BackgroundRenal cell carcinoma is the third most common tumor that metastasizes to the head and neck, after breast and lung carcinomas. Tongue metastasis as an initial presentation of renal cell carcinoma is extremely rare, and very few cases have been reported. The prognosis is poor. We present a rare case of metastatic renal cell carcinoma that initially presented as a tongue lesion.Case presentationWe report the case of a 55-year-old white man who presented with a large exophytic lesion on his tongue. A biopsy was taken, and pathologic examination showed a poorly differentiated carcinoma including a sarcomatoid component. Subtotal glossectomy with neck dissection were planned, but a positron emission tomographic-computed tomography scan showed a left kidney mass. Immunohistochemical evaluation of the tongue lesion was performed, and it was compatible with metastasis from primary renal cell carcinoma. The biopsy of the renal lesion showed a high-grade unclassified renal cell carcinoma. Although our patient underwent systemic therapy, he died of hemorrhagic complications 3 months after the initiation of therapy.ConclusionTongue lesions require a complete assessment to distinguish a metastasis from a primary cancer in order to give the appropriate treatment.
Background Moroccan incidence of cancer is increasing with the lengthening of life expectancy. Data regarding elderly Moroccan cancer patients are lacking. In the context of our project aiming to develop an adapted version of the Comprehensive Geriatric Assessment CGA to the Moroccan population, we launched the first Moroccan multicenter transverse study to explore the characteristics of elderly Moroccan cancer patients. Methods The study was conducted in nine Moroccan medical oncology departments. Patients were enrolled over 4 months. Inclusion criteria were patients aged 65 years or over with verified solid cancer. The questionnaire included four sections: socio-demographic and economic data, clinical data, vulnerability and EORTC-QLQ C30. We explored the entire included population. Then, we compared the results according to age (65–70 years old and ≥ 71 years old) and sex. We also explored the correlation between G8 scores and the ability to practice religion as an indicator of fitness level. Results In total, 164 patients were enrolled. The mean age was 73.18 ± 6.01 years. The majority of patients were married, lived with their children and received their financial income from them. Fifteen percent of families asked to hide the diagnosis from the patient. Breast (23%), colorectal (15.9%) and lung (14%) cancers were the most frequent, and 83.5% had an abnormal G8. The majority of the patients were independent for basic daily activities. Female patients had poorer social and economic conditions. Abnormal G8 was correlated with religious practice and quality of life scores. Conclusion This is the first multicenter prospective study designed to collect data on the lifestyle and clinical profiles of elderly Moroccan cancer patients as an Arab and Muslim population. Our study shows that it is a well-cared-for population with strong social ties. However, there is deep economic vulnerability, especially among women, requiring urgent care. Religious practice is an important daily activity for our elderly patients and should be included in the Moroccan CGA.
Acute pancreatitis is an inflammatory disorder of the pancreas characterized by upper abdominal pain, nausea, and vomiting, with elevated serum amylase or lipase. Gallstones and alcohol are the two main etiologies; drug-induced pancreatitis is uncommon. Paclitaxel associated with pancreatitis is very rare and since that time, only seven case reports have been published. We report a case of a 54-year-old female who developed an acute pancreatitis after administration of the first cycle of neoadjuvant chemotherapy with paclitaxel (175 mg/m over 3 h) and carboplatin (AUC 6) for ovarian adenocarcinoma. After conservative management, pancreatitis was resolved. The patient received an additional five cycles of carboplatin with no complication. Because Paclitaxel is used in many chemotherapy protocols, it is important for clinicians to be aware that paclitaxel can induce acute pancreatitis, as early diagnosis can be vital.
Background: Gastric cancer represents the fifth most common tumor and the thirdleading cause of cancer-related death worldwide. The results of surgical treatment of locally advanced gastric cancer remain generally poor due to the high rate of relapse after surgery. In the last decade, neoadjuvant chemotherapy has become the standard of care for patients with stage IB resectable advanced gastric cancer. The benefit in progression-free and overall survival was confirmed by several randomised trials and meta-analyses compared to immediate surgery. However, data in the "reallife" setting are rare. We conducted a retrospective study to clarify the question of whether this benefit is achievable under real-life conditions.Methods: Our retrospective study concerned patients with histologically-confirmed advanced gastric cancer clinical stage II-IIIc according to UICC (8th edition) treated at the University Hospital of Marrakech between January 2017 and December 2018. They received 2-4 cycles/3 weeks of neoadjuvant chemotherapy based on FLOT, FOLFOX, XELOX, EOX or 5FU-Cisplatin protocols.Results: 48 patients with a median age of 56 years were diagnosed with advanced gastric cancer. 67% of them are male were. Only 16 patients (33,3%) had received neoadjuvant chemotherapy and 19 were operated immediately (39,5%). Protocols used in perioperative were FLOT in 8 patients (50%) and FOLFOX in 4 patients (25%). The rest have received either EOX (1 patient), XELOX (2 patients) or 5FU-cisplatin (1 patient). 7 patients (43,75%) received 4 cycles of neoadjuvant chemotherapy. Side effects were represented by mycosis grade 2 in 2 patients, neutropenia grade 2 in 4 patients and only one patient had grade 3 toxicity. After neoadjuvant chemotherapy, we observed 3 cases of partial response and 4 of stable disease. 5 patients (31,25%) underwent surgery (R0 in all cases) by total gastrectomy and D2 lymphadenectomy. 68,42% of the group who did not receive neoadjuvant chemotherapy, were treated by concomitant chemoradiotherapy. The median overall survival in the neoadjuvant group was 21 months compared to only 12 in the second group. Conclusion:Despite the small number of patients treated, our analysis showed that selected patients with locally advanced adenocarcinoma can be safely managed with perioperative chemotherapy in daily clinical practice and our results confirm the survival benefit of perioperative treatment. abstracts Annals of Oncology Volume 31 -Issue S3 -2020 S191
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