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Biomedical subjects

F Ben Ayed

Publications and source records attributed to F Ben Ayed.

At least 19 recordsLinked to original sources

[Soft tissue epithelioid hemangioendothelioma: a case report].

We report a case of epithelioid hemangioendothelioma observed in soft tissue in a 35-year-old man who presented a painful mass of the right arm which progressed in size for two years. Imaging revealed a 7-cm poorly limited expansive tumor process located in the medial muscle compartment of the right arm. Surgical resection was performed. Histological and immunohistochemical examination led to the diagnosis of soft tissue epithelioid hemangioendothelioma. The tumor recurred in the right arm and the right axillary fossa with development of multiple nodules in the contralateral thoracic wall and pleural effusion. Adjuvant chemotherapy and radiotherapy were performed, but the patient died at two years.

Adult↗

An open randomised trial of second-line endocrine therapy in advanced breast cancer. comparison of the aromatase inhibitors letrozole and anastrozole.

It was previously shown that letrozole (Femara) was significantly more potent than anastrozole (Arimidex) in inhibiting aromatase activity in vitro and in inhibiting total body aromatisation in patients with breast cancer. The objective of this study was to compare letrozole (2.5 mg per day) and anastrozole (1 mg per day) as endocrine therapy in postmenopausal women with advanced breast cancer previously treated with an anti-oestrogen. This randomised, multicentre and multinational open-label phase IIIb/IV study enrolled 713 patients. Treatment was for advanced breast cancer that had progressed either during anti-oestrogen therapy or within 12 months of completing that therapy. Patients had tumours that were either positive for oestrogen and/or progesterone receptors (48%) or of unknown receptor status (52%). The primary efficacy endpoint was time to progression (TTP). Secondary endpoints included objective response, duration of response, rate and duration of overall clinical benefit (responses and long-term stable disease), time to treatment failure, and overall survival, as well as general safety. There was no difference between the treatment arms in TTP; median times were the same for both treatments. Letrozole was significantly superior to anastrozole in the overall response rate (ORR) (19.1% versus 12.3%, P=0.013), including in predefined subgroups (receptor status-unknown, and soft-tissue- and viscera-dominant site of disease). There were no significant differences between the treatment arms in the rate of clinical benefit, median duration of response, duration of clinical benefit, time to treatment failure or overall survival. Both agents were well tolerated and there were no significant differences in safety. These results support previous data documenting the greater aromatase-inhibiting activity of letrozole and indicate that advanced breast cancer is more responsive to letrozole than to anastrozole as second-line endocrine therapy.

Adult↗

Frequency and genome load of Epstein-Barr virus in 509 breast cancers from different geographical areas.

Since the few data exploring a possible association between Epstein-Barr virus (EBV) and breast cancer are conflicting, we investigated this association together with the influences of geographical areas. 509 breast cancers were sampled from areas with varying risks of nasopharynx carcinoma (NPC) such as North Africa (Algeria and Tunisia, high-risk area); southern France (Marseille, intermediate-risk area); and northern Europe (northern France, the Netherlands and Denmark; low-risk areas). Polymerase chain reaction (PCR) of a subregion of EBV BamHIC encoding the EBERs demonstrated that 31.8% of the tumours contained the viral genome. No significant differences were observed among the geographical areas. However, positive samples showed higher loads of the EBV genome in the NPC high- and intermediate-risk areas than in the low-risk areas. EBV type 1 was the dominant strain. In situ hybridization studies using a(35)S-labelled riboprobe for EBER1 and a laser capture microdissection, combined with quantitative PCR, showed that EBV localization was restricted to some tumour epithelial cell clusters. EBV could not be detected in the stroma. Considering the whole population covered, the presence of the EBV genome was not correlated with age, menopausal status, tumour, size, nodal status or histological grade.

Adult↗

[Evaluation of implantable sites in medical oncology in Tunisia. Prospective study of 205 cases].

OBJECTIVE: To evaluate the insertion and use of implantable central venous accesses in medical oncology at the Institute Salah Azaïz. METHODS: From January 1992 to June 2000, 205 patients including 179 adults (118F/61M) and 26 children aged 7 months to 72 years (mean 37 years) required the insertion of an implantable port (IP). Tumoral pathology was dominated by metastatic breast carcinoma (93/179), digestive cancer (42/179) and paediatric cancer (26 cases). RESULTS: Excluding 3 initial failures, we inserted 205 IP for 202 patients. The supraclavicular anatomic way (Yoffa) was used in 156/205 cases and the subclavicular (Aubaniac) for the resting 32 cases with a jugular conversion in 17 cases. Initial complications were represented by 6 arterial puncture (2.9%), 3 pneumothorax (1.5%) and 1 catheter migration in the right pulmonary artery. Median life duration of the material was 210 days (3 to 1460 days) for adults and 185 days (3 to 1460 ays) for children. Mean life duration for the 205 IP was 240 days +/- 239 (3 to 1460 days) with a total of 49,200 IP-days. We explanted 17 IP for infection (8 cases), cutaneous ulceration (8 cases) and actinomycin extravasation (1 case). We observed 6 cases (2.9%) of subclavian and jugular thrombosis treated by anticoagulants and conservation management of the port. Presently, 58 patients are alive with IP in place. CONCLUSION: Implantable ports represent a useful option in medical oncology for patients treated with prolonged chemotherapy and adjuvant treatments such as antibiotics, transfusion. This method allows a good comfort for the patients and also the treating team but requires a prealable training for the nursing team.

Adolescent↗

[Primary chemotherapy with the Rosen T10 protocol before conservative surgery in limb primitive osteosarcomas: results about 56 cases].

We report the results of a prospective Tunisian study using primary chemotherapy followed by conservative surgery in primitive limb osteosarcoma. From January 1988 to January 1998, 56 patients affected by limb osteosarcoma entered in a prospective study of neoadjuvant chemotherapy with the T10 protocol before surgery with a conservative intent. Initial work-up include: clinical exam with tumor measurements, chest and limb X-rays, limb CT-scan or MRI, chest CT-scan, bone scintigraphy and hematological and renal biological exams. Patients receive pre- and post-operative chemotherapy according to the T10 modified protocol. Fifty-six patients (33 M/23 F) with a mean age of 19 years (8 to 28) are included. Mean clinical and radiological tumor size is around 14 cm. Main histologic type is classic osteosarcoma (50% of cases) and 10 patients (9%) presented with initial metastasis; 42 patients on 56 receive the whole pre-operative protocol. Treatment is well tolerated excluding 18 episodes of mucositis, 29 of leucopenia (< grade 3), 7 of thrombopenia (< grade 3), 4 of cutaneous toxicity, 2 of pulmonary toxicity and 3 of nausea-vomiting. We observe 36% of good histological responders and 64% of bad responders to primary chemotherapy, 27 patients on 49 operated (53%) have a conservative surgery and 18 (47%) a radical surgery. With a median follow-up of 51 months (8 to 128), 29 patients remain alive free of disease (15/17 GR and 14/30 BR), 2 are alive with disease, 2 died by toxicity, 14 died by progressive disease and 9 are lost to follow-up with evolutive disease. Five year disease-free survival is 55% for the 46 non metastatic patients. In univariate analysis, seric alkaline phosphatase level (p = 0.0014) and histological response to chemotherapy (p = 0.0218) are significant factors for prognosis.

Adolescent↗

[Dermatomyositis and nasopharyngeal carcinoma: 3 cases].

BACKGROUND: Nasopharyngeal carcinoma is a common cancer in Tunisia with an estimated incidence of 1.8/100,000. The tumor shows a characteristic association with paraneoplastic syndromes. CASE REPORTS: We report three cases of histologically proven dermatomyositis associated with nasopharyngeal carcinoma in patients aged 40, 24 and 65 years. In all cases, the course of the paraneoplastic syndrome ran parallel to the nasopharyngeal carcinoma. DISCUSSION: Dermatomyositis is one of the numerous paraneoplastic syndromes associated with nasopharyngeal carcinoma. Systematic examination of the nasopharynx is required in case of dermatomyositis.

Adult↗

[The use of neuron specific enolase in the prognosis and followup of neuroblastoma in children. Results of a retrospective series of 21 patients].

OBJECTIVE: To report the results of seric neuron specific enolase in pediatric neuroblastoma. PATIENTS AND METHODS: Our retrospective study concerns 21 children treated in our institution from 1992 to 1998 for neuroblastoma. Seric NSE was determined by immunoenzymology technique at different stages of the disease and the treatment. RESULTS: Mean value for the 39 dosages of the whole patients was 127.9 ng/ml with a sensitivity of 56%, five patients has presented normal values. Mean value for the 18 patients in stage IV was 132.38 ng/ml. We also observed in 3 patients, an evolution of the seric NSE parallel to this of the disease under chemotherapy. CONCLUSION: NSE represents a moderate sensitive and specific tumor marker for pediatric neuroblastoma. However, it represents a good value in prognosis and follow-up after chemotherapy.

Biomarkers, Tumor↗

[Primary gastric MALT lymphoma in children. Report of 2 cases].

Primary gastric MALT non-Hodgkin's lymphoma is rare in immunocompetent children. To our knowledge, only two cases have been previously described. We report two cases of gastric MALT lymphoma associated with Helicobacter pylori. Clinico-pathological features are similar to those observed in adults. The relationship between the microbial infection and non-Hodgkin's lymphoma development is discussed.

Adolescent↗

[Role of lactate dehydrogenase (LDH) level in the aqueous humor in the diagnosis of retinoblastoma (RB)].

In spite of the progress of the imagery in ophthalmology, the retinoblastoma remains in some particular cases, difficult to make. Moreover, the therapy sanction is often heavy. The lactate dehydrogenase (LDH) dosage in aqueous humor is an invasive technique conceivable when there are diagnosis problems particularly in retino-blastoma of old children and in affections simulating retino-blastoma. The purpose of this work is to lay out three observations where the LDH dosage enabled to keep the retinoblastoma diagnosis in one 8-year old child and eliminate it in two children having pseudoglioma with spontaneous evolution allowing to confirm the non-tumoral nature of the affection. Thus, the technique of LDH dosage has been reliable for the 3 cases which we have introduced. The authors compare the reliability of the different cytochemical techniques during the retinoblastoma diagnosis.

Aqueous Humor↗

[Secondary head and neck osteosarcoma following treatment of undifferentiated nasopharyngeal neoplasms (UCNT)].

Secondary tumours after radio and/or chemotherapy are mainly of hematopoietic (acute non lymphoblastic leukemia, non-Hodgkin lymphoma) or soft tissue lineage previously described most frequently after breast cancer and Hodgkin disease treatment with radio and/or chemotherapy. We report two cases of classical osteosarcoma's observed 9 and 3 years after treatment for UCNT with combined radiotherapy and alkylant-based adjuvant chemotherapy in one case and exclusive loco-regional irradiation in the second case.

Adult↗

[Depression and cancer. Results of an initial study of 707 patients].

Within a multifactorial etiology of cancers and a bio-psycho-social approach of patients, considering, among the risk factors, those related to personality in a preventive view, the authors investigate, by an epidemiologic methodology, for a correlation between break-down phenomena and the development of a cancer. The study was carried out at the Salah Azaïez Institute in 1992 and included 707 patients aged from 15 to 82 years, 44% presenting a malignant tumour. For a retrospective evaluation of break-down semiology, the study is based on DSM-III criteria of break-down diagnostic. Search for a clinic/psychic diagnostic relation reveals the difficulty of coexistence between break-down signs and the development of a cancer. That difficulty increases in case of an organised break-down.

Adolescent↗

[Choroid metastases].

PURPOSE: The aim of the present study is to investigate the clinical features and the risk factors characteristic of choroidal metastasis, which is known as the most common malignant neoplasm of the adult eye. METHODS: A systematic ophthalmologic examination together with angiography and echography were performed in 106 patients with carcinoma. RESULTS: 10% of patients showed choroïdal metastasis. Breast and bronchogenic carcinoma were the most common primary tumor. 82% of cases died within a mean 6.5 months. Clinical, angiographic, echographic and histopathologic features of such metastasis were described. CONCLUSIONS: The importance of an early diagnosis of such metastasis are raised.

Adolescent↗