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Najat Idelhaj
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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 | Author(s): Najat Idelhaj
- 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 | Author(s): Najat Idelhaj
- 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.
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EP1.17 - Treatment of Early Stage/Localized Disease (ID 207)
- Event: WCLC 2019
- Type: E-Poster Viewing in the Exhibit Hall
- Track: Treatment of Early Stage/Localized Disease
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2019, 08:00 - 18:00, Exhibit Hall
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EP1.17-10 - First Results of the Bronchial Cancer Registry of the Thoracic Oncology Intergroup (IGOT) of Casablanca, Morocco (ID 1892)
08:00 - 18:00 | Author(s): Najat Idelhaj
- Abstract
Background
Primary bronchial cancer is the leading cause of cancer deathwith an estimated incidence of 1.6 million new cases per year and a mortality rate of 1.4 million per year.
In Morocco, according to the Casablanca Cancer Registry, itaccounts for 22.1% of all cancers.
The objective of this work is to describe the epidemiological, clinical, pathological and therapeutic characteristics of patients diagnosed with primary bronchial cancer.
Method
This is a descriptive retrospective study of a series of 74 cases, conducted by the Thoracic Oncology Intergroup (IGOT) of the Ibn Rochd University Hospital Center in Casablanca from January 2016 to October 2018 and which met the inclusion criteria. All records of patients diagnosed with primary bronchial cancer were retained based on histopathological examination of operative specimens.
Result
The majority of patients were diagnosed in the later stages of the disease:stage I and II :9,3%, stage III : 16% and the stage IV : 73,7%. We were able to operate only 6.3% of the 9.3% resecable which is 74 patients. There were 56 men (76%) and 18 women (24%) with a sex ratio calculated at 3.11. The average age was 58.5 years, with age extremes ranging from 24 to 82 years. 35% of our patients had histological confirmation at the time of the diagnosis carried out by the flexible bronchoscopy or the scanno-guided biopsy puncture.
Occupational exposure was not noted in our patients. 65% of our patients were smokers. The medical pathological antecedents were tuberculosis in 10% of cases, arterial hypertension in 10% of cases, diabetes in 8% of cases and chronic obstructive pulmonary disease in 4% of cases. Neoplastic antecedents were lung cancer in 4% of cases, digestive cancer in 4% of cases, breast cancer in 3% of cases, cancer of the Otorhinolaryngology sphere in 6% of cases.
The average consultation time exceeded three months in 80% of cases. The symptomun derlying the consultation was chest pain in 46% of cases.
The radiological lesions were preferentially located at the level of the right lower lobe. The PET-Scan was performed in 65% of the cases and the respiratory functional exploration in 93% of the cases.
Neoadjuvant chemotherapy was necessary in 32% of cases and neoadjuvan tradiotherapy in 19% of cases.
The treatment was surgical. Surgical approache was postero lateral thoracotomy in 21 cases (28%) and video-assistedt horacic surgery (VATS) in 53 cases (72%). Conversion to thoracotomy was necessary in 9 cases.
The interventions performed were 63 lobectomy (85%) and 11 pneumonectomy (15%).The average size of the tumor was 5.5 cm (0.5-12 cm). The predominant histological type was adenocarcinoma in 64% of cases.
On the evolutionary level, in the short term, the operative follow-up was simple in 80% of the cases. The other cases had various complications. The main complication recorded was prolonged bubbling in 3.2% of cases.
Conclusion
The very low level of stage I and II at the time of diagnosis requires sensitization on the interest of screening and early diagnosis so that patients can benefit from endoscopic treatment.
