Unusual location of myxopapillary ependymoma in the sacrum: Case report and review of the literature

Myxopapillary ependymoma, a rare variant of ependymoma, commonly occurs in the conus medullaris or filum terminale. The rarity of these tumors can make their diagnosis and treatment challenging. This case report presents an atypical occurrence of myxopapillary ependymoma within the sacrum in a 68-year-old patient presented with a 3-month history of persistent left-sided low back pain radiating to the legs and fecal dysfunction. The patient underwent a sacral laminectomy and subtotal excision of the tumor, followed by adjuvant radiotherapy with favorable outcomes. This report highlights the significance of tailored approaches for unconventional tumor locations emphasizes the potential benefits of multimodal treatment strategies and provides insights from a comprehensive literature review on similar cases.

Synergizing Expertise and Technology: The Artificial intelligence Revolution in Radiotherapy for Personalized and Precise Cancer Treatment

Artificial intelligence (AI) has truly revolutionized many fields, including healthcare. In radiation oncology, AI has emerged as a powerful tool for improving the speed, accuracy and overall quality of radiotherapy treatments. The radiotherapy workflow involves complex processes that require coordination between healthcare professionals with diverse skills. AI and deep learning methods offer unprecedented potential to transform this workflow by leveraging imaging modalities, digital data processing and advanced software algorithms. Despite the revolutionary potential, challenges remain in seamlessly integrating AI into clinical workflows. Ethical considerations, data privacy, and algorithm interpretability necessitate cautious implementation. Additionally, fostering interdisciplinary collaboration between AI experts and radiation oncologists is imperative to harness the technology's full potential. This paper explores the impact of AI in four key areas of radiotherapy: automated segmentation, dosimetric and machine quality assurance, adaptive radiation therapy, and clinical outcome prediction. Key words: Artificial intelligence, Radiotherapy, Workflow, Accuracy, cancer ,machine-learning.

Paradigm change in urological, gynaecological and breast cancer management: A new practice-changing data from ASCO 2022 annual meeting

Changing medical practice has been a constant process based on many scientific findings for years. In the oncology community, the American Society of Clinical Oncology (ASCO), one of the major annual conferences, presented the latest updates on practice-changing in cancer. At the recent meeting of 2022, held this year on June 2-6, researchers presented essential findings in urological, gynecological, and breast cancer management. In urological cancer, olaparib + abiraterone was demonstrated thru the PROpel trial to benefit in first-line treatment mCRPC regardless of the HRR stratification factor, along with the adjuvant therapy everolimus, for fully resected RCC in the EVEREST trial. In gynecological cancer, tisotumab vedotin demonstrated a potential role in improving clinical outcomes in 1st line r/mCC thru InnovaTV-205. In breast cancer, trastuzumab deruxtecan showed significant benefit for redefined human epidermal growth factors receptor 2 status in HER2 low BC patients, where current targeted-HER2 therapies are ineffective in the DESTINY-BREAST 04 study. The use of Immuno-based combinations in the medical management of TNBC patients has been supported thru several recent studies, showing positive results and outcomes, as demonstrated by the expert's opinions in Rizzo et al. research papers. In this article, we resumed the different renowned and what we considered intriguing to review studies presented during these three long sessions at the ASCO 2022 meeting.

Syndrome De Lyell Et Syndrome De Stevens-Johnson: Étude Rétrospective De 30 Cas

Stevens-Johnson syndrome and Lyell syndrome are severe bullous drug reactions that can be life-threatening. The aim of this study is to describe the epidemiological, etiological, clinical, therapeutic and evolutionary data of patients hospitalized in our Dermatology Department. This is a retrospective descriptive study over a period of 10 years. All records of patients admitted to the Dermatology Department for these cutaneous adverse drug reactions were included. A total of 30 patients were recorded, with a male predominance. There were 18 cases of Lyell syndrome, 8 cases of Stevens-Johnson syndrome and 4 cases of overlap syndrome. The mean time to onset after drug administration was 7.5 days. The average skin area detached was 48%. Visceral involvement was frequently observed: pulmonary involvement, renal involvement, hepatic cytolysis and hematological involvement. The notion of medication was found in all our patients, with self-medication in 23% of cases. The reason for prescription was dominated by post-surgical anticonvulsant prophylaxis. All our patients received symptomatic treatment, and corticosteroid therapy was administered in only one patient for macrophagic activation syndrome. The mortality rate was of 17%. Skin area involved, presence of renal failure or respiratory distress were the main prognostic factors.

Clinicopathological features of adult right-sided cardiac masses: Analysis of 19 cases

Background

Right sided cardiac masses are rare. The purpose of this study is to review the clinical experience and pathological characteristics of right-sided cardiac masses and to provide a prognostic analysis in our hospital.

Methods

We retrospectively reviewed 19 consecutive cases of right heart masses diagnosed in our institution from 2016 to February 2020. All available clinicopathological features, imaging characteristics and disease outcomes were summarized and presented.

Results

The subjects included 9 men and 10 women with a mean age of 48.5 years. The most frequent complaint was dyspnea. The most common site was the right atrium (42.1%) followed by the tricuspid valve (36.8%). Clinical diagnosis revealed vegetations in 8 patients (42.1%), thrombi in 7 patients (36.8%), myxoma in 1 patient, hydatid cyst in 1 patient and metastatic (secondary) masse was seen in 2 cases. In the 19 patients, 3 patients underwent surgery, 15 patients were managed with medical treatment, therapeutic abstention was indicated in one patient. 14 patients were all alive at the end of the follow-up period. In contrast, 5 patients were dead (26.3%).

Conclusion

In our series, the majority of right cardiac masses were benign, outnumbering the malignant ones, as described in the literature. The mortality rate was relatively high about 26.3%.

A Rare Case of Henoch-Schönlein Purpura Following a COVID-19 Vaccine-Case Report

In the COVID-19 pandemic era, anti-SARS-CoV-2 vaccination is considered to be the most efficient way to overtake the COVID-19 scourge. Like all medicines, vaccines are not devoid of risks and can in rare cases cause some various side effects. The objective of this case report is to highlight this unusual presentation of Henoch-Schönlein purpura following an anti-COVID-19 vaccination in a 62-year-old adult. The 62-year-old patient admitted to the emergency room for a petechial purpuric rash, sloping, occurring within hours, involving both legs and ascending. The clinical signs also included polyarthralgia and hematuria. Reported in the history the notion of an anti-COVID-19 vaccination 8 days prior to the onset of symptomatology. In the case of our patient, we retain the diagnosis of rheumatoid purpura based on the EULAR/PRINTO/PReS diagnostic criteria. Corticosteroid therapy (prednisone) was started, resulting to a rapid regression of clinical and laboratory symptoms, few days after the treatment. Patient was asymptomatic on subsequent visits. The low number of published cases of post-vaccine vasculitis does not question the safety of vaccines, but knowledge of such complications deserves to be known in order to avoid new immunizations that could have more serious consequences, and to avoid aggravating or reactivating a pre-existing vasculitis.

Acute myocarditis related to Covid-19 infection: 2 cases report

INTRODUCTION AND IMPORTANCE

Since COVID 19 was described for the first time in December 2019, we have not stopped discovering its different clinical manifestations. Despite the respiratory complication which is the most common symptomatology, multi-organ dysfunction and multiple cardiovascular complications were described such as acute myocarditis, heart failure and even arrhythmias.

CASES PRESENTATION

Two patients aged 26 and 56 year-old, developed acute myocarditis related to Covid-19 infection but with different symptomatology.

CASE 1

Presented to the emergency room with digestive symptomatology, Covid-19 infection was confirmed by a positive chest CT scan and positive COVID-19 serology testing. Clinical, biological, radiological findings allowed making the diagnosis of a Covid-19 infection with a bacterial superinfection complicated by a fulminant myocarditis.

CASE 2

Presented to the emergency department with a chest pain, dyspnoea, paroxistic cough, myalgia and fever. A Covid-19 infection was confirmed. The electrocardiogram showed a diffuse ST elevation, echocardiography showed normal systolic function and the high-sensitivity cardiac troponin I level was high. Invasive coronary angiography was performed, revealing angiographically normal coronary arteries.

CLINICAL DISCUSSION

Our 2 cases were treated differently, case 1 received antibiotherapy because of the bacterial superinfection and inotropic support for the septic and cardiogenic choc. Contrarily to case 2 who received inotropic support, immunoglobulin and corticosteroid. With a total recovery for both patients.

CONCLUSION

This article can help in considering cardiac affection due to SARS-CoV2, even with poor respiratory symptomatology, and to insist on the importance of the cardiac evaluation for young patients with a sever Covid-19 infection.

Patent foramen oval: A rare case of acute ischemia of the upper limb: A case with 2 year follow-up

Introduction and importance

Paradoxical emboli (PDE) represent less than 2% of all arterial emboli, that is why they are considered as a rare event. We notice that the upper limb ischemia is very exceptional as part of a paradoxical embolism. This case presentation can help in considering the diagnosis the PFO as one of the most important risk factors of paradoxical embolism.

Case presentation

Here, we present a rare case of a 69-year-old woman with paradoxical systemic arterial embolism, presented by an acute ischemia of the upper limb, secondary to deep venous thrombosis and pulmonary embolism in the presence of patent foramen ovale, treated with long-term anticoagulation with rivaroxiban 20 mg/day, because of the mutation of the Factor II whish indicate already the anticoagulation.

Discussion

Echocardiographic techniques such as transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), or transcranial echocardiography (TCE) are the principal tools used to detect PFO. There are no clear consensus on the treatment of PDE. Presenting symptoms largely depend upon the location of the embolus, necessitating a different approach for each patient, but There is essentially three therapeutic options: surgical embolectomy, thrombolysis, and anticoagulation.

Conclusion

PFO closure is, today, a standardized and safe intervention, but the indication stay individualized to each patient.

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Paradoxical emboli represent less than 2% of all arterial emboli, that is why they are considered as a rare event.

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The patent foramen oval stay the most frequent intracardiac defect associated with paradoxical emboli.

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transesophageal echocardiography TEE is the most reliable diagnostic test of the patent foramen oval.

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Recommendations for treatment should be individualized.

Chondrosarcoma of the parapharyngeal space: Case report and literature review of an extremely rare location

Chondrosarcoma of the head and neck region is a rare disease, representing approximately 0.1% of all head and neck neoplasms. Parapharyngeal location is extremely rare and low-grade ones are even rarer. Surgery alone or followed by adjuvant radiotherapy is the treatment of choice. In this article, we report a case of a 67-year-old male with low-grade parapharyngeal chondrosarcoma who presented with a 3-month history of dysphagia. A cervical magnetic resonance imaging was performed that shows a well-defined mass located at the right parapharyngeal space, causing medial deviation of the mucosal space. Surgical resection of the tumor without neck dissection followed by adjuvant radiotherapy was undertaken with a favorable response. The purpose of this article is to add our case to the limited literature for good management of parapharyngeal chondrosarcomas.

Primary intrapulmonary malignant peripheral nerve sheath tumor: A rare case

A rare case of malignant peripheral nerve sheath tumor (MPNST) was found in the lungs of a 68-year-old male patient. He was referred to our hospital because of visual disturbances, confusion, and headaches. Upon admission, a chest-Abdomen-Pelvis CT scan (CT scan of CAP) showed a right posterobasal pulmonary lesion process associated with liver metastases and a lytic lesion of the vertebral body of D3. Brain MRI (Magnetic Resonance Imaging) revealed secondary brain lesions above and below the tentorium. Image guided liver biopsy showed a suspicious site of malignancy. In the histopathological examination, a diagnosis of MPNST was established. A biological agent, Imatinib, was administered and the patient underwent cerebral radiotherapy. CT scan of CAP showed a partial tumor response according to Chun's criteria. Pre-existing literature indicates that MPNSTs with metastases to the brain are very rare and have a poor prognosis - survival after brain metastases would be about 10 months. Our case report agrees with the literature, as the disease stabilized with treatment up to 7 months, after which the patient was unreachable and our team lost track of him. Our case report appears to be one of the first cases of primary MPNST in the lungs with brain metastases.

Metastasis to the pancreas: a rare site for secondary malignancy of breast cancer (a case report)

Breast cancer is the most frequent invasive cancer in women and the second cause of death by cancer in women after lung cancer. It causes metastases especially to bones, liver and lungs. Pancreatic metastases from a primary breast neoplasm are rare and unusual, occurring in less than 3% of the cases. There have been only 28 cases described in the literature. This paper adds one more case to the published literature. We present a case of pancreatic metastasis of the breast in a 64-year-old female and a discussion based on a review of the literature.

Advances in the management of non-small cell lung cancer (NSCLC): A new practice changing data from asco 2020 annual meeting

At the meeting of the American Society of Clinical Oncology (ASCO 2020), held this year virtually on May 29-31, investigators presented important practice changing findings in non-small cell lung cancer (NSCLC). In the early-stage resectable NSCLC, the key presentation was ADAURA study. This phase III clinical trial showed that the use of adjuvant osimertinib in stage IB-IIIA NSCLC patients harboring EGFR mutations had a clinically meaningful benefit. In locally advanced NSCLC, the recent studies investigated the role of immune checkpoint inhibitors (ICIs) administred early with or before concurrent chemoradiotherapy. In advanced-stage NSCLC with driver mutations, new targets and drugs were explored. The major step forward was the approval of personalized treatment in very uncommon genomic alterations, as RET fusions or MET mutations. In advanced NSCLC without targetable mutations, some new immunotherapy combination strategies have been presented. One of such combination was tiragolumab, an immune checkpoint inhibitor binding to TIGIT, evaluated with atezolizumab. There were also data from the Checkmate 227 and Checkmate 9LA trials that led to recent approvals.

Rare association of aortoarteritis and pheochromocytoma: A case report

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Pheochromocytoma is a great masquerador.

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The coexistence of pheochromocytoma along with both aortoarteritis and renal artery stenosis is very rare.

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Management of vascular abnormalities is based on the control of catecholamine release.

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Pheochromocytoma should be included as differential diagnosis of aortoarteritis.

Introduction

Pheochromocytoma is an uncommon but treatable cause of secondary hypertension, it may present with a wide variety of manifestations. The coexistence of pheochromocytoma and vascular abnormalities is described but rarely reported entity.

Presentation of case

A 36-year-old man was admitted to our hospital for severe hypertension, examination revealed absent femoral pulses with notion of intermittent claudication. Abdominal computed tomography revealed the presence of a right adrenal pheochromocytoma. CT angiogram showed thickening of the thoracoabdominal aortic wall and the proximal portions of some of its branches with stenosis of more than 50% of the origin of the celiac trunk, bilateral occlusion of the external iliac arteries and trunk stenosis of the right renal artery. The Pheochromocytoma was surgically removed.

Discussion

Coexistence of pheyochromocytoma and vascular abnormalities especially renal artery stenosis and aortoarteritis seems to be an association rather than a coincidence.

Conclusion

To the best of our knowledge, the coexistence of pheochromocytoma along with both aortoarteritis and renal artery stenosis has not been reported thus far. The diagnosis, management and potential mechanisms underlying such an association will be discussed in this case.

Managing Cancer Center During the SARS-COVID-19 Pandemic: Moroccan Experience

Objective: The principal aim of this work is to describe the different measures taken by three departments involved in treatment of patients followed for cancer during the SARS pandemic COVID-19. Method: A prospective study, using anonymous questionnaire, among the medical and paramedical team of hematology, medical oncology and radiotherapy during the pandemic. Results: The staff nursing was mainly constituted by a paramedical team (71,5%), with female predominance at 77,8%, sex ratio F/M=3,5, the high majority range age of the team was 30-45 years, living as a couple (52,4%). During the Covid pandemic, all our staff used bib, normal bib (76,2%), FPP2 (20,6%) combined bib (FFP2/normal) in 28,6% with visor in 6,3%. The duration of using of the same bib was variable, it has been used for 12h and more in 52, 5% and during 4h, 6h and 8h in 12,5%, 7, 5% and 27,5% respectively. For the out work management, more than half of our team return home without confinement to their family or children and only 8% have been confined on hotel. Our staff expressed a very important professional impact in 87,3% as well as in their personal lives in 85,7%.Conclusion: The vulnerability of the patients followed for cancer had obliged heath professional in this field to be even more rigorous and more vigilant on protective measures while ensuring continuity of care during the COVID pandemic. Our study illustrates that, despite the staff’s efforts of adaptation, the impact in personal and professional lives has been not negligible.

COVID-19 Recommendations for Patients with Cancer: The post-COVID-19 Era

Despite the extent of the COVID-19 infection worldwide, the impact of the pandemic in our country remains low thanks to containment measures. On July 11, 2020, the spread of the virus in Morocco has caused more than 15,000 cases and 243 deaths. It is important to note that cancer patients are at high risk of developing COVID-19 disease. However, little changes have been made in our clinical practice in cancer management. Medical care aims are to ensure optimal treatment while minimizing the risk of COVID-19 transmission. Management should be discussed in a multidisciplinary team meeting, and any decision made, particularly influenced by the context of the COVID-19 pandemic, should be discussed and shared with the patient. In this article, we summarize our practical recommendations and how we prioritize cancer patient care during the post-COVID-19 phase.

Infective Endocarditis Caused by Klebsiella Oxytoca in a Patient with Hemodialysis: A CARE-Compliant Case Report and Review of the Literature

The rarity of endocarditis due to Klebsiella species limits its recognition. We report the case of a 63-year-old man, known to have a tight calcified aortic stenosis presenting with acute heart failure associated with high fever. Klebsiella oxytoca endocarditis was diagnosed based on three sets of positive blood cultures together with fluttering vegetation (11 mm × 14 mm) on the middle segment of the anterior leaflet of the mitral valve. After 6 weeks of intravenous ceftriaxone and gentamicin bi-therapy, the patient had completely recovered. This case illustrates how sporadic this condition is, for which early assessment and proper treatment are crucial to enhance the short outcomes.

[Skin metastasis from undifferentiated carcinoma of the nasopharynx: about a case]

Les métastases cutanées du carcinome indifférencié du cavum représentent une entité clinique rare, de pronostic défavorable. Nous rapportons à travers cette observation le cas d'un jeune patient de 16 ans qui présente 6 mois après la fin de sa radiochimiothérapie concomitante, pour un carcinome indifférencié du cavum, une métastase cutanée unique au niveau du scalp avec une évolution rapide et le patient est décédé un mois après le diagnostic de la métastase. Vu son pronostic sombre, le diagnostic de métastases cutanées doit toujours être évoqué devant des lésions cutanées chez les patients ayant un antécédent de cancer.

COVID-19, Brachytherapy, and Gynecologic Cancers: a Moroccan Experience

The treatment of gynecological cancers is the main activity of brachytherapy units. However, during COVID-19 pandemic, precautions should be done in order to reduce the spread of the virus while maintaining all chances to recovery for all patients (Radiother Oncol 148, 227-228, 2020). Despite the extent of the pandemic in our country, limited data are available to establish recommendations with a sufficient level of evidence (Radiother Oncol 148, 227-228, 2020). More recently, the American Brachytherapy Society published some clarifications in this regard and international expert consensus recommendations of radiation therapy for gynecologic malignancies during the COVID-19 pandemic were published (https://www.americanbrachytherapy.org/about-abs/abs-news/abs-statement-on-coronavirus/, Gynecol Oncol 15, 2020). In this commentary, we sought to share the procedures adopted for the management of gynecological cancer patients during COVID-19 pandemic in our brachytherapy unit.

Spontaneous Coronary Artery Dissection (SCAD): A Series of 7 Cases, Experience of the University Hospital Center Mohammed VI, Oujda, Morocco

Spontaneous coronary artery dissection is a less known pathology by the cardiologists and represents a real challenge especially to the interventional cardiologist. The positive diagnosis is based on the visualization of intimal flap with the false lumen by intracoronary imaging means. This entity particularly interests young people without classic cardiovascular risk factors of atherosclerosis and female during the peripartum period. We report, in this paper, our experience in the University Hospital Center of Mohammed VI, Oujda, Morocco, about 7 cases diagnosed by coronary angiography during 3 years of practice while comparing our results with data from large series published in the literature. The purpose of this work is to draw more attention to this particular pathology that is becoming more and more common.

Uremic pericarditis in patients with End Stage Renal Disease: Prevalence, symptoms and outcome in 2017

The prevalence of uremic pericarditis (UP) used to range from 3% to 41%. More recently, it has decreased to about 5%-20% and to <5% in the last decades, as hemodialysis techniques have become widely used and dialysis quality improved. The objective of this work is to determine the initial clinical picture and the prognosis of patients presenting End Stage Renal Disease (ESRD) with UP.

MATERIALS

This is a retrospective study (May 2015-September 2017). Inclusion criteria targeted patients who had uremic pericarditis defined as pericarditis occurring in a patient with ESRD before initiation of renal replacement therapy, or within eight weeks of its initiation.

RESULTS

16 patients met the inclusion criteria. The median age of patients was 54 [24, 71] years and 56.2% were male. Pericardial effusion was small, moderate and large in 31.2%, 37.6% and 31.2% of cases respectively. One pericardiocentesis was performed in view of a clinical picture of impending cardiac tamponade and three pericardial drainages were performed given presentation of tamponade. Hemodialysis was initiated for all the patients and continued for 2 to 3weeks until complete regression of the pericardial effusion. The mean number of dialysis sessions was 11±3.5. One patient died of septic shock that developed three weeks after diagnosis of uremic pericarditis.

CONCLUSION

UP is considered a rare but fatal complication of ESRD because of the risk of tamponade and its prognosis remains dependent on early diagnosis and adequate treatment of ESRD.

Neoadjuvant Chemotherapy: A New Standard for Muscle Invasive Bladder Cancer?

Bladder cancer is the seventh most common cancer and the ninth most common cause of cancer deaths for men worldwide. Cystectomy with pelvic lymph nodes dissection is the standard local treatment of muscle invasive bladder cancer (MIBC) (T2-T4). In the last decade, the management of MIBC had become multidisciplinary involving peri-operative chemotherapy (neo- or adjuvant chemotherapy). Randomized trials and meta-analyses confirmed the survival benefit of neoadjuvant chemotherapy before local treatment (surgery and/or radiotherapy). Consequently, this sequence should be considered as standard treatment of choice, for patients with good performance status (0-1) and good renal function. The benefit of adjuvant chemotherapy is not clear for patients treated with primary surgery.

[Diffuse cutaneous mastocytosis of an infant: A case report]

Mastocytosis is a group of diseases related to abnormal accumulation and proliferation of mast cells in one or more organs. They may be associated with an acquired point mutation and the activation of the receptor tyrosine-kinase c-KIT of CFS (mast cell growth factor). The clinical manifestations are varied and secondary to the release of mast cell mediators and/or infiltration of various organs. There are two main types of mastocytosis: pure cutaneous mastocytosis and systemic mastocytosis when more than two organs are involved in mast cell infiltration (bone marrow, gastrointestinal tract, bone, liver and spleen, lymph nodes). Mastocytosis affects children in two thirds of cases, most frequently as an isolated cutaneous form. The most common clinical form in children is urticaria pigmentosa and solitary mastocytoma; bullous diffuse mastocytosis is rare. We report the case of an 8-month-old infant who presented with a diffuse pruritic bullous eruption. The histology and immunohistochemistry results were suggestive of mastocytosis. A serum tryptase test yielded positive results. Laboratory investigations did not identify systemic involvement. The patient was given antihistamine H1 medication and local care. Advice regarding the disease was offered to the parents. The course of the disease was marked by a decrease in the number of blisters and attenuation of the pruritus at the 6-month follow-up. This observation emphasizes the importance of awareness of this rare entity, which should be considered in all cases of bullous dermatosis in children, thereby allowing for early treatment.

Epidemiology and outcome of cervical cancer in national institute of Morocco

Background

On behalf of the medical staff of the National Institute of Oncology of Rabat, we conducted a retrospective study to report epidemiology and 5-year outcomes of cervical carcinoma in Moroccan women.

Methods

We reviewed all women diagnosed with invasive cervical carcinoma in our institute between January 2006 and December 2006. Outcomes and prognoses are analyzed in patients who received at least one treatment.

Results

The analysis included 646 women. Median age was 50 years (23–85 years). Bleeding was the most frequent symptom (95 %). The most predominant histology was squamous cell carcinoma (94 %). The majority of patients were diagnosed at locally advanced stages (88 %). Among patients who received treatment (n = 550), the management was based on concurrent chemoradiotherapy in 69.7 % of cases. The median duration of follow-up was 60 months (range 2–78 months). Overall survival, progression free survival, and locoregional recurrence free survival were 63.2, 60.7 and 79.1 % respectively. Significant poor prognostic factors in univariate analysis included stage, tumor size, lymph node involvement, anemia and absence of response to radiotherapy. The prognostic significance of response to radiotherapy and stage were retained in multivariate analysis.

Conclusion

Cervical cancer in our Institute is diagnosed at locally advanced stages. Two third of patients were treated by concurrent chemoradiotherapy. Outcome of Moroccan patients are comparable to that of western countries. Significant prognostic factors were stage, tumor size, lymph node involvement, anemia, and response to radiotherapy. The way to reduce the global burden of cervical cancer in our country continues to be the development of vaccination and screening programs.

Electronic supplementary material

The online version of this article (doi:10.1186/s12905-016-0342-2) contains supplementary material, which is available to authorized users.

Small-cell carcinoma of the genitourinary tract: a point of view

We read with great interest the article by Pervez et al. about genitourinary (GU) small-cell carcinoma (SCC) [...]

Evaluation of the cost of cervical cancer at the National Institute of Oncology, Rabat

Introduction

The Cervical Cancer (CC) is one of the heavy and costly diseases for the population and the health system. We want to know through this study, the first in Morocco, the annual cost of the treatment of this disease at the National Institute of Oncology (NIO) in Rabat, we also want to explore the possibility of flat-rate management of this disease in order to standardize medical practices and improve reimbursement by health insurance funds.

Methods

550 patients were treated for their cervical cancer in the Rabat's NIO. Data of all of medical and surgical services offered to patients were collected from the NIO registry. The cost of care was assessed using the method of micro-costing. We will focus to the total direct cost of all the services lavished to patients in NIO.

Results

The global cost was about US$ 1,429,673 with an average estimated at US$ 2,599 ± US$ 839. Radiotherapy accounts for 55% of total costs, followed by brachytherapy (27%) and surgery (7%). This three services plus chemotherapy influence the overall cost of care (p <0.001). Other services (radiology, laboratory tests and consultations) represent only 10%. The overall cost is influenced by the stage of the disease, this cost decreased significantly evolving in the stage of CC (p <0.001).

Conclusion

The standardization of medical practices is essential to the equity and efficiency in access to care. The flat-rate or lump sum by stage of disease is possible and interesting for standardizing medical practices and improving the services of the health insurance plan.

The burden among family caregivers of elderly cancer patients: prospective study in a Moroccan population

Background

In Morocco, families play a major role in caring for elderly cancer patients.

Methods

We conducted a prospective descriptive study, in the National Institute of Oncology in Morocco. The study aimed to include family members who are caregivers for patients aged ≥70 years old.

Findings

After obtaining IRB approval, a total of 150 caregivers responded to the questionnaire. Mean age was 44.7 years. The majority were females (59.3%), living in urban areas (66.7%), and educated (62.7%).Offspring (sons or daughters) represented 56.7, 54% lived with their relatives in the same house. Most of the participants were married and have familial responsibilities. In relatives, anxiety was found in 79.3%, it was related to fear of losing the patient in 57% and resulted in the use of anxiolytics in 10%. Guilt feeling towards patients regarding neglecting their early symptoms was reported in 38%. Depression and anxiety were more frequent among female relatives and among those of urban origin. Obsession of dying from cancer was present in about 30% and fear of contagion was more common among those from rural areas and illiterate. Economic resources were exceeded in 78.7 and 56% have used banking credits, and sale of properties. Work lay-off was recorded in 54%. Relatives participated in treatment making decisions in 86% of patients.

Conclusion

Even there was a great impact on elderly cancerous patients relatives, the benefits of caregiving was observed in 80%. More studies have to be conducted, especially in developing countries where the lack of resources majors the impact on family caregivers.

Electronic supplementary material

The online version of this article (doi:10.1186/s13104-015-1307-5) contains supplementary material, which is available to authorized users.