Oral adjuvant hormone therapy for early breast cancer, despite its proven importance in terms of survival and prevention of recurrence, does not fall within the scope of clinical pharmacy programs set up for oral anticancer drugs, even though issues of therapeutic adherence have been clearly identified. The aim of our study was to explore the perception of healthcare professionals regarding the prescription and dispensing of this hormone therapy, in order to identify the risks for these patients and determine the clinical pharmacy actions that could address these risks.

Lipomas are mesenchymal neoplasms that affect the head and neck region in about 13% of cases. However, they are rarely reported in the pediatric population. We here report the case of a 6-month-old infant with no notable medical history, admitted for the management of a large left lateral cervical mass that had been progressing for 4 months. Ear, nose and throat (ENT) examination revealed a large left lateral cervical mass extending to the submental area, approximately 7cm in length, with no signs of compression. Cervical CT scan showed a fat-density mass, consistent with a lipoma. The patient underwent exploratory cervicotomy with excision of the mass. Histological analysis confirmed the diagnosis of lipoma. The clinical outcome was favorable, with no recurrence after 15 months of follow-up. Although rare in the pediatric population, cervical lipomas should be considered in infants with a cervical swelling. Its clinical manifestation is similar to that of a cystic lymphangioma.

The most common cancer in women is breast cancer (BC). MicroRNA-21 was one of the first oncomiRs to be found at elevated levels in a number of malignancies, including gliomas, BC, and colorectal cancer (miR-21). MiRNA is associated with processes such as apoptosis, invasion, metastasis, and proliferation, which are known features of cancer. This study aimed to investigate the molecular basis and clinical significance of miR-21 in BC, as microRNAs play a critical role in this disease.

The incidence of kidney cancer is rising. It is the 7th most common cancer in men and the 10th most common in women. Diagnosis is based on imaging (thoraco-abdominopelvic computed tomography scan +/- abdominal magnetic resonance) and histopathology. Clear cell carcinoma is the most frequently observed histological subtype. Management of localized kidney cancer involves surgery or ablative treatments. Active surveillance is indicated in the indolent oligometastatic setting with local treatment in case of localized progression. Apart from this specific situation, two first-line therapeutic strategies are recommended in the metastatic setting : a dual immunotherapy regimen or the combination of immunotherapy with an antiangiogenic tyrosine kinase inhibitor. Both combinations have demonstrated superior survival outcomes compared to sunitinib, the previous standard of care until 2019. Treatment selection should be individualized, considering the characteristics of the disease (histology, tumour burden, location of metastases and if they are threatening, speed of progression), potential side effects of the treatments, the patient's general health, comorbidities and preferences.

Leptomeningeal disease (LMD) from breast cancer is defined by the invasion of the leptomeninges and cerebrospinal fluid (CSF) by tumor cells. Historically associated with a very poor prognosis and survival measured in weeks, their management has evolved considerably. Therapeutic advances, such as the introduction of targeted therapies, and a better understanding of the pathophysiology of LMD now enable earlier diagnosis through dedicated MRI sequences and optimized CSF analysis. The EANO-ESMO classification notably distinguishes type I LMD (cytology-positive), which carries a worse prognosis but is more sensitive to intrathecal (IT) treatments, from type II LMD (negative or uncertain cytology), often more responsive to local-regional approaches like radiotherapy. Data from large retrospective cohorts highlight the importance of combination therapies: systemic treatments, IT injections, radiotherapy, as well as early symptomatic and palliative care. This multidisciplinary approach improves median survival, now reaching several months, and can even surpass 10 months in HER2+ cases. Innovative clinical trials, such as ETIC-LM (NCT05800275) - a French phase II study evaluating the combination of IT trastuzumab, oral tucatinib, and oral capecitabine offer encouraging new strategies for patient care. Although the prognosis remains poor, recent advancements suggest a more hopeful future, providing better disease control and improved quality of life for patients with LMD from breast cancer.

Multiple myeloma (MM) is a malignant bone marrow plasma cell dyscrasia, associated with the secretion of a monoclonal immunoglobulin (Ig). The purpose of this study is to describe the epidemiological, clinical, biological and prognostic features of a cohort of patients with multiple myeloma, whose data were collected at the Laboratory Department of Habib Thameur Hospital in Tunis. We conducted a retrospective descriptive study of patients with MM in the Laboratory Department of Habib Thameur Hospital in Tunis over a period of 10 years (2003-2023). Data collection and analysis were performed using patient records and Microsoft Excel 2010 software. A total of 60 patients were included, with a mean age of 67.61 ± 8.7 years and a male-to-female ratio of 0.76. Bone pain was the most common presenting symptom, occurring in 75% of cases. Radiological abnormalities were identified in 50 patients (83%), predominantly affecting the spine (57%). Laboratory tests showed anemia in 74% of patients, thrombocytopenia in 17% of patients, an elevated erythrocyte sedimentation rate (ESR) in 90% of cases. Myelogram confirmed the diagnosis in 70% of cases. The monoclonal immunoglobulin identified was IgG in 62% of cases, IgA in 22%, IgM in 2%, and light chain in 12%, one patient presented with biclonal MM. According to the Durie and Salmon classification, the majority of patients (74%) were diagnosed at stage III. This study provides a better understanding of the epidemiological, clinical, and biological characteristics of MM. Despite significant advances made over the past two decades, multiple myeloma remains a disease with a poor prognosis.

Plasma cell leukemia (PCL) is a rare lymphoproliferative disorder characterized by clonal proliferation of plasma cells in the bone marrow and peripheral blood. In 2021, the International Myeloma Working Group (IMWG) redefined LCP as the presence of 5% or more circulating plasma cells in patients otherwise diagnosed with multiple myeloma. In this work, we report five cases of PCL collected in the hematology laboratory of the Mohammed VI University Hospital in Oujda. The interest of this work is to elucidate the importance of hematological cytology in diagnostic guidance as well as therapeutic innovation concerning this rare pathology.

Female pelvic masses could be difficult to diagnose given the fact that there are so many structures within the pelvis that could be related to the mass. These benign or malignant neoplasms could be diagnosed through careful and systematic evaluation by history, biochemical, imaging, and surgical approaches. Although an ultrasound scan is often the first-line imaging modality for the evaluation of pelvic masses, it could be limited by poor acoustic windows and poor depth penetration. However, in low-resource settings, its usage is nonnegotiable. The case of a 26-year-old female with a 5-year history of lower abdominal swelling is hereby presented. The swelling was gradual in onset and associated with occasional dull lower abdominal cramps that radiate to the back, urinary retention, dysuria, and urinary frequency. An ultrasound scan diagnosed an ovarian mass and uterine fibroid with the suspicion of a bladder mass. She had a laparotomy, in which a left ovarian mass and a huge calcified pelvic mass extending from the region of the isthmus of the uterus through the posterior bladder wall and the anterior vaginal wall were discovered. Left ovariectomy and removal of the mass were done; a histologic diagnosis of mature ovarian teratoma and cervical fibroid was made. She had a smooth postoperative recovery on antibiotics and analgesics. The diagnostic challenge of pelvic masses even with the use of USS is demonstrated, and laparotomy has shown to be a diagnostic procedure here. Preoperative magnetic resonance imaging could be helpful when available and affordable.

The association of light-chain (AL) amyloidosis with type B follicular lymphoma is extremely rare, as the clone secreting the amyloidogenic light chain is generally plasmacytic. We here report the case of a 67-year-old patient with no specific pathological history, presenting with a deterioration in general condition, progressively worsening dysphonia and dysphagia, and a large mass in the cavum. Biopsy findings indicated grade 1-2 type-B follicular non-Hodgkin's lymphoma. Cervico-thoraco-abdomino-pelvic computed tomography (CT) scan revealed a nasopharyngeal mass measuring 70 mm x 40 mm and extending over 60 mm. Bone marrow biopsy and pre-therapeutic evaluations were normal. The patient received 4 cycles of rituximab plus CHOP (cyclophosphamide, adriamycine, prednisone and oncovin) with no response, followed by 3 cycles of rituximab plus DHAOX (dexamethasone, high-dose cytarabine and oxalipatin) with persistence of the mass. A subsequent biopsy of the mass revealed the disappearance of B-cell lymphoid infiltration but showed AL kappa chain amyloid deposits. Immunoelectrophoresis of plasma proteins detected the presence of IgM kappa immunoglobulin. Positron emission tomography (PET) imaging identified a hypermetabolic nasopharyngeal process. The patient is currently undergoing treatment with a protocol combining bortezomib, prednisone, and bendamustine.

Non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) still spark controversy regarding histological diagnostic criteria and therapeutic management.

West Guiana is characterized by a precarious, poor, dispersed population, exposed to infectious and chemical factors. Prostate cancer is the leading cancer in terms of incidence in men. We examined its characteristics, management and main exposomes in this context.

Radial scars (RS) are benign lesions, but their imaging appearance can mimic that of carcinoma. Traditionally, most RS were surgically excised due to the risk of underestimation. However, guidelines now exist allowing for their surveillance. The objective of this study was to evaluate the risk of underestimation and, secondarily, to identify associated risk factors, as well as to describe the proportion of women who developed breast cancer during follow-up.

Tobacco addiction is prevalent in South and Southeast Asia. This study aimed to assess upper gastrointestinal (GI) tract changes in smokeless tobacco (SLT) users through upper GI endoscopy (UGIE).

The detection of circulating tumor DNA (ctDNA) has made significant advances in oncology in recent years. ctDNA offers a range of applications, including the identification of theranostic mutations, monitoring of tumor recurrence, and assessing treatment efficacy. In breast cancer, several ctDNA-based tests for detecting relapse during follow-up are currently under validation, with some already available in countries like the United States. In metastatic breast cancer, ctDNA levels and their dynamics during treatment have prognostic value. The PADA-1 trial demonstrated that a therapeutic adaptation based on the detection of a circulating subclone via circulating tumor DNA (ctDNA) was feasible and potentially beneficial for patients. This review will explore the methods for ctDNA detection and discuss the potential benefits of incorporating this technology into breast cancer monitoring and management across various clinical scenarios.

This work describes a case of hepatocellular adenoma with β-catenin mutated discovered during imaging follow-up of hyperplastic regeneration nodules in patient with cirrhosis due to a a Budd-Chiari syndrome. This case highlights the importance of using imaging protocols in the follow-up of patients with hepatic vascular diseases to identify adenomas at an early stage and differentiate them from large regenerative nodules, as well as to provide a complete immunohistochemical profile of all biopsied hepatocellular lesions. Indeed, since the early 2000s, the identification of genetic alterations associated with immuno-histochemical markers has allowed the classification of hepatocellular adenomas into six molecular subtypes. Each subtype presents different histological, clinical, radiological and evolutionary characteristics, all important for the management of the lesion. Furthermore, the risk of malignant transformation of an adenoma is not limited to the subtype β-mutated catenin, lesion size and male sex, but hepatic vascular disorders also appear to be another major risk factor.

Neuroblastoma is a rare tumour originating from neural crest cells, primarily occurring in the adrenal glands and sympathetic ganglia, with prenatal diagnosis often complicated by the difficulty in distinguishing it from other foetal abdominal or paraspinal masses. We present a case of foetal neuroblastoma in a 26-year old woman who, at 36 weeks of gestation, experienced absent foetal movements, leading to ultrasound confirmation of foetal demise with associated effusions. An emergency caesarean section revealed a stillborn male foetus with a previously undetected encapsulated mass in the posterior mediastinum, which was confirmed as neuroblastoma through histopathological analysis. This case highlights the challenges in prenatal diagnosis, as the tumour went unnoticed despite routine imaging. It contributes to the limited literature on foetal neuroblastoma, underscoring the need for further research on effective management strategies.

Intracardiac masses may be revealed by an ischemic cerebrovascular accident (stroke). They are sometimes difficult to differentiate by echocardiography. Determining their nature is a crucial aspect of patient management. We here report the case of a 58-year-old man with untreated hypertension, active smoking, a history of psoriasis, chronic obstructive pulmonary disease (COPD) and a nodule in the left upper lobe suspected to be lung cancer. He was hospitalized for an ischemic stroke which was treated with thrombolysis, resulting in hemorrhagic transformation. Routine echocardiography revealed a large mass in the left atrium suggestive of intra-atrial myxoma. Histological examination of the surgical specimen confirmed the diagnosis. Left atrial myxomas can remain asymptomatic for a long time and may be revealed by systemic embolic complications. Echocardiography guides the diagnosis and anatomopathological examination confirms it. Management should be multidisciplinary.

Carcinosarcomas of the bile ducts are very rare tumors. Their diagnosis and management remain difficult. We here report the case of a patient in whom the diagnosis was suspected due to cholestatic jaundice associated with a deterioration in general condition. Biologically, bilirubin, alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) levels were elevated. Imaging showed a tumor in the head of the pancreas. Surgical exploration, tumor biopsy and anatomo-immunohistochemical study confirmed the biliary origin. The purpose of our case report is to highlight the difficulties in diagnosis and management as well as the importance of anatomopathological and immunohistochemical studies in confirming the diagnosis.

Hepatocellular carcinoma (HCC) is the most common primary malignant liver tumour, with a poor prognosis, ranking third for cancer mortality worldwide. HCC is a morphologically and molecularly heterogeneous tumour. This update aims to address this heterogeneity by describing the different histological and molecular subtypes of HCC. Morphologically, eight subtypes have been described according to the WHO classification: steatohepatitic, macrotrabecular massive (MTM), clear cell, chromophobe, scirrhous, fibrolamellar, lymphocyte-rich and neutrophil-rich. Other HCCs are classified as non-specific (not otherwise specified or NOS). These subtypes may be associated with a different prognosis, particularly the MTM, which displays a poorer survival than the other subtypes. Genomically, most HCCs present mutations in the TERT promoter, while other mutations occured later in carcinogenesis, such as TP53 and CTNNB1. TP53 mutated HCCs are associated with a poor prognosis and the MTM subtype. From a transcriptomic standpoint, two classifications are particularly noteworthy, as they are associated with both prognosis (proliferative vs. non-proliferative classification) and clinical, morphological and genomic tumour characteristics (G1-G6 classification). In conclusion, the morphological heterogeneity of HCC, directly linked to molecular heterogeneity, is associated with prognosis. This strongly supports the specification of the different HCC subtypes in our reports.

Extraskeletal Ewing's sarcoma is a malignant tumour most often found in children and adolescents, but rarely in the cervicofacial region. When it affects the parapharyngeal space, diagnosis is often delayed, resulting in poor prognosis. We here report the clinical case of a 37-year-old female patient admitted to the emergency department with inspiratory dyspnea, asthenia and anorexia. Cervical spine MRI revealed a process in the right parapharyngeal space obstructing almost the entire pharyngeal lumen. Anatomopathological, immunohistochemical and cytogenetic examinations showed extraskeletal Ewing's sarcoma. The metastatic workup was negative. The patient received chemotherapy. Extraskeletal Ewing's sarcoma of the parapharyngeal space is extremely rare: only four cases have been reported in the literature. Nonetheless, clinical and paraclinical characteristics are similar. It is a neoplasm that must be recognized for early diagnosis to improve prognosis and management.