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Pulmonary artery intimal sarcoma (PAIS) is an extremly rare and agressive tumor. The prognosis is very poor, with median overall survival between 11 and 18 months. We report a case of a 38 year old man who presented to our oncology department with diagnosis of PAIS confirmed by histological examination after surgical resection and bioprosthetic pulmonary valve replacement. Six months after adjuvant chemotherapy, the patient presented a recurrence of his disease that requires other lines of chemotherapy with prolonged survival.

It is well known that breast cancer treatment and especially mastectomy can affect body image, and sexuality of women with breast cancer, as well as to provide a general understanding of their quality of life .A descriptive exploratory study was conducted in department of Medical oncology in Morocco with a sample of 100 post mastectomy women. Disturbance of body image with loss of self-confidence was reported in 58% of our patients and the feeling of depression was found in 48% of the patients. Sexual unsatisfaction was reported in 50% of the patients. The results of this study could contribute to the medical oncologists and other physicians of the QOL and sexuel side of women with breast cancer.

The clivus is situated at an anatomically critical location next to brainstem and the majority of the cranial nerves and involved in approximately 1% of intracranial tumors. Isolated metastase to clivus have been rarely reported in breast cancer. We report a case of 58 year old women, who present a cranialnerve palsy as the first presentation of isolated clival metastasis in a treated patient of breast cancer. The etiology was obteined by brain CT, magnetic resonance imaging (MRI) which showed lesion in the clivus. The diagnosis of clival metastasis from breast cancer was confirmed by transsphenoidal biopsy. The patient received radiotherapy with corticotherapy with favorable evolution within 5 days.

INTRODUCTION: In Morocco, Kidney cancer is the 18th most common tumour and the 19th lethal cancer in 2020. The average age of diagnosis is 65 years and men are more affected. Molecular studies of renal cell carcinoma (RCC) allowed the detection of several genetic abnormalities in each histological subtype. These aberrations got different diagnostic value, prognostic implication and for some, therapeutic utility. The aim of our study is to evaluate the utility of fluorescence in-situ hybridization (FISH) in the diagnosis and the prognosis of renal cell carcinoma. MATERIAL AND METHODS: We included prospectively cases of RCC diagnosed after histological examination and immunohistochemistry analysis for some cases. The methodology consisted in highlighting by FISH method, molecular abnormalities for each histological subtypes using Zytolight® probes. Probes were chosen depending on the histological diagnosis. RESULTS: A total of 23 case of RCC were included. Clear cell carcinoma (ccRCC) represented 47,8% (11 cases) followed by papillary RCC (pRCC) with 26%, chromophobe RCC (chRCC) with 13%, a case with uncertain diagnosis, ccRCC or pRCC (4,3%), one case of renal oncocytoma (RO) (4,3%), and a case of tubulo-cystic RCC (4,3%). FISH method supported the morphological diagnosis in all cases except in one biopsy diagnosed histologically as a ccRCC and this method allowed the diagnosis correction to pRCC by the detection of chromosome 17 polysomy described in this histological subtype. FISH can also be used in the prognostic categorization of patients by detecting of some genetic aberrations with a prognostic implication like CDKN2a loss which predict a worse evolution. CONCLUSION: FISH method got an implication in the diagnostic approach of RCC, especially in cases with non-conclusive histology and immunohistochemistry. It can also be used in the prognosis in addition to other histo-prognostic factors. This method will lead to more precision in diagnosis and better care management personalization.

Metastatic small bowel tumors in the testes are uncommon often indicating an advanced stage of sickness with poor prognosis. The route of spread to the scrotal level has not yet been defined. The most of these tumors are diagnosed at autopsy or orchiectomy for metastatic carcinoma. The diagnosis is mainly based on histological and immunohistochemical data. In this paper, we report the case of a 36-year-old patient with a spermatic torsion secondary to a testis metastasis from an adenocarcinoma of the small intestine confirmed histologically, occurring as first clinical manifestation that was taken care in the medical oncology department of CHU Hassan II in Fes. The aim of the subject is to highlight this rare metastatic localization of gastrointestinal cancer; how to approach the diagnosis and distinguish between primary testicular cancer and testicular metastasis; by describing the different clinical, radiological and anatomopathological aspects of metastatic gastrointestinal cancer to the testis.

Introduction: Non-small cell lung cancer is the most common lung cancer. Despite the therapeutic advances, its prognosis is very reserved. Aim: Determine the different prognostic factors of patients with metastatic non-small cell lung cancer and their correlation with patient survival. Methods: A retrospective study was conducted at the medical oncology department of Hassan II University Hospital in Fez, collecting 405 patients during a period of 10 years, from January 2008 to January 2018. The statistical analysis of the results was done by the software SPSS version 23, the survival was calculated by the Kaplan-Meier method. The Cox method was used to study prognostic factors. Results: The average age of our patients was 59 years, with a sex ratio M/F of 6.1. In multivariate analysis, we found a significant correlation between the deterioration of survival and an age greater than 75 years (p = 0.023), a general degraded state (p Conclusion: The prognostic factors of metastatic NSCLC in our patients were PS, age, anemia, hypoalbuminemia and inflammatory syndrome. We propose to validate all the factors identified by retrospective studies by prospective studies in order to guarantee the best chances of survival for patients.

Background: Non-clear cell renal cell carcinomas represent a very rare and heterogeneous variety of kidney cancer. The aim of this study is to describe the main epidemiological, clinical, paraclinical, histological and therapeutic characteristics of these cancers. Methods: A descriptive retrospective study was conducted in the Medical Oncology Department of the Hassan II Hospital in Fez, collecting 23 patients with these tumors during the period from January 2008 to January 2020. The statistical analysis is made by the SPSS software version 23. Survival was calculated by the Kaplan-Meier method. Results: The average age of the patients was 57.4 years. The sex ratio M/F was 1.3. The main risk factor was smoking (n = 10). The most common symptom was low back pain (n = 23). 17 patients were metastatic, while 6 patients had localized disease. The most common histological type was papillary carcinoma (n = 12). Patients with localized disease have undergone an extended total nephrectomy. After a median follow-up of 145 months, the median of recurrence-free survival was 48 months and that of overall survival was 150 months. In a metastatic situation, 16 patients had received systemic treatment, of which 13 patients had received sunitinib, 2 patients pazaopanib and only one patient received everolimus. After a median follow-up of 20 months, the median of progression-free survival was 5 months and that of overall survival was 9 months. Conclusion: At the present time, there is no therapeutic standard for the management of patients with these tumors. Surgery for people with localized or locally advanced disease remains the initial and most important approach. For patients with advanced disease, a clinical trial should be considered.

Tyrosine kinase inhibitors (TKIs) have become a prominent option in the therapeutic arsenal of several cancers. The safety of these drugs has shown various toxicities with varying frequency and severity between different agents. The aim of this study is to describe the safety profile of different classes of TKI used in various solid tumors. It is a retrospectively descriptive study conducted in the Department of Medical Oncology at Hassan II University Hospital of Fez, Morocco, over a period of 6 years from April 2013 until April 2019. It included 216 patients who received one or more TKI for different indications in solid tumors. The average age in our series was 61.4 years with a sex ratio F/M of 1.07. Among the most used TKIs in our department according to their availability: Imatinib (32%) and sunitinib (32%). All patients received one or more tyrosine kinase inhibitors according to the indication. Kidney cancer was the most common malignancy (36%), followed by gastrointestinal stromal tumors (33%). The median duration of treatment was 15 months with extremes of 1 month and 102 months. The main side effects were: Cutaneous in 43% of patients. Digestive toxicity occurred in 36% of cases. Hematotoxicity was reported in 33% of cases. The safety profile of TKIs used in our study was comparable to their global tolerance reported in literature. More studies are needed to investigate the relationship between their toxicity and their efficacy in Moroccan population.

Background: Refractory thyroid carcinomas are rare. The prognosis of these carcinomas depends on several factors including the histological type and the evolutionary stage. Aim: Determine the epidemiological, pathological and prognostic characteristics of refractory thyroid carcinomas and to focus on the therapeutic modalities used for the treatment of these cancers. Methods: Our work is a retrospective descriptive study on 28 cases collected in the medical oncology department of Hassan II hospital in Fez over a period of 7 years, from January 2012 to January 2019. The statistical analysis of the results was done by SPSS version 23. Survival was calculated by the Kaplan-Meier method. Results: The average age was 57.3 years, with a sex ratio F/M of 1.3. Thyroid nodule and multi-hetero nodular goiter were present in 32.1% and 28.5% of cases, respectively. The most common carcinoma was the papillary (36%) followed by the vesicular (25%), the anaplastic (25%) and the medullary (14%). The first line treatment was based on SORAFENIB (administered to 40% of patients) and on conventional chemotherapy (60%). After an average number of 4 courses, the objective response rate was 47%. The median of progression-free survival was 15 months and that of overall survival was 25 months. Conclusion: Overall, refractory thyroid cancers are rare. Systemic treatments have evolved considerably in recent years with the development of targeted therapies, pending the advent of immunotherapy that could improve the prognosis of patients with these cancers, particularly those with anaplastic carcinoma.

Resume Introduction Les cancers du sein touchent environ un quart des femmes en âge de procreer dans le monde. Les profils biomoleculaires observes dans les formes localisees necessitent le plus souvent le recours a la chimiotherapie adjuvante, chose qui peut compromettre la fertilite de ces jeunes patientes. Le but de notre etude est de preciser l’incidence de l’insuffisance ovarienne apres chimiotherapie chez les patientes premenopausees traitees pour cancer du sein localise, et d’identifier les facteurs predictifs de sa survenue. Methodes Il s’agit d’une cohorte retrospective transversale ayant inclus toutes les patientes premenopausees traitees pour cancer du sein localise au service d’oncologie medicale du centre hospitalier universitaire Hassan II de Fes, pendant une periode d’une annee. L’amenorrhee chimio-induite (ACI) a ete etudiee, ainsi que les facteurs predictifs de sa survenue. Resultats Notre etude a inclus 100 patientes. L’âge moyen etait de 36 ans [21–45]. L’incidence de l’ACI etait de 82 % dont 66,7 % ont repris leurs menstruations. Les facteurs de risque associes a l’ACI ont ete analyses. Seul l’âge etait correle a l’ACI de facon statistiquement significative. Conclusion Notre etude a objective une incidence elevee de l’IOCI (insuffisance ovarienne chimuio-induite) avec un faible taux d’amenorrhee reversible. L’âge des patientes est le seul facteur predictif de sa survenue. Les methodes de preservation de la fonction ovarienne doivent etre utilisees chez ces patientes afin de reduire l’impact de la chimiotherapie sur leurs reserves ovariennes.

Neuroendocrine tumors are a rare and aggressive histological variant of the cervix, and they have several differences compared to other types of cervical cancer, in prognosis, diagnosis and treatment. In this paper we report the case of a 39-year-old patient that was taken care of in the medical oncology department at the Hassan II University Hospital Center, for an advanced neuroendocrine carcinoma of the cervix with a Sister Mary Joseph’s nodule. The aim of this work is to highlight this rare location of neuroendocrine tumors and their very aggressive character; by describing the different clinical, radiological and anatomopathological aspects of the primary tumor as well as umbilical metastasis.

Objective Our prospective study aims to define the correlation of EGFR(epidermal growth factor receptor) mutations with major histological subtypes of lung adenocarcinoma from resected and non-resected specimens, according to the WHO 2015 classification, in Moroccan North East Population. Methods Epidermal growth factor receptor mutations of 150 primary lung adenocarcinoma were performed using Real-Time PCR or SANGER sequencing. SPSS 21 was used to assess the relationship between histological subtypes of lung adenocarcinoma and EGFR mutation status. Results 25 mutations were detected in the series of 150 lung adenocarcinomas, most of which were found in cases with papillary, acinar, patterns than without these patterns and more frequently occurred in the cases without solid pattern than with this pattern. A significant correlation was observed between EGFR mutation and acinar (P = 0,024), papillary pattern (P = 0,003) and, negative association with a solid pattern (P < 0,001). In females, EGFR mutations were significantly correlated with the acinar pattern (P = 0,02), whereas in males with the papillary pattern (P = 0,01). Association between the histologic component and exon 19 deletions and exon 21 mutations were also evaluated and, we found a significant correlation between the papillary major pattern with exon 19 mutations (P = 0,004) and, ex21 with the acinar component (P = 0,03). Conclusion An analysis of resected and non-resected lung ADC specimens in 150 Moroccan Northeast patients, revealed that acinar and papillary patterns may predict the presence of a mutation in the EGFR gene. While the solid major pattern may indicate a low mutation rate of the EGFR gene.

Cancer in young women is a major health problem in the Middle Eastern and North African population. We explored the awareness, barriers and practice of Arab oncologists towards oncofertility.Oncologists from Arab countries treating female cancer patients were invited to complete a 30-item web-based questionnaire that explores oncologists' demographics, available techniques and barriers to oncofertility.170 oncologists working in 9 different Arab countries responded to the questionnaire. Among the responders, 89 (52.4%) were from Egypt and the central region, 60 (35.3%) were from North Africa and 21 (12.4%) were from the Gulf region.While most participants considered a dedicated training 'necessary', only 43 oncologists (25.3%) received a formal training. Only 17 participants (10%) had a fertility clinic in their centre, 44 (25.9%) and 13 (7.6%) had to refer patients to other centres or other cities, respectively. A total of 96 oncologists (56.5%) did not have access to a fertility preservation service.Out of 147 responders, 79 (53.7%) offered fertility preservation only in patients presenting with early disease and 38 (25.9%) did not offer fertility preservation. In terms of proposed strategies, 50 responders (29.4%) offered embryo cryopreservation, 79 (46.5%) oocyte cryopreservation and 48 (28.2%) ovarian tissue cryopreservation.A large gap exists between international clinical practice guidelines and current practices of fertility preservation in Arab countries. Barriers to optimum service delivery include the lack of physician awareness/training, unavailability of some advanced techniques and a lack of dedicated fertility clinics within the cancer centres.

Introduction: Burnout is an unwanted outcome of chronic occupational stressors. Oncology staff is expected to suffer from burnout more than other health-care professionals. The aim of this survey was to determine the prevalence of burnout among Moroccan oncologists and to determine potential causal factors. Methods: We conducted a cross-sectional analytical study using an online self-administered questionnaire to oncologists in Morocco. We used the Maslach Burnout Inventory and additional questions exploring work and lifestyle factors. The questionnaire was sent in January 2018. Results: A total of 100 oncologists answered the questionnaire with predominance of women (75%), young participants (74%), and medical oncologists (60%). Eighty-five percent of the oncologists showed evidence of burnout. The rates of high scores of emotional exhaustion, depersonalization, and low scores of personal accomplishment were, respectively, 57%, 44%, and 56%. In the univariate linear analysis, age younger than 35 years (p = 0.014), being in residency training (p = 0.004), not having extra professional activities (p = 0.009), having an experience less than 10 years (p = 0.02) and estimating vacation time as not adequate (p = 0.05) were all significantly associated with increased burnout scores. In the multivariate analysis, only age

Background: Lung cancer is a public health problem in Morocco. Multiple clinical practice guidelines recommend rapid evaluation of patients with suspected lung cancer. It is uncertain whether delays in diagnosis and management are correlated with outcomes. The objective of this study was to evaluate if these delays have any negative effect on outcomes. Methods: This retrospective study included 140 patients diagnosed with non-small cell lung cancer (NSCLC). It was conducted at the Medical Oncology Department of Fez from January 2016 to December 2017. We have studied many wait times and considered that: wait time to consult (WTC) is the delay from the first symptom to initial consultation, wait time to diagnosis (WTD) is the delay from initial consultation to diagnosis, wait time to referral (WTR) is the delay from diagnosis to referral to the oncologist, and wait time to treatment (WTT) is the time from referral to treatment initiation. Our analysis used Kaplan–Meier method to estimate the overall survival (OS). To compare the OS between wait time categories, we used the logrank test. Results: The median age was 59.46 years. The sex ratio was 6 men for 1 woman. The most common histological subtype was adenocarcinoma (58.6% of cases). Eighty-two percent of patients were diagnosed at stage IV. The median WTC was 240 days (range, 15–280 days), WTD was 45 days (13–65), WTR was 54 days (13–63), and WTT was 32 days (12–40). The only factor that was associated with a long WTD was long distance (> 60 km) to the hospital (p = 0.05). We found that short WTC, WTD, and WTR had better OS: 12 versus 3 months (p < 0.0001), 12 versus 4 months (p < 0.0001), and 14 versus 5 months (p < 0.0001), respectively. We found no difference in OS between short and long WTT. Conclusion: In our study, patients with lung cancer experience significant delays from development of symptoms to first treatment initiation. We found a clear association between survival and short delays from initial symptoms to consultation, from consultation to diagnosis, and from diagnosis to referral to the department of oncology.

The main objective of this study is to describe the association between the consumption of either traditional or modern dairy products or calcium intakes and the risk of colorectal cancer (CRC) in the adult Moroccan population. A case–control study was conducted in five Moroccan hospital centers. The study was matched on sex, age (± 5 years) and center. Data were collected using validated food frequency questionnaire (FFQ) taking into account different types of Moroccan dairy products. Conditional logistic regression models were used to assess the association between dairy products consumption, calcium intakes and CRC risk subtypes. In all statistical tests, the significance level was set at 0.05. Among 1453 cases and 1453 matched controls, 50.7% were women and 49.3% were men. Milk ORb 0.84, 95% CI 0.74–0.96 and yogurt ORb 0.74, 95% CI 0.64–0.86 were inversely associated with CRC risk. Similar inverse associations were observed for traditional dairy products namely Lben ORb 0.77, 95% CI 0.67–0.88, Raib ORb 0.86, 95% CI 0.76–0.96 and Jben ORb 0.77, 95% CI 0.67–0.88. The dairy calcium intake was inversely associated to CRC overall ORb 0.83, 95% CI 0.74–0.93. Our study supports previous international evidence and suggests that individuals who have a high intake of either modern or traditional dairy products are at lower risk for CRC. These findings should be further confirmed by longitudinal data and studies investigating potential pathways involved.

Rectal gastrointestinal stromal tumors are rare and optimal treatment is yet to be defined. The aim of this report is to highlight the possible aggressive behavior of four cases of rectal GISTs treated with neoadjuvant imatinib in a tertiary care medical hospital.Four cases of rectal GISTs were retrospectively reviewed for patients demographics, clinical presentation, histology, and imatinib therapy.GISTs were common in men. Age ranged to symptoms were nonspecific. All cases were initially considered to have locally unresectable. Patients received preoperative imatinib. Course was unfavorable. 3 patients died of progressive disease, and one from infectious complications.Rectal GISTs may be aggressive and resistant to medical treatment. Thus only early diagnosis may offer the best chance of recovery.Rectal - gastrointestinal stromal tumor - neoadjuvant imatinib - resistance.

Background: Colorectal cancer is the first cause of cancer death in developed countries. Although colon and rectal cancers are frequently grouped as a single disease entity, these malignancies have important differences in treatment approaches ; The preoperative radio-chemotherapy combination has become the standard for tumors of the middle and lower rectum, improving local control. But unlike colon cancer, currently there is no compelling evidence of the benefit of adjuvant chemotherapy in rectal cancer. This study examines the role of adjuvant chemotherapy after a neoadjuvant treatment and chirurgy in localy advanced rectal cancer, especially in poor responders to neoadjuvant therapy. Patients and Methods: Using the medical files collected at the medical oncology department at the Hassan II Hospital Center in Fez , Morocco; patients with rectal cancer diagnosed in 2014 through 2019 who received neoadjuvant CRT(concomitant radio chemotherapy) and surgery with or without AC(adjuvant chemotherapy) were identified. Kaplan-Meier analysis, log-rank tests were used to assess survival. Results: A total of 90 patients were identified; 70 received AC and 20 did not (observation [OBS] group). Median overall survival(OS) of the general population was 40 months, CI 95% = [25-56], the median disease-free survival (DFS) was 17 months,CI 95% = [7-26]. In the analysis of survival according to the ypT and ypN subgroups: the median OS in the ypT1-2 and ypN0 subgroup was higher than in the ypT3-4 or ypN + group (40 months vs 33 months and 44 months vs. 31 consecutive months); DFS was also better in the ypT1-2 and ypN0 group (29 months vs. 11 months (p = 0.05) and 29 months vs. 13 months respectively).The median OS was 40 months for AC and 23 months for OBS (p = 0.036), by against there was no significant improvement in recurrence-free survival. Conclusions: In this population of patients with LARC (localy advanced rectal cancer) treated with neoadjuvant CRT and surgery

Background: The coronavirus disease 2019 (COVID-19) pandemic presents serious challenges to cancer care because of the associated risks from the infection itself and the disruption of care delivery Therefore, many professional societies have published recommendations to help manage patients with cancer during the current pandemic The objective of our study is to assess the national responses of Middle East North Africa (MENA) countries in terms of publishing relevant guidelines and analyse various components of these guidelines Methods: A survey based on the preliminary review of the literature regarding cancer care adaptations has been developed and then completed by a group of oncologists from the following Arab countries affected by the pandemic: Algeria, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Saudi Arabia, Syria, Tunisia, United Arab Emirates and Yemen The survey inquired about COVID-19 cases, national recommendations regarding general measures of COVID-19 prevention and patient care in oncology as well as their implementation about cancer care adaptations during the pandemic Results: Analysis of the COVID-19 pandemic-related guidelines revealed at least 30 specific recommendations that we categorised into seven essential components All included countries had national guidelines except one country Estimated full compliances with all specific category recommendations ranged from 30% to 69% and partial compliance ranged from 23% to 61% Conclusion: There is a very good response and preparedness in the Arab Middle East and North Africa region surveyed However, there are inconsistencies in the various components of the guidelines across the region, which reflects the evolving status of the pandemic in each country as well as the lack of clear evidence-based guidelines for many of the issues in question There is a need for a clear framework on essential components that should be included in these guidelines to assure providing the best guidance to the oncology community Copyright: © the authors;licensee ecancermedicalscience This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons org/licenses/by/3 0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited

Background: Available treatments for metastatic RCC (mRCC) are usually non-curative. In the last decade, novel targeted therapies have significantly improved mRCC outcome. The objective in this study was to describe outcomes in patients with mRCC in Morocco.Methods: 100 patients with mRCC were recruited between January 2008 and December 2018 in the Hassan II University Hospital of Fez. Data were retrospectively collected. Kaplan-Meier survival analysis was used to determine overall survival (OS) and progression free survival (PFS).Results: Mean age of the patients was 58.6 years(±12). Sixty seven percent of patients were male. Clear cell carcinoma was the most common histological subtype (78%). According to the IMDC scoring, 72% of patients were in the intermediate and 18% in the poor risk groups. Seventy patients received targeted therapy. Overall response rate (according to RECIST criteria version 1.0) was 38.6%. The median PFS was 7.0 months (95% CI, 4.6 to 9.4). The median OS was 11.6 months (95% CI, 7.9 to 15.3). In the multivariate analysis, cancer specific mortality was impacted by treatment with VEGFR inhibitors (HR: 0.2; 95% CI, 0.1 to 0.4; p =0.001) and IMDC score (intermediate risk group HR: 3.5 (95% CI, 1.4 to 9.1; p =0.009); and poor risk group HR: 5.5 (95% CI, 1.9 to 16.1; p =0.002)).Conclusion: This is the first report from clinical practice in an African country of OS data in mRCC. The study showed high mortality rates. However, outcomes of VEGFR inhibitors are consistent with studies investigating these treatments.

Traditionnellement, 80% des tumeurs du rein sont decouvertes par la triade classique: hematurie macroscopique, lombalgie et masse du flanc, et 30 a 40% des patients se presentent avec une maladie locale avancee ou des metastases. Parfois, on peut decouvrir le cancer d'une maniere fortuite ou revelee par un syndrome paroplasique tel que l'hypercalcemie, l'anemie et plus rarement la polyglobulie. Cet article rapporte un cas de carcinome a cellule renales associant une hypercalcemie et une polyglobulie.

Background: Gastric metastases due to ovarian carcinoma are extremely rare and the patients' prognosis is poor. We report a case of gastric ovarian cancer metastases revealed by gastrosplenic perforation. The secondary gastric tumor appeared seven years after the diagnosis of primary cancer.Case presentation:The patient is a 71-year-old woman with a serous ovarian cancer hospitalized for asthenia with digestive hemorrhage. At esophagogastroduodenoscopy, a protruding mass was noted at the level of the gastric antrum. She underwent a hemostasis of an endoscopic hemostasis by argon plasma; with effective hemostasis. The final pathology revealed gastric metastases of serous ovarian adenocarcinoma. Weekly gemcitabine chemotherapy was adopted, but the disease progressed rapidly. The patient died 4 months later.Conclusion:We have reported a case of gastric metastasis of ovarian tumor origin revealed by digestive hemorrhage. This work reiterates that this secondary localization of this cancer is possible although extremely rare. Studies are still needed to elucidate much of this unclear situation.

Singnet ring cell carcinoma of the breast is a rare and aggressive tumor. We report the case of a 44-year-old woman with signet ring cell carcinoma of breast who was treated in the gynecology and medical oncology departments of HASSAN II Hospital University in Fez. She received a neoadjuvant chemotherapy with the anthracyclines and taxanes. After she had radical mastectomy and radiotherapy. Currently she has remained in good control.

Pulmonary epithelioid hemangioendothelioma (PEH) is a rare vascular tumor of borderline or low-grade malignancy, Vascular endothelial growth factor (VEGF) and the VEGF receptor were found on PEH tumor cells, suggesting that target therapies that block VEGFR have a logical base in this rare malignancy. We report a 25 years old woman with a pulmonary hemangioendothelioma, treated with pazopanib, the only anti angiogenic registered agent for sarcoma, with clinical improvement of symptoms and durable stabilization for more than two years of lung tumor.

Ovarian rhabdomyosarcoma is extremly rare and the diagnosis might be a real dilemma clinically and histologically. We report here the case of a 19-year-old patient, who presented a progressive increase of the abdominal volume associated with dyspnea and general conditions deterioration. The pelvic MRI showed bilateral ovarian masses associated with peritoneal carcinomatosis. CA125 was elevated (273u/ml) while other markers including bHCG, inhibine, AFP were normal. Simultaneously, the patient developed a cutaneous lesion in the thenar's lodge of the right hand rapidly increasing volume, painful and necrotic. The MRI of the right hand showed a large necrotic tissue mass of the right thenarian lodge without bone involvement which may correspond to a secondary localization. Cutaneous biopsy was performed and revealed a skin localization of undifferentiated malignant tumour and IHC analysis were compatible with alveolar rhabdomyosarcoma. After these findings, an exploratory laparotomy was performed and revealed the presence of two bilateral ovarian masses with ascites of great abundance and large dissemination of carcinomatosis nodules. Several biopsies were performed and the histological analysis with IHC have confirmed the diagnosis of ovarian rhabdomyosarcoma (desmin, myogenin, myoD1 were positive). The patient received chemotherapy based on: vincristine, adriamycin and cyclophosphamide with peritoneal and thenar progression after 6 cycles. Patient refused hand amputation and was proposed for radiotherapy. A second line chemotherapy with etoposide and ifosfamide was established.

Drug-induced immune thrombocytopenia may occur secondary to several chemotherapeutic agents or new targeted monoclonal antibodies, but thrombocytopenia induced by trastuzumab is a very rare occurrence. We report a case of severe thrombocytopenia related to the first administration of a biosimilar trastuzumab, trastuzumab rechallenge was undertaken with the reference trastuzumab without other problems.

Introduction Women with breast cancer eligible for neoadjuvant therapy (NAT) present a disorder of biopsychosocial variables and alteration of their quality of life. They cope with this changing by adopting psychological adjustment strategies, either passive or active. This systematic review aims to investigate the psychological distress, coping strategies, and quality of life in breast cancer patients under neoadjuvant therapy. Methods Cochrane Library, PubMed, ScienceDirect, Scopus, Web of Science, and Wiley Online library represent the databases that were searched to identify relevant published articles until September 27, 2021. Full-text published articles, written in English and assessing the main outcomes (namely: psychological distress, coping strategies, and quality of life) in women with breast cancer under NAT will be included. Also, we will integrate papers dealing with the related bio psychosocial variables to the main variables. The paper selection, data extraction, and quality assessment of selected studies will be performed independently by two researchers, and disagreements will be resolved through discussions. We will bring together the results of all of the included studies to draw conclusions based on the body of evidence. The narrative approach will be adopted to analyze the results and conclusions extracted and we would perform quantitative groupings if we have similar data. Ethics and dissemination Ethical approval is not required as the proposed systematic review will not use primary data. The results of this review will be disseminated through publication in a peer-reviewed journal and conference presentation(s). PROSPERO registration number: CRD42021230300.

Primary Ewing sarcoma (ES) and primitive neuroectodermal tumor (PNET) are considered as Ewing sarcoma family of tumors (ESFT), characterized by chromosomal translocation t(11; 22) (q24; q12) leading to a chimeric transcript EWS-FLI1 in 85% of cases. It typically involves the soft tissues of the chest wall, pelvis, paravertebral region, abdominal wall, retroperitoneal region and extremities in children, adolescents and young adults. It rarely occurs in the female genital tract. We report an extremely rare case of advanced vulvar Ewing sarcoma/PNET of the vulva confirmed by Fluorescence In Situ Hybridization (FISH) in a 30-year-old woman. The patient was treated by 6 cycles of chemotherapy followed by radiotherapy with favourable outcome.

Triple-negative breast cancer (TNBC) is a heterogeneous subtype of breast cancer that is defined by negative estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status. Treating patients with TNBC remains clinically challenging, as patients are not candidates for endocrine or HER2-directed therapy. As a result, chemotherapy with traditional agents such as anthracyclines and taxanes remains the only available option with moderate success. Recent discoveries have revealed that TNBC is a heterogeneous disease at the clinical, histological and molecular levels. The use of biomarkers to identify distinct subsets of TNBC that derive the greatest benefit from presently approved as well as novel therapeutics has become the main focus of current research. The aim of this review is to explore the clinical and biological complexity of TNBC as well as identify novel therapeutic options that target the various molecular subsets of TNBC.

Renal cell carcinoma (RCC) is known as a highly aggressive malignancy with frequent metastasis that the major sites being lungs, lymphatic ganglions, bones, liver and brain. Cutaneous metastasis is uncommon with only a few reported cases in the literature. We report a case of a women patient aged 49 years old with RCC who underwent nephrectomy and 8 months previously, she consulted the dermatological service due to the development of recent skin lesions that had been diagnosed as cutaneous metastasis of her RCC. The treatment has associated surgical excision and systemic therapy based on sunitinib.

Background: Tumor-related leukocytosis is a paraneoplastic syndrome that is encountered occasionally in the clinical course of patients with lung carcinoma. The aim of this study is to evaluate the prognostic significance of leucocytosis in patients with metastatic non small cell lung carcinoma. Methods: We retrospectively reviewed 205 cases of metastatic non small cell lung carcinoma diagnosed between January 2007 and December 2012 at the department of medical oncology, Hassan II University Hospital of Fez, Morocco. Clinical and laboratory data were collected including white blood cells at baseline. Leucocytosis was studied in relation to overall survival and progression free survival. Results: The frequency of leucocytosis was of 57.5%. Patients with leucocytosis had shorter overall survival (OS, p = 0.015) and disease-free survival (DFS, p 0.0001) than those without leucocytosis. In multivariable analysis, patients with leucocytosis had a significantly greater risk of death and recurrence than those without leucocytosis. Conclusion: Leucocytosis was valuable for predicting the prognosis of patients with metastatic non small cell lung carcinoma.

The cancerous teratoma of the ovary is a rare entity. We report the case of a 57-year-old woman post menauposal with malignant transformation of ovarian mature teratoma who was treated in the gynecology and medical oncology departments of CHU HASSAN II in Fez. The patient underwent bilateral adnexectomy and a total hysterectomy with omentectomy. The evolution was marked by the appearance of carcinomatosis nodules postoperatively. She received chemotherapy with platinum and taxanes .she had complete remission after 6 cycles and has remained under good control at present.

Le syndrome neurologique paranéoplasique (SNP) est caractérisé par l'apparition aigue et subaigue d'un syndrome neurologique associé à un cancer actif ou infraclinique. C'est une manifestation rare dont le diagnostic précoce modifie le pronostic neurologique et carcinologique. Parmi les SNP on distingue la dégénérescence cérébelleuse subaiguë souvent associée à un cancer gynécologique ou mammaire. Nous rapportons le cas d'une patiente de 50 ans suivie pour un adénocarcinome d'ovaire opéré et dont la récidive s'est révélée par une dégénérescence cérébelleuse subaiguë avec des AC anti Yo positifs.

La dermatomyosite est une maladie systémique idiopathique, associant une double symptomatologie cutanée et musculaire. La maladie fait partie de dermatose paranéoplasique. L’association de la dermatomyosite à un cancer rectal est rarement décrite dans la littérature. Nous présentons un cas d’une patiente atteinte de dermatomyosite paranéoplasique associé à un adénocarcinome rectal métastatique, et qui a présenté une symptomatologie clinique typique d’une dermatomyosite paranéoplasique, confirmée par les autres examens complémentaire (taux de créatine phosphokinase (CPK) + EMG (électromyogramme) + biopsie cutanée). La patiente était mise sous chimiothérapie, mais après sa deuxième cure, la patiente a présenté une aggravation rapide de son état général, décédée en quelque jours dans un tableau de défaillance multi-viscérale. Notre objectif est d’illustrer le caractère agressif de la dermatomyosite paranéoplasique et de faire une mise au point des connaissances actuelles concernant la place de la chimiothérapie dans la dermatomyosite néoplasique.

Background: COVID-19 pandemic presented serious challenge to oncology care due to the associated risks form infection and from disruption of care delivery Therefore, many professional societies published recommendations to help manage cancer care during the crisis The objective of our study was to assess the national responses of MENA countries in terms of publishing relevant guidelines and analyse various components of these guidelines Methods: A survey based on literature review regarding cancer care adaptation was developed then completed by senior oncologists representing the following countries: Algeria, Egypt, Iraq, Jordan, Kuwait, Lebanon, Morocco, Oman, Saudi Arabia, Syria, Tunisia, UAE and Yemen The survey queried about instructions of the national recommendations regarding (1) general measures of COVID-19 prevention in oncology, (2) cancer care adaptations during the pandemic Results: Analysis of the guidelines revealed 31 essential recommendations categorized into seven essential components with specific recommendations for each component These components are patients’ management, health care workers (HCW) management, facility management, testing for COVID-19, measures to reduce hospital visits, measures to reduce complications, and site-specific recommendations The table showed compliance of these guidelines with having the required components and relevant recommendations [Formula presented] Conclusions: There is inconsistency in the components of the guidelines across the region, which may reflect the evolving nature of the pandemic and lack of clear evidence for many issues in question There is a need from clear framework on essential components to be included in the guidelines to assure providing the best guidance to the oncology community Editorial acknowledgement: On behalf of the International Research Network on COVID-19 Impact on Cancer Care (IRN-CICC) Legal entity responsible for the study: The authors Funding: Has not received any funding Disclosure: M A M A AlNassar: Research grant/Funding (institution): Roche A Jazieh: Research grant/Funding (institution): MSD All other authors have declared no conflicts of interest

Desmoid tumors are rare benign neoplasms with an aggressive local growth. In children, intra-abdominal localization is less frequent and few reports exist in the literature about the management of DTs in those special patients. In our report, we describe a case of a 13-year old patient with a bifocal intra-abdominal DT, treated unsuccessfully with tamoxifene, and we discuss briefly the existing literature data.

Background Breast cancer is the most common cancer in women worldwide. In the Moroccan context, the role of well-known reproductive factors in breast cancer remains poorly documented. The aim of this study was to explore the relationship between menstrual and reproductive factors and breast cancer risk in Moroccan women in the Fez region. Methods A case–control study was conducted at the Hassan II University Hospital of Fez between January 2014 and April 2015. A total of 237 cases of breast cancer and 237 age-matched controls were included. Information on sociodemographic characteristics, menstrual and reproductive history, family history of breast cancer, and lifestyle factors was obtained through a structured questionnaire. Conditional logistic regression models were used to estimate odds ratios and 95% confidence intervals for breast cancer by menstrual and reproductive factors adjusted for potential confounders. Results Early menarche (OR = 1.60, 95% CI: 1.08–2.38) and nulliparity (OR = 3.77, 95% CI: 1.98–7.30) were significantly related to an increased risk of breast cancer, whereas an early age at first full-term pregnancy was associated with a decreased risk of breast cancer (OR = 0.41, 95% CI: 0.25–0.65). Conclusion The results of this study confirm the role of established reproductive factors for breast cancer in Moroccan women. It identified some susceptible groups at high risk of breast cancer. Preventive interventions and screening should focus on these groups as a priority. These results should be confirmed in a larger, multicenter study.

Gastric cancer constitutes one of the leading causes of cancer incidence and mortality in the worldwide despite its decline over the past century. In this article we will first review descriptive epidemiology of gastric cancer. Next we will discuss its precursors and risk factors; the principal risk factors of stomach cancer are HP Infection, smoking, high salt intake and genetic factors. Finally we will discuss screening strategies and prevention of gastric cancer.