyomatous forms are classically described as having a more favorable prognosis. Treatment is based on a multidisciplinary approach that includes indications for conservative surgery, chemotherapy, radiotherapy and brachytherapy.

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/β-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.

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.

[The ovarian immature teratoma with gliomatosis peritonei]

OBJECTIVE

We return a case of ovarian immature teratoma with peritoneal gliomatose at a woman aged of 20 years.

MATERIAL AND METHODS

The diagnosis discovered following pelvic mass increasing volume and treaty by a one-sided annexectomy, with chemotherapy.

RESULTS

Eighty-seven cases have been published in the literature. Although potential for recurrence is high, the risk of malignancy is very low.

CONCLUSION

Ovarian immature teratoma is a malignant germ cell tumor and represents less than 1% of ovarian malignant tumors. Tissues are derived from the three germ layers (endo-, meso- and ectoderm). Tumor grading is based on the amount of immature neuroepithelium present. The prognosis is directly correlated to histological grade. Rapid (fast) growth leads to large tumors with an early diagnosis. Gliomatosis peritonei is a rare situation, characterized by the recurrence of peritoneal implants after the surgical treatment of ovarian teratoma. This entity does not modify the good prognosis of mature teratomas, but we recommend regular follow-up.