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Endometrial cancer is the most prevalent genital tract cancer in occident and the third most common cancer among women in Tunisia. It is dominated by carcinoma. The identification of prognostic factors allows a better understanding of its outcome and guides its therapeutic approach. We propose to describe the clinicopathological features and identify the histoprognostic factors of this cancer. It is a retrospective analysis of a series of 62 total hysterectomy specimens with bilateral salpingo-oophorectomy from women with primary carcinoma of the endometrium, colligated in Anatomy Laboratory and Pathology Salah Azaiz Institute of Tunis over a period of 5 years, from January 2003 to December 2007. The median age was 60 years. At the time of diagnosis, 25% of patients were nulliparous and 86% were menopaused. The endometrioid adenocarcinoma was the most common, accounting for 84% of cases (5% of them were grade 3). A myometrial invasion superior or equal to 50% was observed in 40% of cases. 42% of cases were classified as stage IA, 14% in stage IB, 16% in stage II, 18% stage III and 10% in stage IV. 22% of patients had nodal involvement. Overall survival at 5 years was 81%. In multivariate analysis, stage IV, nodal involvement and brachytherapy have influenced this rate. Event-free survival at 5 years was 71%. It was directly related to stage and nodal involvement. Stage, histological type, tumor grade, invasion of more than half of the myometrium and lymph node involvement were the most important adverse prognostic factors, dictating an appropriate management of these tumors.

A novel decavanadate compound, Mg(H2O)6(C4N2H7)4V10O28·4H2O, was synthesized by slow evaporation at room temperature and characterized through single crystal X-ray diffraction, SEM-EDX, IR spectroscopy. The compound crystallizes in a monoclinic system, P21/n space group with a=10.661(5) A, b=21.256(9) A, c=10.767(5) A, β=102.82(4), Z=2 and a volume of 2379.13(2) A3. The compound structure consists of centrosymmetric decavanadate groups, Mg(H2O)6 polyhedral, (C4N2H7)+ cations and water molecules linked through N-H…O and O-H…O hydrogen bonds. The three-dimensional Hirshfeld surface (3D-HS) and the relative two-dimensional fingerprint plots (2D-FP) revealed that the structure is dominated by H…O/O…H and H…H interactions. When injected to mice by intraperitoneal route, Mg(H2O)6(C4N2H7)4V10O28·4H2O showed toxicity only at a high dose (5 mg/kg), as revealed by clinical and biochemical results, as well as histological examination of mice's liver and kidney. Interestingly, the synthetic compound inhibited the growth of three invasive cancer cell lines; U87 (glioblastoma), IGR39 (melanoma) and MDA-MB-231(triple negative breast cancer) by a dose dependent manner with an IC50 values of 2 µM for both U87 and MDA-MB-231 cells and 3 µM for IGR39 cells. Therefore, we could consider that Mg(H2O)6(C4N2H7)4V10O28·4H2O opens up a window toward the conception of potential organo-metalic dugs with antitumoral properties.

Glassy cell carcinoma is a rare neoplasm that occurs most frequently in the uterine cervix. We describe the second reported case of glassy cell carcinoma arising in the vagina. We present a case of a 24-year-old woman with a history of post-coital bleeding associated with menometrorrhagia. Different explorations have concluded in a glassy cell carcinoma arising in the vagina, with clinical staging III according to the International Federation of Obstetrics and Gynecology. The patient received three cycles of neoadjuvant chemotherapy with a good response. Then she had a para-aortic lymphadenectomy and ovarian transposition. Following the surgery, she had radiotherapy. The gynecological examination showed no budding lesion and the biopsy was negative. Six months later, the patient complained of a pelvic pain. The examination revealed a locoregional recurrence. Surgical revision was not possible and the patient was a candidate for a palliative chemotherapy. Although, glassy cell carcinoma runs an aggressive clinical course, an early diagnosis may help in a more effective management and offer a better prognosis.

Currently we observe the emergence of different infectious diseases, whose remedies are not available. On the other hand, an increasing number of potential applications for polyoxometalates in human medicine have been reported in the literature. In the present study, we have synthesized an hexa [4-methylimidazolium] decavanadate trihydrate, (C4H7N2)6V10O28·3H2O for an eventual therapeutic application. The structure of this compound has been characterized by: crystal X-ray diffraction, Infrared (IR) spectroscopy and Scanning Electron Microscopy (SEM) with Energy Dispersive X-Ray Analysis (EDX). Single-crystal analysis indicates that the formula unit is composed of one decavanadate [V10O28]6- anion, six 4-methylimidazolium [C4H7N2]+ cations and three water molecules. The cohesion is provided by N H⋯O, O H⋯O hydrogen bonds, and Van der Waals interactions leads to a three-dimensional structure. In the crystal, organic cations are linked by π-π interactions (inter-centroid distance = 3.693 A). The Hirshfeld surface (HS) and their relative two-dimensional fingerprint plots (2D-FP) reveal that the structure is dominated by O…H/H…O (40.9%) and H…H (29.1%) contacts. Analysis of hepatic enzymes activities, lipid profile and liver histologic examination, showed that high doses of (C4H7N2)6V10O28·3H2O are safe when injected into mice, suggesting that it could be used as a potential therapeutic molecule.

Objectif de l’etude La radiotherapie adjuvante est indiquee dans la majorite des carcinomes conjonctivaux etant donne leur risque eleve de rechute postoperatoire. L’objectif de cette etude etait d’evaluer les resultats de la radiotherapie de contact dans le traitement des carcinomes conjonctivaux. Materiel et methode Nous avons revu retrospectivement les dossiers cliniques des patients traites dans le service de radiotherapie de l’institut Salah-Azaiz par irradiation de contact pour des carcinomes conjonctivaux, entre janvier 1990 et decembre 2015. Nous avons releve les caracteristiques clinicopathologiques de ces tumeurs, les modalites therapeutiques, le controle de la maladie et la tolerance du traitement. Resultats Vingt-deux patients ont ete inclus dans notre etude, dont 18 hommes et 4 femmes. L’âge median etait de 54 ans (extremes : 20–84 ans). Le diametre median de la tumeur etait de11 mm (extremes : 6–20 mm). L’epaisseur mediane de la tumeur etait de 4 mm (extremes : 1–15 mm). Il s’agissait d’un carcinome epidermoide dans tous les cas. Tous les patients ont d’abord ete operes, avec des marges d’exerese de moins de 2 mm. L’energie de photons X utilisee etait 60 kV dans 16 cas, 80 kV dans quatre cas et 100 kV dans deux cas. La dose d’irradiation mediane delivree dans le lit tumoral etait 64 Gy (60–70 Gy). Quatre patients ont eu une association de radiotherapie de contact et de curietherapie par disque de strontium 90. Avec un recul median de 110 mois, deux tumeurs ont recidive localement. Le taux de controle local a 5 ans etait de 90,9 %. Les principales complications etaient la conjonctivite, le larmoiement, la cataracte et le glaucome. Conclusion La radiotherapie de contact reduit le risque de rechute postoperatoire des carcinomes conjonctivaux, avec une tolerance acceptable. Une etroite collaboration entre le chirurgien ophtalmologue et le radiotherapeute est necessaire pour garantir les meilleurs resultats therapeutiques.

Desmoplastic fibroblastoma is a benign, rare, slow-growing soft tissue tumor which is found in a wide anatomic distribution, predominantly in adult males. The characteristic gross aspect is that of a typical cartilage-like tumor which histologically presents regular fibroblastic proliferation, often in a stellar shape within a dense collagen or myxo-collagen stroma. We report a new case observed in the foot and study the anatomic and clinical aspects of this rare entity.

Introduction Le sarcome fibromyxoide de bas grade (SFMBG) ou tumeur d’Evans est un sarcome rare des tissus mous, de l’adulte jeune, caracterise par un potentiel metastatique assez tardif et un aspect morphologique anodin deroutant. Objectifs Mettre le point sur les particularites anatomocliniques, immunohistochimiques, moleculaires et evolutives du SFMBG. Determiner les parametres histopronostiques les plus significatifs correles au risque de rechute. Methodes Etude retrospective portant sur une periode de 20 ans (1994 a 2014) analysant 4 cas de SFMBG colliges au service d’anatomie pathologique de l’institut Salah-Azaiez avec une revue systematique de 404 cas de la litterature. Resultats Le SFMBG touchait surtout l’adulte jeune de sexe masculin. L’âge moyen etait de 35,5 ans. La localisation preferentielle etait la partie proximale des membres (64,2 %) suivie par la tete et le cou (6,7 %) avec un siege profond dans 66,5 % des cas. Le delai au diagnostic etait prolonge, de 4 ans et demi en moyenne pouvant atteindre 34 ans. La taille tumorale moyenne etait de 8 cm (de 1 a 30 cm) avec une taille > 5 cm dans 67 % des cas. L’aspect histologique etait classique dans 79 % des cas et sous forme de variante a rosettes geantes dans 21 % des cas. Dans la forme classique, des aspects histologiques inhabituels etaient notes focalement dans 21 cas (16 %) : 6 cas avec foyers de type fibrosarcome epithelioide sclerosant, 1 cas avec foyers type sarcome pleomorphe de haut grade et 1 cas presentant des plages de dedifferenciation a cellules rondes. A l’etude immunohistochimique, le marqueur MUC 4 etait positif dans 87,5 % des cas. En biologie moleculaire, le gene de fusion FUS/CREB3L2 ou FUS/CREB3L1 etaient retrouves dans 64,4 % ; 3,5 % des cas comportaient le gene de transcrit ESWR1/CREB3L1. L’evolution etait marquee par des recidives locales (30 %) apres un delai moyen de 66,5 mois, une progression metastatique (20,5 %) apres un delai moyen de 123 mois et deces (6,2 %). Les taux de SSE etaient respectivement de 58,5 % a 5 ans, 37,5 % a 10 ans et 17 % a 15 ans. En dehors, de l’index mitotique ( p = 0,000), de la presence de foyers de dedifferenciation et de la qualite d’exerese ( p = 0,044), aucun parametre histologique n’etait significativement correle au risque de rechute. Le delai moyen de rechute des patients avec exerese incomplete etait nettement plus court. La rechute tumorale ne constituait pas un facteur pronostique significatif predictif de deces des patients porteur de SFMBG ( p = 0,677). Discussion et conclusion Le SFMBG est une tumeur d’evolution lente, dotee d’un important potentiel de metastases a distance et de recidives locales tardives soulignant l’importance d’une surveillance prolongee des patients. Le principal facteur influencant l’evolutivite tumorale est la qualite d’exerese.

Mucinous tubular and spindle cell carcinoma is a rare and newly described type of renal cell carcinoma (RCC) with a relatively indolent behaviour. We report a case of 53-year-old woman who had macroscopic hematuria and flank pain. A right radical nephrectomy was performed showing a well circumscribed tumour confined to the kidney and measuring 17cm. The histologic findings consisted of tightly packed, small, elongated tubules separated by pale mucinous stroma. The tumour cells were cuboidal to spindled with eosinophilic cytoplasm and lower nuclear grade. Tumour was immunoreactive for cytokeratin CK 7, CK19 and epithelial membrane antigen (EMA). The morphological and immunohistochemical features were consistent with mucinous tubular and spindle cell carcinoma of kidney.

Background and aim: Cytopathological identification of circulating tumor cells (CTC) is a critical issue in non-invasive predictive oncology. However, in very rare cases, such as kidney cancers, the diagnostic value of cytology is weak. We thus planned to study the impact of genetic molecular analysis in combination with cytology in the CTC field. To this aim, we have taken advantage from the model of Clear Cell Renal Carcinoma (CCRC), which is characterized by the VHL genetic marker, and used genetic analysis in addition to the cytopathological study of CTC. Methods: We have treated by ISET the blood of 30 patients with CCRC, collected before surgery, to isolate circulating rare cells. Cytopathological analysis was performed blindly by 3 pathologists on the isolated cells to identify CTC and distinguish them from circulating cells with uncertain malignant features (CC-UMF) and from cells with benign features (CC-BF). CTC, CC-UMF and CC-BF were then individually microdissected. Single cells DNA was preamplified, amplified by VHL-specific primers and analyzed by sequencing. VHL-specific genetic analysis was performed blindly in microdissected cells and in the corresponding tumorous tissue. Results: We found CTC/ CC-UMF in 29/30 analyzed patients with CCRC. VHL mutations were found in the tumor of 25 out of the corresponding 29 CCRC tumors. Among 327 microdissected CTC/ CC-UMF, we obtained VHL-specific results in 205 including 64 CTC and 141 CC-UMF, according to the cytopathological analysis. VHL mutations were blindly detected in 57/64 CTC and in 125/141 CC-UMF. These results were analyzed according to the presence or absence of VHL mutations in the tumor tissue. Conclusion: This is the first study using single cell genetic analysis and cytopathology to study CTC in patients with CRCC. Our results show that genetic analysis is a very interesting approach potentially complementing cytopathology for the diagnosis of CTC.