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Amina Moumen
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EP1.15 - Thymoma/Other Thoracic Malignancies (ID 205)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Thymoma/Other Thoracic Malignancies
- Presentations: 2
- Now Available
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.15-06 - Askin Tumor: A Case Report (Now Available) (ID 2234)
08:00 - 18:00 | Presenting Author(s): Amina Moumen
- Abstract
Background
Askin's tumor is a rare highly malignant tumor that originates from the soft tissue of the chest wall, rarely in the lung. It is observed with predilection in the young subject and still raises many questions about his own individualization and his links with Ewing's sarcoma.
Method
We report the case of child Y. I, 12 years old, who had left chest pain with dyspnea stage 1 6 months before his admission
Result
The chest CT objectified 2 contiguous formations of the left chest base (30mm and 92mm) with peripheral calcification that contrasted homogeneously with a left pleural effusion. After a multidisciplinary meeting, a biopsy was indicated and its examination found an aspect of round cell tumor proliferation infiltrating muscle tissue and expressing intensely anti CD99 Ac, in favour of a primary peripheral neuro-ectodermal tumor (PNET) Askin type. The patient was then referred to haematology where he received 6 cycles of neo-adjuvant chemotherapy (VIDEprotocol). The thoracic CT evaluation showed a regression of the 2 formations with a slight thickening in the mid-arc of the 9th left rib.
The patient therefore benefited from a one-piece resection of the left lateral arches of Co8, Co9 and Co10. The post-operative history was simple. The patient left the ward the fourth day after the surgery. The anatomopathological examination of the resected piece concluded that there was a residual site compatible with the Askin tumour representing 10 to 50% of the tumor mass and evaluated as grade II of Huvos and Rosen with the presence of necrotic and fibrohyaline changes. The resection was complete.
After an adjuvant chemotherapy and 8 months before surgery, the patient is regularly followed in consultation and shows no sign of recurrence.
Conclusion
The therapeutic management of Askin's tumor is not yet well codified and patients are most often treated on a case-by-case basis. All decisions should therefore be taken within the framework of a multidisciplinary meeting.
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EP1.15-21 - Thymic Epithelial Tumors: Review of Clinical and Pathological Findings and Prognostic Factors for the Survival (Now Available) (ID 2266)
08:00 - 18:00 | Presenting Author(s): Amina Moumen
- Abstract
Background
Considered as a very rare malignances (0,15 cases per 100.000), thymic epithelial tumors are also the most commun tumor of the anterior mediastinum. Their treatment is based on multidisciplinary management. The basis of the treatment is a complete surgical and carcinological resection. In locally advanced tumors, neo-adjuvant chemotherapy can be performed. In the case of invasive tumors or incomplete resection, adjuvant radiotherapy is usually recommended.
Method
We conducted a monocentric, descriptive and retrospective study based on the medical record of 32 patients who underwent surgery for a thymic epithelial tumors in the department of thoracic surgery in the university hospital Ibn Rochd, Casablanca, Morocco. The aim of this study is to review the clinical and pathological findings and also to determine which factors independently predict survival after surgical resection.
Result
The average age was 48 years and the sex ratio was 0. 88. Of the 32 cases, 32,4% had symptoms consistent with myasthenia gravis. Surgical resection was performed either by sternotomy, thoracotomy or VATS. It was complete in 87,5% of cases.
3 patients (9,4%) received neoadjuvant chemotherapy to reduce tumor size before the surgery. Post-operative radiotherapy was indicated in 31. 2% of patients.
We have experienced only one death due to the disease in our series and 2 patients were lost to the follow-up.
After an univariate analysis, prognostic factors were: the histological type, the Masaoka-Koga stage and the extent of surgical resection. No multivariate analysis could be done due to small numbers of patients.
Conclusion
Thymic epithelial tumors present specific problems from anatomical pathology to therapeutic strategy. Their optimal care is still poorly defined because of their rarity and of the resulting difficulty to conceive large clinical trials. Meanwhile, ITMIG, UICC and AJCC are trying to develop a consensus on easier and more universal classification, based on the TNM, to help improve the management.
