Publications by authors named "Abdelmalek Ousadden"

44 Publications

Prognostic Impact of Tumor Budding on Moroccan Colon Cancer Patients.

Int J Surg Oncol 2022 21;2022:9334570. Epub 2022 Jan 21.

Laboratory of Anatomic and Molecular Pathology, University Hospital Hassan II, Sidi Mohamed Ben Abdellah University, Fez, Morocco.

Background: Tumor budding is now emerging as one of the robust and promising histological factors that play an important role in colon cancer. In this study, we aimed to investigate the association between tumor budding and tumor clinicopathological factors, tumor molecular signature, and patient survival for the first time in a Moroccan population.

Methods: We collected data of 100 patients operated from colon adenocarcinoma. Tumor budding was assessed on HES slides, according to the International Tumor Budding Consensus Conference 2016 recommendations. The expression of MMR proteins was performed by immunohistochemistry. KRAS and NRAS mutations testing was performed by Sanger sequencing and pyrosequencing.

Results: High tumor budding grade (BUD 3) was found to be significantly associated with adverse clinicopathological features including older age (=0.03), presence of perineural invasion (=0.02), presence of vascular invasion (=0.05), distant metastases ( < 0.001), advanced TNM stage (=0.001), the occurrence of relapse (=0.04), and the high number of deceased cases (=0.02). Interestingly, we found that tumors with high-grade tumor budding were more likely to be microsatellite stable (MSS) (=0.005) and harbor more KRAS mutations (=0.02). Tumors with high-grade tumor budding were strongly associated with KRAS G12D mutation (=0.007). In all stages, high tumor budding was correlated with poorer overall survival (=0.04) and decreased relapse-free survival with a difference close to significance ((=0.09). We concluded that high tumor budding was strongly associated with unfavorable clinicopathological features and special molecular biomarkers and effectively affects the overall survival of CC patients.

Conclusions: Based on these findings and the ITBCC group recommendations, tumor budding should be taken into account along with other clinicopathologic factors in the risk assessment of colorectal cancer.
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http://dx.doi.org/10.1155/2022/9334570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799359PMC
February 2022

Comparative analysis of clinicopathologic features between adenoma and hyperplasia in surgically treated patients for hyperparathyroidism: A retrospective study.

Ann Med Surg (Lond) 2021 Nov 9;71:102929. Epub 2021 Oct 9.

Department of Pathology, Hassan II University Hospital, Fès, Morocco.

Background: Hyperparathyroidism (HPT) is a common endocrine disorder resulting from overproduction of parathyroid hormone (PTH). Usually HPT is caused by parathyroid adenoma (PA) or parathyroid hyperplasia (PH). Our aim is to assess clinicopathologic features associated with PA and PH in patients with HPT.

Methods: We retrospectively collected 29 cases of HPT recorded at the Department of Pathology of Hassan II University Hospital of Fes, Morocco, from 2013 to 2016.

Results: The mean age was 52.14 ± 15.7 years (range of 22-76 years), 13 patients (44.8%) had primary HPT, 16 (55.2%) had secondary HPT. The largest size of the resected parathyroid specimens ranged from 1 to 3.6 cm (mean of 2.26 ± 0.66 cm). Seventeen patients (58.6%) had PA, the remaining cases were diagnosed as PH. There were no significant statistical differences between PA and PH in age, sex, clinical presentation, preoperative serum PTH, or in parathyroid gland size ( > 0.05). However compared to PH, PA is more often a single-gland disease, found in primary HPT with higher preoperative calcium level ( ˂ 0.05).

Conclusions: In patients surgically treated for HPT, PA is associated with some distinctive clinicopathologic features. These findings could be helpful to pathologists and clinicians for appropriate clinicopathologic management.
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http://dx.doi.org/10.1016/j.amsu.2021.102929DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517285PMC
November 2021

Mutation status and prognostic value of KRAS and NRAS mutations in Moroccan colon cancer patients: A first report.

PLoS One 2021 30;16(3):e0248522. Epub 2021 Mar 30.

Faculty of Medicine and Pharmacy, Laboratory of Biomedical and Translational Research, Sidi Mohamed Ben Abdellah University, Fez, Morocco.

This study aimed to estimate the incidence of KRAS, NRAS, and BRAF mutations in the Moroccan population, and investigate the associations of KRAS and NRAS gene mutations with clinicopathological characteristics and their prognosis value. To achieve these objectives, we reviewed medical and pathology reports for 210 patients. RAS testing was investigated by Sanger sequencing and Pyrosequencing technology. BRAF (exon 15) status was analyzed by the Sanger method. The expression of MMR proteins was evaluated by Immunohistochemistry. KRAS and NRAS mutations were found in 36.7% and 2.9% of 210 patients, respectively. KRAS exon 2 mutations were identified in 76.5% of the cases. RAS-mutated colon cancers were significantly associated with female gender, presence of vascular invasion, classical adenocarcinoma, moderately differentiated tumors, advanced TNM stage III-IV, left colon site, higher incidence of distant metastases at the time of diagnostic, microsatellite stable phenotype, lower number of total lymph nodes, and higher means of positive lymph nodes and lymph node ratio. KRAS exon 2-mutated colon cancers, compared with KRAS wild-type colon cancers were associated with the same clinicopathological features of RAS-mutated colon cancers. NRAS-mutated patients were associated with lower total lymph node rate and the presence of positive lymph node. Rare RAS-mutated tumors, compared with wild-type tumors were more frequently moderately differentiated and associated with lower lymph node rate. We found that KRAS codon 13-mutated, tumors compared to codon 12-mutated tumors were significantly correlated with a higher death cases number, a lower rate of positive lymph, lower follow-up time, and poor overall survival. Our findings show that KRAS and NRAS mutations have distinct clinicopathological features. KRAS codon 13-mutated status was the worst predictor of prognosis at all stages in our population.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248522PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8009361PMC
October 2021

[Epiploic appendagitis: a rare cause of acute abdomen].

Pan Afr Med J 2020 3;36:149. Epub 2020 Jul 3.

Service de Chirurgie Viscérale, CHU Hassan II, Faculté de Médecine, Fès Maroc.

Epiploic appendagitis is a rare cause of acute abdomen. It can mimic other inflammatory processes such as diverticulitis or appendicitis. Diagnosis is based on CT scan. Medical management is the approach of choice in the absence of complications.
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http://dx.doi.org/10.11604/pamj.2020.36.149.21033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436646PMC
December 2020

Analysis of Molecular Pretreated Tumor Profiles as Predictive Biomarkers of Therapeutic Response and Survival Outcomes after Neoadjuvant Therapy for Rectal Cancer in Moroccan Population.

Dis Markers 2020 11;2020:8459303. Epub 2020 Jan 11.

Laboratory of Biomedical and Translational Research, University of Medicine and Pharmacy of Fez, Morocco.

Pathologic features depending on tumor response to preoperative chemoradiotherapy are important to determine the outcomes in patients with rectal cancer. Evaluating the potential predictive roles of biomarker expression and their prognostic impact is a promising challenge. We reported here the immunohistochemical staining of a panel marker of mismatch repair protein (MMR), Ki67, HER-2, and p53. Additionally, identification of somatic mutations of KRAS, NRAS, and BRAF genes were performed by direct sequencing and pyrosequencing in pretreated biopsy tissues from 57 patients diagnosed for rectal cancer. Clinical features and pathological criteria for postneoadjuvant treatment surgical resection specimen's data were collected. Immunohistochemical expression and mutational status were correlated with therapeutic response, overall survival, and disease progression. The mean age of patients was 56 years. Seven (12.3%) out of 57 patients had a complete therapeutic response. Our analysis showed that when using complete therapeutic response (Dworak 4) and incomplete therapeutic response (Dworak 3, 2, and 1) as grouping factor, high p53 expression at the pretreatment biopsy was significantly associated to an incomplete response ( = 0.002). For 20 and 2 out of 57, KRAS and NRAS mutations were detected, respectively. The majority of these mutations affected codon 12. KRAS mutations detected at codon 146 (A146T, A146V) was associated with the appearance of recurrence and distant metastasis ( = 0.019). A high expression of HER-2 corresponding to score 3+ was observed in 3 pretreatment biopsy specimens. This class was significantly associated with a short relapse-free survival ( = 0.002). Furthermore, the high expression of Ki67 was moderately correlated with an older age ( = 0.016, = 0.319). In addition, this shows that high p53 expression in the pretreatment biopsy was associated with an incomplete response in surgical resection specimens after neoadjuvant treatment, and a HER-2 score 3+ can be a predictive factor of distant metastasis and local recurrence. Larger, prospective, and more studies are needed.
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http://dx.doi.org/10.1155/2020/8459303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6977322PMC
September 2020

A laparoscopic treatment of a suspicious adrenal mass revealing an unsual cause of adrenal incidentaloma.

Pan Afr Med J 2019 12;34:28. Epub 2019 Sep 12.

Department of Endocrinology and Diabetology, University Hospital of Fez, Fez, Morocco.

Schwannomas are rare tumors, usually benign, originating from the Schwann sheath of the peripheral or cranial nerves. They are an extremely uncommon cause of adrenal incidentaloma. It is difficult to diagnose adrenal schwannoma preoperatively by imaging alone due of their aspect suspect on it. We report a case of adrenal mass discovered incidentally in a 41 years old patient who presented an atypical abdominal pain. Biological assessment was unremarkable, and imaging studies did not show strict imaging criteria for a typical adenoma. A surgical excision of the adrenal incidentaloma was decided. Histopathological examination and immunohistochemical staining of the excised specimen revealed a benign schwannoma.
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http://dx.doi.org/10.11604/pamj.2019.34.28.18239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859016PMC
December 2019

[Voluminous colorectal foreign bodies inserted voluntarily: about a case].

Pan Afr Med J 2019 13;34:142. Epub 2019 Nov 13.

Service de Chirurgie Viscérale, CHU Hassan II, Fes, Maroc.

Insertion of foreign bodies is a curiosity and a taboo in our country. It is characterized by the severity of possible complications and the different therapeutic opportunities. We report the case of a patient with rectal incarceration of a vouminous object introduced voluntarily. He underwent manual extraction. Extraction, when possible, allow to avoid surgery that is necessary in the case of failure or complications.
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http://dx.doi.org/10.11604/pamj.2019.34.142.20793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7906543PMC
March 2021

[Acute intestinal intussusception revealing intestinal T-cell lymphoma in adults].

Pan Afr Med J 2019 1;33:153. Epub 2019 Jul 1.

Service de Chirurgie Viscérale A, CHU Hassan II, Fès, Maroc.

Acute intestinal intussusception occurs primarily in infants and young children. It uncommonly occurs in adults. It can have various causes. In the vast majority of cases, it is secondary to a benign or malignant tumor. Intestinal T-cell lymphoma revealed by intestinal intussusception is very rare. We report the case of a 43-year old patient admitted with intestinal occlusion to the Emergency Department at the University Hospital Hassan II, Fes, Morocco. Abdominal CT scan showed acute intestinal intussusception associated with incarcerated bowel loop with bowel wall thickening. Treatment was based on open carcinological resection. Anatomopathological and immunohistochemical examination of the surgical specimen showed large T-cell anaplastic lymphoma. After surgery, chemotherapy was indicated to improve prognosis and to avoid a potential relapse. Intestinal intussusception rarely occurs in adults. It most often leads to the detection of an organic cause such as a tumor. This study and literature review aim to highlight the clinical and diagnostic features as well as the therapeutic approaches for this rare disease.
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http://dx.doi.org/10.11604/pamj.2019.33.153.18758DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754853PMC
October 2019

[Internal hernia through the falciform ligament: a rare cause of intestinal obstruction].

Pan Afr Med J 2019 28;32:48. Epub 2019 Jan 28.

Service de Chirurgie Viscérale A, CHU Hassan II, Fès, Maroc.

Internal hernias are a rare cause of acute intestinal obstruction. Hernias through the falciform ligament is uncommon. Diagnosis is often made intraoperatively. Abdominal CT scan, performed in an emergency situation, can enable preoperative diagnosis and guide the therapeutic approach. In this respect, we here report a case whose data were collected in the Department of Visceral Surgery at the University Hospital Hassan II in Fez. The study involved a 48-year old patient, with no particular previous history, admitted to the Emergency Department with occlusion evolving over 4 days. Abdominal x-ray without treatment objectified multiple hydroaeric levels in small bowel some of which projected towards the hepatic region as well as the presence of a flat intestinal loop in continuity with distended intestinal segment. Abdominal CT scan was not performed due to altered renal function. The patient then underwent emergency surgery after stabilization of his condition and the diagnosis of internal hernias through the falciform ligament was made intraoperatively. In adults, internal hernia through the falciform ligament is a rare cause of acute intestinal obstruction in our daily practice. The diagnosis is most often made intraoperatively. It is necessary to suspect it in young patients with no history of abdominal surgery or intraperitoneal infectious process and with hydroaeric levels in the right upper quadrant.
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http://dx.doi.org/10.11604/pamj.2019.32.48.17845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6522209PMC
June 2019

Transverse colon volvulus presenting as bowel obstruction: a case report.

J Med Case Rep 2019 May 25;13(1):156. Epub 2019 May 25.

Visceral Surgery Department A, CHU Hassan II, Fez, Morocco.

Background: Transverse colon volvulus is an uncommon cause of bowel obstruction. The total number of cases reported in the literature is 100. It constitutes a surgical emergency since it can lead to bowel infarction, peritonitis, and death if not diagnosed at once. It seemed appropriate to report this case that was treated at the Department of Visceral Surgery A, University Hospital Center Hassan II of Fez in Morocco.

Case Presentation: We report a rare case of transverse colon volvulus in a 42-year-old Arabic man, with no particular history, who presented to our emergency department with a 5-day history of constipation, progressive abdominal pain, nausea, and vomiting. His last bowel movement had been 3 days ago. Abdominal radiography showed a large bowel obstruction with a "U-shaped" loop in the left upper abdomen. Abdominal computed tomography was not performed because of impaired renal function. He was operated on urgently after conditioning and the diagnosis of a transverse colon volvulus was done intraoperatively. Rotated in a 360° clockwise direction on its mesentery, the bowel was intact without signs of ischemia. An extended right hemicolectomy was carried out with end-to-side ileocolic anastomosis. Through this case, we will try to discuss its physiopathology, etiologies, diagnosis, and management in emergencies.

Conclusion: This case is unusual because no etiological factor has been found. Its diagnosis can be difficult and management effectiveness remains controversial. It is important to highlight this case and those of the literature, as many surgeons may have never seen a case of transverse colon volvulus. Volvulus of the transverse colon may therefore not be considered in the differential diagnosis of recurrent intermittent abdominal pain or acute intestinal obstruction. Prompt recognition with emergency intervention constitutes the key to a successful outcome.
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http://dx.doi.org/10.1186/s13256-019-2080-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6534884PMC
May 2019

Applicability and outcome of laparoscopic adrenalectomy for large tumours.

Pan Afr Med J 2018 11;31:23. Epub 2018 Sep 11.

Department of Visceral and Endocrine Surgery, Hassan II University Hospital, Fez, Morocco.

Laparoscopic adrenalectomy has been shown to be as safe and effective as conventional open surgery for small and benign adrenal lesions. With increasing experience with laparoscopic adrenalectomy, this approach has become the procedure of choice for the majority of patients requiring adrenalectomy. In our department, from 2011 to 2016, a total of 28 patients with 31 adrenal tumours underwent laparoscopic adrenalectomy regardless of tumour size. Our policy in the department is to exclude adrenal tumours that are potentially malignant or metastatic adrenal tumours for laparoscopic resection. In this a retrospective study, we divided patients into two groups according to tumour size: < 5 or ≥ 5 cm, which was considered as the definition of large adrenal tumours. We compared demographic data and per- and postoperative outcomes. There was no statistical difference between the two groups for per-operative complications (16,6% vs 18,75% , P = 0.71), postoperative complications (16,6% vs 18,75% , P = 0.71), postoperative length of hospital stay (5 vs 8 days P = 0.40), mortality (0% vs 0%) or oncologic outcomes: recurrence and metastasis (8.3% vs 6.25% P = 0.70). The only statistical difference was the operating time, at a mean (SD) 194 (60) vs 237 (71) min (P = 0.039) and the conversion rate (0% vs 12.5% P < 0.01). Laparoscopic adrenalectomy can be done for all patients with adrenal tumours regardless of tumour size, even it needs more time for large tumour but appears to be safe and feasible when performed by experienced surgeons.
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http://dx.doi.org/10.11604/pamj.2018.31.23.15153DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430842PMC
April 2019

[Gastroduodenal trichobezoar: about a case].

Pan Afr Med J 2018 15;30:25. Epub 2018 May 15.

Université Sidi Mohamed Ben Abdellah, Service de Chirurgie Viscérale A (C3), CHU Hassan II Fes, Maroc.

Gastroduodenal trichobezoar ulcer is rare. Its diagnosis is easy in the presence of an evocative context. We report the case of a 21-year old patient followed up for schizophrenia, admitted with acute abdominal pain, vomiting and epigastric mass. Abdominal CT scan suggested the diagnosis of bezoar on the basis of heterogeneous, non-enhanced lesions occupying the entire stomach and appearing to be separated from the gastric wall. Surgical removal of trichobezoar by gastrotomy was performed without complications. The patient was referred to the Department of Psychiatry.
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http://dx.doi.org/10.11604/pamj.2018.30.25.12239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110540PMC
September 2018

[Volvulus of the cecum: a rare cause of intestinal occlusion: about two cases].

Pan Afr Med J 2017 19;28:162. Epub 2017 Oct 19.

Service de Chirurgie Viscérale A(C3), CHU Hassan II, Fès, Maroc.

The cecum is the second part of the colon that is most commonly affected by the volvulus after sigmoid colon and before left corner and the transverse colon. This condition occurs in patients with abnormally mobile cecum. Volvulus is characterized by torsion or tilt. Clinically, it appears as bowel obstruction due to acute strangulation. Abdominal x-ray without treatment and abdominal CT scan are the radiological procedures of choice in the diagnosis of volvulus of the cecum. Treatment is based on emergency surgical excision of the cecum and of the terminal ileum. We report two cases of patients with volvulus of the cecum admitted to the emergency department with acute intestinal obstruction. In both patients, the diagnosis was confirmed by abdomino-pelvic CT scan and the treatment was based on ileocolic resection with immediate restoration of the intestinal continuity. The postoperative course was uneventful.
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http://dx.doi.org/10.11604/pamj.2017.28.162.12237DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5847055PMC
March 2018

The expression of MDM2 in gastrointestinal stromal tumors: immunohistochemical analysis of 35 cases.

BMC Clin Pathol 2018 24;18. Epub 2018 Jan 24.

1Department of pathology, Hassan II university hospital, Fès, Morocco.

Background: Gastrointestinal stromal tumors (GIST) are the most common primary mesenchymal tumors of the digestive system. The assessment of their biological behavior still remains a scientific challenge. To date, there are no well-established biological prognostic markers of GIST. Our aim is to study the expression of the MDM2 oncoprotein in GIST through an immunohistochemical analysis.

Methods: It was a retrospective study of 35 cases of GIST diagnosed from 2009 to 2012 in the department of pathology of Hassan II university hospital, Fès, Morocco. MDM2 immunohistochemical staining was performed on archival paraffin-embedded and formalin-fixed specimens (with a threshold of nuclear positivity > 10%). Analysis of correlations between MDM2 immunoexpression and clinicopathological features of GIST has been performed.

Results: The mean age was 55.23 years (range 25-84 years) with a male predominance (sex ratio = 1.5). The stomach was the main site of GIST, with 17 cases (48.57%) followed by the small bowel (9 cases, 25.71%). The spindle cell type GIST was the most frequent morphological variant (29 cases, 82.85%). Tumor necrosis was present in 8 cases (22.85%). Two patients (5.71%) had very low risk GIST, 5 (14.28%) had low risk GIST, 7 patients (20%) had intermediate risk tumors. The remaining 21 cases (60%) had high risk GIST. At the time of diagnosis, 9 patients (25.71%) had metastatic tumors. At immunohistochemical analysis, 40% of cases (14 patients) stained positive for MDM2. Of these MDMD2-positive tumors, 11/14 (78.57%) had high risk tumors and 8/14 cases (57.14%) presented with metastatic GIST. MDM2 positivity was significantly associated with the metastatic status ( = 0.001).

Conclusion: The current study suggests that MDM2 immunohistochemical expression is a negative histoprognostic factor in GIST with a statistically significant correlation with metastasis.
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http://dx.doi.org/10.1186/s12907-018-0069-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781285PMC
January 2018

[High grade insulinoma detected in a patient with a 5-year history of severe hypoglycemias].

Pan Afr Med J 2017 4;27:250. Epub 2017 Aug 4.

Service de Chirurgie Viscérale A, CHU Hassan II, Fès, Maroc.

Functional endocrine tumors of the pancreas are rare. Among them insulinomas are the most common types. The majority of the patients with insulinoma are between 30 and 60 years of age and 59% of them are women. Most insulinomas are sporadic tumors while 10% of them develop in patients with multiple endocrine neoplasia (MEN). Diagnosis is based on clinical examination and laboratory tests. Preoperative imaging assessment (echo-endoscopy, CT, MRI) is essential for tumor localization in more than 80% of cases. Surgical excision is the treatment of choice. We here report the case of a 50-year old patient with high grade insulinoma developed on the anterior surface of the pancreas tail.
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http://dx.doi.org/10.11604/pamj.2017.27.250.13144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5622836PMC
October 2017

Epigenetics could explain some Moroccan population colorectal cancers peculiarities: microsatellite instability pathway exploration.

Diagn Pathol 2015 Jun 24;10:77. Epub 2015 Jun 24.

Department of pathology, University hospital Hassan II of Fez, Fez, Morocco.

Background: Colorectal Cancers (CRC) are one of the most common malignancies in the world. Their incidence in Morocco, between 2005 and 2007, was 5.6 for 100000 inhabitants, which is very low compared to what found in developed countries. In addition, CRCs show a high frequency of rectal localizations, and occurs in a younger population in Morocco compared to what found in developed countries. The purpose of this study is to confirm these CRC peculiarities in Morocco and try to explain them by exploring the microsatellite instability molecular pathway.

Methods: This is a prospective observational study conducted since January 2010, including 385 patients admitted in Hassan II University Hospital of Fez. We collected clinical, radiological and pathological data. We investigated the expression of mismatch repair (MMR) proteins in 214 patients and BRAF gene mutations in 159 patients.

Results: Mean age was 55.08 +/- 15.16 years. 36.5% of patients were less than 50 years old and 49.3% of tumors were localized in the rectum. Loss of MMR protein expression was observed in 11.2% of cases. It was independently associated with individual or family history of cancer belonging to Hereditary Non-Polyposis Colorectal Cancer (HNPCC) spectrum (p = 0.01) and proximal localization (p = 0.02). No BRAF mutation was detected in all cases.

Conclusions: These results confirm the high occurrence of CRCs to young patients and the high frequency of rectal localizations in Moroccan population. They mostly show an absence of BRAF mutation, supposing a rarity of MLH1 promoter hypermethylation pathway, which may even partially explain the CRC peculiarities in our context.

Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/5868184711716884.
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http://dx.doi.org/10.1186/s13000-015-0326-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477595PMC
June 2015

[Large intra-rectal foreign body : a case report].

Pan Afr Med J 2014 4;18:273. Epub 2014 Aug 4.

Service de Chirurgie Viscérale, CHU Hassan II - Fès, Université Sidi Mohamed Ben Abdellah, Faculté de Médecine et de Pharmacie de Fès, Fès, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.18.273.4226DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4258213PMC
July 2015

[Small bowel volvulus on peritoneal hydatid disease: a rare cause of obstruction].

Pan Afr Med J 2014 24;18:79. Epub 2014 May 24.

Service de Chirurgie Viscérale, CHU Hassan II - Fès, Université Sidi Mohamed Ben Abdellah, Faculté de Médecine et de Pharmacie de Fès, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.18.79.4205DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4231250PMC
July 2015

Benign cystic mesothelioma of the peritoneum: a case report and literature review.

World J Emerg Surg 2013 Oct 13;8(1):43. Epub 2013 Oct 13.

Department of Surgery, School of Medicine and Pharmacy of Fez, Sidi Mohammed Ben Abdallah University, University hospital HASSAN II, BP: 1893, Km2,200, Route de Sidi Hrazem FEZ 30000, Morocco.

Benign cystic mesothelioma of the peritoneum (BCM) is an uncommon lesion with some 130 cases reported since the first case described by Smith and Mennenmeyer in 1979. It is a rare intra abdominal tumor occurring predominantly in women of reproductive age. Due to the rarity of this tumor, similarity of patient presentation, and comparable features on imaging, the diagnosis of this pathology is difficult, and is based on histological findings. This tumor is known for local recurrence. It's agreed that surgery is the only effective treatment, but there are no evidence-based treatment strategies for BCM.
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http://dx.doi.org/10.1186/1749-7922-8-43DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3853709PMC
October 2013

Traumatic appendicitis: a case report and literature review.

World J Emerg Surg 2013 Aug 9;8(1):31. Epub 2013 Aug 9.

School of medicine and pharmacy of Fez, Sidi Mohammed Ben Abdellah University, BP: 1893; km2,200, route de sidi Hrazem, Fez 30000, Morocco.

Appendicitis and trauma may exist together, which causes an interesting debate whether trauma has led to appendicitis. We report a case of appendicitis after an abdominal trauma. Our patient developed acute appendicitis following a stab wound in the right iliac fossa. Surgical exploration confirmed the traumatic origin of appendicitis, appendectomy was performed and our patient made an excellent recovery. In non operative management of abdominal trauma, physical examinations and radiological explorations should be repeated in order to diagnose traumatic appendicitis.
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http://dx.doi.org/10.1186/1749-7922-8-31DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3750490PMC
August 2013

Fournier's gangrene: our experience with 50 patients and analysis of factors affecting mortality.

World J Emerg Surg 2013 Apr 1;8(1):13. Epub 2013 Apr 1.

Department of surgery, University hospital Hassan II, Fez, Morocco.

Introduction: Fournier's gangrene is a rare, rapidly progressive, necrotizing fasciitis of the external genitalia and perineum. Case series have shown a mortality rate of 20% to 40% with an incidence of as high as 88% in some reports. In this study we aimed to share our experience in the management of Fournier's gangrene and to identify risk factors that affect mortality.

Methods: The medical records of 50 patients with Fournier's gangrene who presented at the University Hospital Hassan II of Fez from January 2003 to December 2009 were reviewed retrospectively to analyze the outcome and identify the risk factors and prognostic indicators of mortality.

Results: Ten males and five females were enrolled in the study. The mean age was 54 years (range 23-81). The most common predisposing factor was diabetes mellitus (34%). E. coli was the most frequent bacterial organisms cultured. All patients were treated with a common approach of resuscitation, broad-spectrum antibiotics, and wide surgical excision. The mortality rate was 24%. The advanced age, renal failure on admission, extension of infection to the abdominal wall, occurrence of septic shock and need for postoperative mechanical ventilation are the main prognostic factors of mortality. In multivariate analysis, none of these variables is an independent predictor of mortality.

Conclusions: Fournier's gangrene is still a very severe disease with high mortality rates. Early recognition of infection associated with invasive and aggressive treatment is essential for attempting to reduce these prognostic indices.
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http://dx.doi.org/10.1186/1749-7922-8-13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616831PMC
April 2013

[Colon trauma: experience of the CHU Hassan II of Fez].

Pan Afr Med J 2012 21;13:61. Epub 2012 Nov 21.

Department of surgery, University hospital Hassan II, Fez, Morocco.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3549446PMC
July 2013

A case report of acute acalculous cholecystitis due to Salmonella Paratyphi B complicated by biliary peritonitis.

Pan Afr Med J 2013 30;16:127. Epub 2013 Nov 30.

Department of surgery, University hospital Hassan II, Morocco.

Non-typhoidal salmonella are a rare case of acute acalculouscholecystitis (AAC). Salmonella Paratyphi B, which accounts for one of the less invasive NTS serotypes, has rarely been reported to cause cholecystitis. We describe a case of 65-year old previously healthy man, who present with signs of acute abdomen, due to biliary peritonitis as a complication of acute acalculouscholecystitis caused by Salmonella paratyphi B. Our case illustrates the potential severity of infection with Salmonella Paratyphi B especially in older patient. High index of awarenessshould be considered in endemic areas.
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http://dx.doi.org/10.11604/pamj.2013.16.127.1856DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4021980PMC
November 2014

Squamous cell carcinoma associated anal fistulas in Crohn's disease unique case report with literature review.

J Crohns Colitis 2013 Jul 12;7(6):e232-5. Epub 2012 Oct 12.

Department of surgery, University hospital Hassan II. Fez., Morocco.

Squamous cell carcinoma arising from perineal fistula in patients with Crohn's disease (CD) is a rare entity, with few reported cases in the literature making its clinical characterization troublesome. The outcome is poor following operative treatment as the malignancy of chronic perineal fistula in Crohn's disease is usually overlooked and tardily diagnosed. We present a unique case of a 47-year-old man with a 20-year history of chronic perineal fistula that was diagnosed with extensive perineal squamous cell carcinoma extending down to the right thigh. Computer tomography showed locally advanced disease with inguinal and lung metastasis. Treatment was consisted of diverting colostomy and palliative care. The patient died 3 months later. The clinical data and clinicopathological features of reported cases in the literature were reviewed.
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http://dx.doi.org/10.1016/j.crohns.2012.09.015DOI Listing
July 2013

A giant peritoneal simple mesothelial cyst: a case report.

J Med Case Rep 2011 Aug 10;5:361. Epub 2011 Aug 10.

Service de Chirurgie Viscérale, Hôpital des Spécialités, CHU Hassan II, Route de Sidi Harazem, Fès, 30070, Morocco.

Introduction: A peritoneal simple mesothelial cyst is a very rare mesenteric cyst of mesothelial origin. The size of this lesion usually ranges between a few centimeters and 10 cm. It is usually asymptomatic, but occasionally presents with various, non-specific symptoms, which makes correct pre-operative diagnosis difficult. We present a case of a giant peritoneal simple mesothelial cyst that was successfully managed by complete surgical excision which is the treatment of choice.

Case Presentation: A 21-year-old Caucasian Moroccan woman with vague abdominal discomfort and associated distention, during the previous 2 years, without other symptoms, presented to our hospital. Her past medical history was unremarkable. On physical examination, a mobile, painless and relatively hard abdominal mass was palpated. The laboratory examination and abdominal radiograph were unremarkable. Abdominal radiologic imaging showed a cystic mass of 35 × 20 × 10 cm that occupied the entire anterior and right abdominal cavity. Radical excision of the cyst was performed by midline laparotomy without any damage to the adjacent abdominal organs. The histopathological diagnosis was simple mesothelial cyst. The postoperative course was uneventful with no recurrence.

Conclusion: A peritoneal simple mesothelial cyst is a quite rare abdominal tumor, that must always be considered in differential diagnosis of pelvic cystic lesions and other mesenteric cysts. The treatment of choice is the complete surgical excision of the cyst.
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http://dx.doi.org/10.1186/1752-1947-5-361DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163219PMC
August 2011

A solitary primary subcutaneous hydatid cyst in the abdominal wall of a 70-year-old woman: a case report.

J Med Case Rep 2011 Jul 2;5:270. Epub 2011 Jul 2.

Service de Chirurgie Viscérale, Hôpital des Spécialités, CHU Hassan II, Route de Sidi Harazem, Fès 30070, Morocco.

Introduction: A solitary primary hydatid cyst in the subcutaneous abdominal wall is an exceptional entity, even in countries where the Echinococcus infestation is endemic.

Case Presentation: We report a case of a 70-year-old Caucasian woman who presented to our hospital with a subcutaneous mass in the para-umbilical area with a non-specific clinical presentation. The diagnosis of subcutaneous hydatid cyst was suspected on the basis of radiological findings. A complete surgical resection of the mass was performed and the patient had an uneventful post-operative recovery. The histopathology confirmed the suspected diagnosis.

Conclusion: Hydatid cyst should be considered in the differential diagnosis of every subcutaneous cystic mass, especially in regions where the disease is endemic. The best treatment is the total excision of the cyst with an intact wall.
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http://dx.doi.org/10.1186/1752-1947-5-270DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3152916PMC
July 2011

[Hydatid cysts of the spleen: conservative or radical surgery? ].

Pan Afr Med J 2010 Jun 19;5:21. Epub 2010 Jun 19.

Clinique chirurgicale C, Hôpital Ibn Sina, CHU Ibn Sina, 10000 Rabat, Maroc.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032623PMC
June 2010
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