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Barki A.,Sina | Ait Sakel A.,Sina | Lalya I.,Institute National dOncologie INO | El Khannoussi B.,Service dAnatomie Pathologique | And 8 more authors.
Journal Africain du Cancer | Year: 2013

Introduction: The rhabdomyosarcoma is a rare mesenchymal tumor. Its paratesticular location is the most common urogenital locations. It is a child tumour and is exceptional in adults. The prognosis is poor and treatment is based on the tripod surgery, chemotherapy, and radiotherapy. Materials and methods: A retrospective study of nine cases of paratesticular rhabdomyosarcoma in adults, collected at the National Institute of Oncology in Rabat between January 1995 and December 2007, was performed. We discuss the diagnostic and therapeutic modalities based on literature data. Results: The average age of our patients was 24 years (the extremes are 19 and 32 years). On admission, six patients had a painless scrotal mass and three patients had an impaired genral health.The tumor markers βHCG and αFP were normal in all patients. The ultrasound showed a heterogeneous paratesticular mass with a normal testis. Computed tomography of the chest, abdomen, and pelvis performed in all patients revealed five cases of lymph node metastasis (55.5%), three lung metastasis (33.3%), and only one liver metastasis. All patients had an inguinal orchidectomy and chemotherapy based on vincristine, actinomycin D, and cyclophosphamide. The retroperitoneal lymph node dissection was not performed for any patient. Two patients had radiotherapy for residual retroperitoneal masses. The average duration of follow up was 23 months (12-102 months), and survival rate at three and five years was respectively 66% and 22%. Conclusion: The paratesticular rhabdomyosarcoma is an aggressive and fast growing tumor. The diagnosis is histological. Treatment is based on surgery and chemotherapy. The role of lymphadenectomy is controversial. Radiotherapy must be indicated in patients with residual tumor after chemotherapy or positive nodes at lymphadenectomy. An adequate long-term monitoring must be introduced to detect recurrences that are usually fatal. © Springer-Verlag France 2013.


Chebat A.,Mohammed V University | Chebat A.,Center National Of Pharmacovigilance | Skalli S.,Center National Of Pharmacovigilance | Errihani H.,Institute National dOncologie INO | And 5 more authors.
Phytotherapie | Year: 2014

In order to assess the prevalence of adverse effects (AEs) associated with the use of medicinal plants (MP), we conducted a survey of 1 234 patients during four months at the National Institute of Oncology (INO) in Rabat and more precisely within the inpatient and day hospital of INO. This survey is based on the use of a 10-item questionnaire used to gather the necessary information about the patient and the MPs used. Our researches on the 1 234 patients surveyed showed that 35% use MP. Among them, 98.5% did not disclose the information to their physicians dealing with a sex ratio of 0.6. Of all patients surveyed having used MP, 16% experienced adverse effects more or less serious (68% of women). They cite the tubule-interstitial nephritis, which represents the most common side effect (15.7%) followed by liver damage (12.9%), diarrhea (5.7%), vomiting, constipation and rectal bleeding with a frequency of 4.3% each. Although some plants are criminalized such as Nigella sativa L. and Aristolochia longa L. The use of MP by Moroccan patients is an alternative. These plants can be used before, after or during medical treatments which contributes to the occurrence of AEs. © 2013 Springer-Verlag France. Mots clés: Plante médicinaleOncologieEffet indésirableMaroc.


Benbakhta B.,Sina | Tazi M.,Institute national doncologie INO | Benjaafar N.,Institute national doncologie INO | Khattabi A.,Ecole nationale de sante publique ENSP | Maaroufi A.,Sina
Revue d'Epidemiologie et de Sante Publique | Year: 2015

Background. - In Morocco, breast cancer is the first most common cancer in women. It is diagnosed in most cases at an advanced stage. Delay in diagnosis and access to treatment for breast cancer increases morbidity and mortality. The objective of this study was to determine the consultation delay (patient delay), diagnosis delay and access to treatment delay (health system delays) of women with breast cancer admitted at the National Institute of Oncology in Rabat. Factors associated with these delays were analyzed. Methods. - We conducted a cross-sectional study from December 2012 to May 2013 at the National Institute of Oncology in Rabat. Two hundred eligible and consenting women were interviewed using a structured and pre-tested questionnaire. Stages I and II were identified as ''early stages" and III and IV as "advanced stages". Results. - In our population, 54% were diagnosed at an early stage of breast cancer and 46% at an advanced stage. The median total delay was 120 days (interquartile interval [IIQ] = 81-202 days). The patient delay (median = 65 days, IIQ = 31-121) was longer than the health system delay (median = 50 days, IIQ = 29-77). High risk for a long total delay (more than 4 months) was observed for women who were aged over 65 years (OR = 1.30, 95% CI 1.10-4.20), illiterate (OR = 4.50, 95% CI 2.10-6.20), rural residents (OR = 3.40, 95% CI 1.23-8.13), in a lower socioeconomic category (OR = 4.75, 95% CI 1.45-15.60), without knowledge about breast self-examination (OR = 5.67, 95% CI 2.65-12.15) and seen more than 2 times before diagnosis (OR = 7.70, 95% CI 2.88-20.50). A long total delay increased the risk of being diagnosed at an advanced stage (OR = 5.62, 95% CI 3.03-10.45). Conclusion. - Efforts should be directed to providing good information to the population at risk, better access to screening and continuing medical training to enable diagnosis and early treatment. © 2015 Elsevier Masson SAS.


Kadiri H.,Institute National dOncologie INO | Memeo L.,Mediterranean Institute of Oncology | Belabbas M.A.,Institute National dOncologie INO | Mansukhani M.,Columbia University | Amrani M.,Institute National dOncologie INO
Bio Tribune Magazine | Year: 2010

Background/aim: Desmoid fibromatosis are rare, benign but locally aggressive tumors, characterized by an infiltrative growth and a tendency towards local recurrence, but an inability to metastasise. The morphological diagnosis may be difficult, requiring immunohistochemistry. The aim of our study is to determine the im munohistochemical phenotypes of these tumours to evaluate if they are helpful and to define a diagnostic strategy. Methods: Immunohistochemistry was used to examine the expression of β-catenin, APC protein, in archival material derived from fourteen cases of extraabdominal desmoid tumors. Desmoids specimens were assembled into a clinical data-linked tissue micro - array. Nuclear β-catenin expression was observed in 100% of the specimens. Positive cytoplasmic staining for APC protein was found in 11 of 14 (78,6%). But all samples were negative for oestrogen and progesterone receptors, c-KIT and WT1. Results: Our results regarding β-catenin and APC confirm the previous findings that those proteins play a crucial role in the pathogenesis of sporadic aggressive fibromatosis. © 2010 Springer Verlag France.

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