PubMed Health⌕ Search

Biomedical subjects

M Maalej

Publications and source records attributed to M Maalej.

At least 19 recordsLinked to original sources
PubMed2004

[Solitary bone plasmocytoma: treatment and outcome features].

PURPOSE: - To describe natural history of solitary bone plasmocytomas (SBO) after treatment. PATIENTS AND METHODS: - Between 1975 and 1998, we retrospectively identified 13 patients with SBO treated in the department of radiotherapy at Salah-Azaïz institute of Tunis. To be included in this study, three criteria were needed: histologic confirmation and only one bone lesion without medullary infiltration (or less than 10%). Mean age was 43 years (22-64) with sex-ratio of 3,3. Tumor sites were vertebra (6), flat bones (6) and tibia (1). Megavoltage radiotherapy was given to all patients, associated to surgery in eight cases (5 excisions and 3 laminectomies) and to chemotherapy in three. RESULTS: - With a mean follow-up of 63 months, two local failures were noted at 24 and 48 months. Two patients developed multifocal lesions and one patient had an extramedullary lesion. Multiple myeloma occurred in four patients (30%) after a median follow-up 3,5 years. Unfavorable outcome could not be predicted by age, gender or site of disease but by myeloma protein. CONCLUSION: - Radiotherapy is an effective local treatment for solitary bone plasmocytoma. Prospective studies are needed to better define predictive parameters of unfavourable outcome and indications of combined chemotherapy.

Adult↗
PubMed2004

[Primitive intracranial ependymomas. Salah-Azaîz institute experience].

PURPOSE: - To assess the outcome and prognostic factors of patients with primitive intracranial ependymomas treated at the department of radiotherapy of Salah-Azaîz Institute. METHODS AND MATERIAL: - Between 1972 and 1997, 31 patients aged one to 53 years received postoperative radiotherapy. There were 16 males and 15 females. Location of tumor was infratentorial in 24 cases and supratentoriel in seven cases. Surgical treatment consisted of complete resection in 14, incomplete resection in 13 and unknown type in four patients. All patients were treated with radiotherapy to the craniospinal axis in 26 cases, whole brain in five cases. RESULTS: - Five years survival rate was 63%. For infratentorial tumors, two patients failed locally, two patients failed locally and at distance and four patients failed only at distance, while one patient with supratentorial tumor relapsed locally. Age, performances status, tumor site, gender and extent of surgery had no impact on survival. The treatment field extent was the only variable predictive of outcome. Patients treated with craniospinal irradiation had a survival rate of 86% compared with 37,5% for patients treated with whole brain irradiation. CONCLUSION: - Infratentorial ependymomas seem to have a worse prognosis than supratentorial ones. Irradiation field extent should be correlated to prognostic factors.

Adolescent↗
PubMed2003

[Primary intramedullary ependymomas: retrospective study of 16 cases].

PURPOSE: To review the radiotherapy department experience in treating primary spinal cord ependymomas (PSCE), analyse prognostic factors and provide treatment recommendations regarding literature review. MATERIALS AND METHODS: Sixteen patients with PSCE received postoperative radiotherapy between 1972 and 1997. There were 10 male and 6 female patients with a mean age of 34 years (range 2-63). Surgery was gross total resection in 2 cases, subtotal resection in 9, biopsy in 4 and of unknown type in one patient. All patients were treated with radiotherapy to the craniospinal axis (4 cases), spinal cord (1 case) and to the site of primary tumour in 11 cases. RESULTS: Five year-survival rate was 73%. Two patients had recurrent tumours within the primary site. Gender, extent of surgery and treatment field extent were not prognostic factors. Histologic type was the only variable predictive of outcome. Patients with myxopapillary type had a 5-year survival rate of 100% compared with 47% for those with other histology types. CONCLUSION: We conclude that aggressive surgery is not necessary in the management of PSCE, localised field radiotherapy is associated with favourable outcome, and tumour grade is an important prognostic factor.

Adolescent↗
PubMed2003

[Second malignancies following Hodgkin's disease treatment in Tunisia. Retrospective study of 26 cases observed at the institute Salah-Azaïz].

PURPOSE: To collect second cancers in patients treated for Hodgkin disease (HD) during adolescence and young adulthood at Salah Azaïz Institute of Tunis. METHODS AND PATIENTS: We consider as second cancer all tumours other than HD observed in patients after treatment for HD. RESULTS: Twenty-five patients among 614 treated for HD between 1975 and 1991 developed 26 secondary tumours (4.2%). There were 17 males and eight females (sex ratio 2:1). Mean age at the diagnosis of HD was 32.5 years (12-56). HD was stage II (eight cases), stage III (14) and stage IV in three. The first treatment was combined chemotherapy and radiotherapy in 22 cases and only chemotherapy in three cases (stage IV). Radiotherapy was delivered with Cobalt 60 by large fields. Mean dose was 41.3 Gy (2 Gy/fraction in 21 and 3.3 in one). Chemotherapy was MOPP (13), MOPP and vinblastine (four), MOPP-ABVD (five), ABVD (two) and vinblastine only in one. Mean delay of second tumours was 114.5 months (40-276). There was five acute myeloid leukaemia, two digestive non-Hodgkin lymphomas, five nodal high-grade lymphomas, three breast cancers (one in man associated with thyroid cancer), five lung cancers (three non-small cell and two of small cell type), two gastric tumours and one rectal cancer, one synovialosarcoma of the knee and one malignant Schwannoma of the neck. Median survival was 12.5 months (2-48). Twenty-one patients died and four are still alive with 8, 12, 24 and 48 months of follow-up. CONCLUSION: Second cancer risk after treatment for HD is not low. Risk factors and preventive strategies are discussed.

Adolescent↗
PubMed2003

[Cancers arising from burn scars: 62 cases].

INTRODUCTION: The development of cancer from burn scars is rare but not exceptional since 1 to 2 p. 100 of cutaneous cancers develop on burn scars. PATIENTS AND METHODS: We report a retrospective study of 62 cases arising from burn scars that account for 25 years at the Institute Salah Azaiez in Tunis. The epidemiological, clinic and prognosis characteristics of these cancers are discussed. RESULTS: Forty-five patients were male and seventeen were female. Their age varied from 22 to 83 years, with a mean age of 51.5 years. Limbs were affected in 85 p. 100 of the cases and the lower limbs in 58 p. 100. The mean size of the tumour was of 97 mm. Squamous cell carcinomas were the most frequent cancers arising from burn scar (95 p. 100). Basal cell carcinoma is arising only in two cases and malignant melanoma in one case. The treatment was curative for 49 patients: surgery and radiotherapy (31 cases), surgery only (14 cases) and radiotherapy (4 cases). The overall survival at 2 years, 3 years and 5 years was respectively 49.5 p. 100; 41.5 p. 100 and 37 p. 100. DISCUSSION: The improvement of prognosis depends not only on an earlier diagnosis and treatment, but also on the appropriate management of burns when they occurred.

Adult↗
PubMed2003

[Intrathoracic strangulated diaphragmatic hernia. A diagnostic trap to avoid].

INTRODUCTION: Misdiagnosed and complicated diaphragmatic hernia can lead to diagnostical and therapeutical difficulties. CASE REPORT: A strangulated post-traumatic diaphragmatic hernia in a 53 years old woman was at the origin of whole hemithoracic hydroaeric opacity. The hernia diagnosis based on digestive opacification and thoraco-phreno-abdominal ultrasonography. Emergent intervention is critical and allowed aetiologic and lesional assessment. CONCLUSIONS: After thoracic traumatism, it's necessary to carry on observation and realize, in front of any suspicion, radiological investigations especially modern imaging.

Diagnosis, Differential↗
PubMed2002

Primary Hodgkin's disease of the nasopharynx: a rare but bona fide disease.

We report an uncommon case of Hodgkin's disease confined to the nasopharynx. An isolated polypoid mass of the nasopharynx was observed in a 41-year-old man presenting with increasing bilateral nasal obstruction. Histological study revealed a mixed cellularity type of Hodgkin's disease. Immunohistochemical analysis revealed CD30 and LMP1 expression and a lack of reactivity to CD15, CD3 and CD20. Serological tests excluded recent infection with Epstein-Barr virus. HD of nasopharynx is rare, but has to be recognized as such in view of appropriate treatment.

Adult↗
PubMed2001

[Indications for radiotherapy of benign lesions: yesterday, today and tomorrow].

A better knowledge of the radiobiological effects and the control of the techniques of dosimetry led to a renewed interest for the radiotherapy of the benign lesions. The doses used for these indications are weaker than those recommended for treatment of cancer and the radiobiological mechanisms implied are different. The aim of this review of the literature is to specify the radiobiological mechanisms, the risks and the place of ionizing radiations during the processing of the benign lesions. Although the risk of radiation induced neoplasms remains a limiting factor of the indications, those are very varied. Some indications are well accepted such as keloid, cerebral arteriovenous malformations, graves' ophtalmopathy, prevention of postoperative heterotopic bone formations; and some others remain still controversial such as the prevention of the post angioplasty restenosis and age-related macular degeneration.

Angioplasty↗
PubMed2000

Bilateral cystosarcoma phyllodes of the breast: a case report of malignant form with contralateral benign form.

Bilateral cystosarcoma phyllode is uncommon; bilateral tumors, either synchronous or metachronous, are generally either benign or malignant. We report one case of bilateral synchronous cystosarcoma phyllode in a 32-year-old pregnant woman. The left breast mass, measuring 21 x 17 x 10 cm, was classified as malignant cystosarcoma phyllode (high cellularity, stromal overgrowth, marked nuclear atypia, necrosis, mitotic rate = 4 mitoses/10 high power field, infiltrative margin). The right 9 x 9 cm mass was a benign cystosarcoma phyllode tumor (low to moderate cellularity, discrete nuclear atypia, mitotic rate = 1 mitoses/10 high power field, no necrosis, pushing margin). The patient had a left-sided mastectomy and a complete local excision with clear margin of the right breast mass. The patient is free of disease with a 17-month follow-up.

Adult↗
PubMed2000

[A pierced lung].

Explore the source record for details and available documents.

Diagnosis, Differential↗
PubMed2000

[Costal hydatid cyst (report of 2 cases)].

Hydatidosis is an endemic affection in our country. Hepatic and pulmonary localisation is the most frequent. The other localisation especially in the bone, are exceptional. We report 2 cases of costal hydatid diagnosed on 17 and 33 years old male patients admitted for parietal tumor respectively localized in cervix and thorax. The diagnosis, suspected on chest tomography is confirmed by histologic patterns of resected rib.

Adolescent↗
PubMed1999

[Breast cancer in Tunisia: clinical and epidemiological study].

This study has been realized to determine epidemiological profile and clinicopathologic aspect of breast cancer in Tunisia. We have counted and analyzed all cancers of the breast diagnosed in Tunisia with proof pathologic or to defect cytologic of malignancy, between first January 1994 and 31 December 1994. In the course of this year, 689 new cases of mammary cancers have been diagnosed at the women. The average patient age was 50.0 years, the incidence standardized on the age of the cancer of the breast in Tunisia was 16.7/100,000 women. The average size of the tumor was 49.5 mm (35.8 mm at patients processed in private clinics and 50.7 mm at patients processed in the public hospitals). According to TNM classification of 1988, 7.2% of tumors were classified T1, 48.9% T2, 18.5% T3, and 23.4% T4 (6.2% T4d and 16.1% T4b). 22.1% of tumors were M1. 3.3% were in situ carcinoma. For the infiltrants cancers, the grade II SBR has been the most frequent (53.6%). On the therapeutic plan, the conservative processing has been practiced only at 17.6% of patients. The cancer of the breast in Tunisia rest again relatively little frequent, and its clinic profile resides alarming. The inflammatory cancer notion of the breast (equal T4d) intimately linked to Tunisia overestimates probably the reality. Cancers that were classified "PEV" in many publications would be in reality only for most of locally evolved and neglected cancers.

Adult↗