Publications by authors named "Hicham El Bouhaddouti"

21 Publications

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Reproduction of the Cancer Genome Atlas (TCGA) and Asian Cancer Research Group (ACRG) Gastric Cancer Molecular Classifications and Their Association with Clinicopathological Characteristics and Overall Survival in Moroccan Patients.

Dis Markers 2021 28;2021:9980410. Epub 2021 Jul 28.

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

Introduction: The Cancer Genome Atlas (TCGA) project and Asian Cancer Research Group (ACRG) recently categorized gastric cancer into molecular subtypes. Nevertheless, these classification systems require high cost and sophisticated molecular technologies, preventing their widespread use in the clinic. This study is aimed to generating molecular subtypes of gastric cancer using techniques available in routine diagnostic practice in a series of Moroccan gastric cancer patients. In addition, we assessed the associations between molecular subtypes, clinicopathological features, and prognosis.

Methods: Ninety-seven gastric cancer cases were classified according to TCGA, ACRG, and integrated classifications using a panel of four molecular markers (EBV, MSI, E-cadherin, and p53). HER2 status and PD-L1 expression were also evaluated. These markers were analyzed using immunohistochemistry (E-cadherin, p53, HER2, and PD-L1), in situ hybridization (EBV and HER2 equivocal cases), and multiplex PCR (MSI).

Results: Our results showed that the subtypes presented distinct clinicopathological features and prognosis. EBV-positive gastric cancers were found exclusively in male patients. The GS (TCGA classification), MSS/EMT (ACRG classification), and E-cadherin aberrant subtype (integrated classification) presented the Lauren diffuse histology enrichment and tended to be diagnosed at a younger age. The MSI subtype was associated with a better overall survival across all classifications (TCGA, ACRG, and integrated classification). The worst prognosis was observed in the EBV subtype (TCGA and integrated classification) and MSS/EMT subtype (ACRG classification). . We reported a reproducible and affordable gastric cancer subtyping algorithms that can reproduce the recently recognized TCGA, ACRG, and integrated gastric cancer classifications, using techniques available in routine diagnosis. These simplified classifications can be employed not only for molecular classification but also in predicting the prognosis of gastric cancer patients.
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http://dx.doi.org/10.1155/2021/9980410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8342151PMC
January 2022

Gastric Signet Ring Cell Carcinoma: A Comparative Analysis of Clinicopathologic Features.

Cancer Control 2020 Jan-Dec;27(1):1073274820976596

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

Signet ring cell carcinoma (SRC) is a distinct histological subtype of gastric carcinoma. Our aim is to investigate differential characteristics between gastric SRC and other non SRC carcinomas (nSRC). It was a retrospective study including 183 patients diagnosed with gastric carcinoma over a period of 5 years at our pathology department. We performed statistical comparison of clinicopathological features between patients with SRC and those with nSRC. 127 patients (69.4%) had nSRC, 56 had SRC (30.6%), the mean age was 56.67 ± 14.03 years. Patients with SRC were younger than those with nSRC (mean age of 49.66 59.76, = 0.030). Patients with SRC tend to have more diffuse tumors in the stomach ( = 0.005), with flat macroscopic appearance ( = 0.001). Patients with SRC present more often with pT3 tumors ( < 0.001), lymph node metastasis ( = 0.024) and perineural invasion ( = 0.003). There were no significant differences between SRC and nSRC in gender, vascular invasion or distant metastasis ( > 0.05). The median survival time was 42.82 ± 1.70 months. Patients with nSRC live longer than those with SRC, but the difference was not significant ( = 0.28). SRC is a histological subtype of gastric carcinoma with distinctive clinicopathologic features. The clinical management of patients should take into account these particular features.
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http://dx.doi.org/10.1177/1073274820976596DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8480344PMC
August 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

Implication of Microsatellite Instability Pathway in Outcome of Colon Cancer in Moroccan Population.

Dis Markers 2019 7;2019:3210710. Epub 2019 Dec 7.

Department of Pathological Anatomy, Hassan II University Hospital, Fez, Morocco.

Background: Tumors with microsatellite instability (MSI tumors) have distinct clinicopathological features. However, the relation between these tumor subtypes and survival in colon cancer remains controversial. The aim of this study was to evaluate the overall survival (OS) in patients with MSI phenotype, in FES population.

Methods: The expression of MMR proteins was evaluated by immunohistochemistry for 330 patients. , , and mutations were examined by Sanger sequencing and pyrosequencing methods. The association of MSI status with a patient's survival was assessed by the Kaplan-Meier method and log-rank test.

Results: The mean age was 54.6 years (range of 19-90 years). The MSI status was found in 11.2% of our population. MSI tumors were significantly associated with male gender, younger patients, stage I-II, right localization, and a lower rate of lymph node and distant metastasis. The OS tends to be longer in MSI tumors than MSS tumors (109.71 versus 74.08), with a difference close to significance ( = 0.05).

Conclusion: Our study demonstrates that MSI tumors have a particular clinicopathological features. The results of survival analysis indicate that the MSI status was not predictive of improved overall survival in our context with a lower statistical significance ( = 0.05) after multivariate analysis.
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http://dx.doi.org/10.1155/2019/3210710DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6925747PMC
May 2020

[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

Penile metastases of rectal adenocarcinoma after abdominoperineal resection: a case report.

J Med Case Rep 2019 Jul 28;13(1):233. Epub 2019 Jul 28.

Department of Visceral Surgery, University Hospital, Hassan 2, Fes, Morocco.

Background: Penile metastases are very rare and arise most frequently from genitourinary cancers. Penile metastases from rectal adenocarcinoma are less common.

Case Presentation: We report the case of a 47-year-old North Afican man with penile metastases from a rectal adenocarcinoma, which was discovered 4 months after abdominoperineal resection. A penile biopsy was carried out and established the metastatic nature. He underwent palliative chemotherapy treatment. He was still alive 4 months after diagnosis of penile metastases.

Conclusion: The prognosis of metastasis to the penis is very poor; the best results have been achieved with surgery but only for lesions where metastasis is limited to the penis.
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http://dx.doi.org/10.1186/s13256-019-2147-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6661075PMC
July 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

An unusual site of metastasis: splenic metastastasis from a colon cancer.

J Surg Case Rep 2016 Nov 1;2016(11). Epub 2016 Nov 1.

Service d'anatomie et Cytologie Pathologiques, CHU Hassan II, Fès , Maroc.

Splenic metastasis from colorectal cancers is a very rare occurrence. Few cases have been reported in the literature. We report herein an additionnal case of metachronous splenic metastasis from adenocarcinoma of the sigmoid colon, 3 years after the diagnosis of the primary tumor. A 62-year old woman presented for regular follow-up after colectomy for sigmoid colon adenocarcinoma. A computed tomography-scan found two splenic metastatic nodules for which splenectomy had been performed. The histological analysis of the resected spleen showed a well-differentiated metastatic adenocarcinoma from colon. The patient recovered well after surgery, and 10 months after, she had no signs of the disease.
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http://dx.doi.org/10.1093/jscr/rjw175DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5100687PMC
November 2016

[Cecal volvulus on appendiceal tumor: report of a rare case].

Pan Afr Med J 2014 24;19:199. Epub 2014 Oct 24.

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

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http://dx.doi.org/10.11604/pamj.2014.19.199.4132DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369302PMC
October 2015

[Meckel diverticulum complicated by retroperitoneal abscess: report of a rare case].

Pan Afr Med J 2014 23;19:195. Epub 2014 Oct 23.

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

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http://dx.doi.org/10.11604/pamj.2014.19.195.4379DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4369304PMC
October 2015

Adult intussusceptions caused by a lipoma in the jejunum: report of a case and review of the literature.

World J Emerg Surg 2012 Aug 22;7(1):28. Epub 2012 Aug 22.

Surgery Department, University Hospital Hassan II, Fez 30000, Morocco.

Intussusceptions in adults is rare. Gastrointestinal lipomas are rare benign tumors and intussusceptions due to a gastrointestinal lipoma constitutes an infrequent clinical entity. Lipoma may develop as a benign tumor in all organs and rarely in large or small intestine. The present report describes a case of jejunojejunal intussusceptions in an adult with a history of colicky upper abdominal pain. Ileo-ileal invagination was diagnosed by computed tomography scan. Exploratory laparotomy revealed jejunojejunal intussusceptions secondary to a lipoma which was successfully treated with segmental intestinal resection. A review of the literature is also performed regarding this rare association revealing the diagnostic and therapeutic debates that exist. ABSTRACT (FRENCH): L'invagination chez les adultes est rare. Les lipomes gastro-intestinaux sont de rares tumeurs bénignes et l'invagination intestinale due à un lipome gastro-intestinal constitue une entité clinique trés rare. Le lipome peut se développer comme une tumeur bénigne dans tous les organes et rarement dans l'intestin grêle ou le colon. Le présent rapport décrit un cas d'invagination jéjunojéjunale chez un adulte avec une histoire de douleurs abdominales. Iléo-iléale invagination a été diagnostiquée par tomodensitométrie. Une laparotomie exploratrice a révélé l'existence d'une invagination jéjunojéjunale secondaire à un lipome qui a été traitée avec succès par une résection intestinale segmentaire. Une revue de la littérature est également effectuée au sujet de cette association rare révélant les débats diagnostiques et thérapeutiques qui existent.
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http://dx.doi.org/10.1186/1749-7922-7-28DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3502287PMC
August 2012

[Ileal duplication revealed by a perforation in adults ].

Pan Afr Med J 2010 May 28;5:14. Epub 2010 May 28.

Service de chirurgie viscérale, centre hospitalier Hassan II, Fès, Maroc.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3032616PMC
May 2010

Non-Hodgkin's lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report.

Pan Afr Med J 2010 Mar 13;4:11. Epub 2010 Mar 13.

Department of general surgery (B), University hospital, Hassan II, Fes, Morocco.

Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma's involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent pre-operative evaluation including possible extension and dissemination especially in intestinal lymphomas. The treatment is almost always surgical and the pathological study is needed for diagnostic confirmation. Authors present an unusual case of intestinal intussusception due to lymphoma of the terminal part of the ileum in a 49-year-old man. Computed tomography confirmed the diagnosis of intussusception and non-Hodgkin's lymphoma of B-cell was diagnosed by histological examination after surgical treatment. Primary intestinal lymphomas differ from gastric lymphomas in clinical features, treatment, and prognosis. They are not well characterized and the standardized concepts for their clinical diagnosis and management are absent. The aim of this rare observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults.
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http://dx.doi.org/10.4314/pamj.v4i1.53599DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984306PMC
March 2010

Torsion of a wandering spleen.

Saudi J Gastroenterol 2010 Oct-Dec;16(4):288-91

Department of Digestive Surgery, University Hospital Hassan II, Fes, Morocco.

Wandering spleen is a rare condition defined as a mobile spleen only attached with its pedicle. It can be complicated by a volvulus, which is a surgical abdominal emergency. Preventing infarction is the aim of a prompt surgery that can preserve the spleen and then proceed to splenopexy. We report a rare case of torsion of a wandering spleen associated with a dolichosigmoοd.
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http://dx.doi.org/10.4103/1319-3767.70618DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2995100PMC
January 2011

[Gastric trichobezoar--about two cases].

Pan Afr Med J 2010 19;6:19. Epub 2010 Sep 19.

Service de chirurgie B, CHU Hassan II, Fès, Maroc.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120990PMC
December 2011

[Cystic pneumatosis ileal revealed by a small bowel volvulus ].

Pan Afr Med J 2010 Aug 12;6. Epub 2010 Aug 12.

Service de chirurgie viscérale A, CHU Hassan II Fez, Morocco.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063497PMC
August 2010
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