Publications by authors named "Mohamed Touati"

35 Publications

Gonadal Function Recovery in Patients With Advanced Hodgkin Lymphoma Treated With a PET-Adapted Regimen: Prospective Analysis of a Randomized Phase III Trial (AHL2011).

J Clin Oncol 2021 Jun 22:JCO2100068. Epub 2021 Jun 22.

Department of Haematology, University Hospital F Mitterrand and Inserm UMR1231, Dijon, France.

Purpose: The prospective, randomized AHL2011 trial demonstrated that the use of the doxorubicin, bleomycin, vinblastine, and dacarbazine regimen (ABVD) after two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP) in early responders on the basis of a positron emission tomography (PET)-driven strategy was safe and minimized toxicity compared with standard 6 BEACOPP cycles. This substudy investigated the benefit of this strategy in gonadal function and fertility in patients under 45 years old.

Methods: Ovarian function was assessed by serum measurement of follicle-stimulating hormone (FSH), estradiol, and anti-müllerian hormone in women, and semen analysis, FSH, and testosterone levels were used to evaluate testicular function in men at baseline, end of treatment, and during 5 years of follow-up.

Results: A total of 145 women and 424 men, enrolled between May 19, 2011, and April 29, 2014, were included. The risk of premature ovarian insufficiency (FSH > 24 IU/L) and of having a low ovarian reserve (anti-müllerian hormone < 0.5 ng/mL) was reduced after treatment in the PET-driven group (odds ratio [OR], 0.20; 95% CI, 0.08 to 0.50; = .001 and OR, 0.15; 95% CI, 0.04 to 0.56, = .005, respectively). Both parameters were correlated with age and dose of alkylating agents. However, no significant differences were observed in terms of pregnancy rates. Men in the PET-driven group had a higher recovery rate of sperm parameters after treatment compared with the standard BEACOPP group, as well as a lower risk of severe testicular damage (OR, 0.26; 95% CI, 0.13 to 0.5; < .0001) and a higher likelihood of achieving pregnancy (OR, 3.7; 95% CI, 1.4 to 9.3; = .004).

Conclusion: Although both treatments affected ovarian reserve and spermatogenesis, the PET-driven strategy decreased the risk of gonadal dysfunction and infertility in advanced Hodgkin lymphoma.
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http://dx.doi.org/10.1200/JCO.21.00068DOI Listing
June 2021

Analysis of a cohort of 279 patients with hairy-cell leukemia (HCL): 10 years of follow-up.

Blood Cancer J 2020 05 27;10(5):62. Epub 2020 May 27.

Unite de Recherche Clinique, Hopital Avicenne, Assistance Publique des Hopitaux de Paris, Bobigny, France.

In total, 279 patients with hairy-cell leukemia (HCL) were analyzed, with a median follow-up of 10 years. Data were collected up to June 2018. We analyzed responses to treatment, relapses, survival, and the occurrence of second malignancies during follow-up. The median age was 59 years. In total, 208 patients (75%) were treated with purine analogs (PNAs), either cladribine (159) or pentosatin (49), as the first-line therapy. After a median follow-up of 127 months, the median overall survival was 27 years, and the median relapse-free survival (RFS) was 11 years. The cumulative 10-year relapse incidence was 39%. In patients receiving second-line therapy, the median RFS was 7 years. For the second-line therapy, using the same or another PNA was equivalent. We identified 68 second malignancies in 59 patients: 49 solid cancers and 19 hematological malignancies. The 10-year cumulative incidences of cancers, solid tumors, and hematological malignancies were 15%, 11%, and 5.0%, respectively, and the standardized incidence ratios were 2.22, 1.81, and 6.67, respectively. In multivariate analysis, PNA was not a risk factor for second malignancies. HCL patients have a good long-term prognosis. PNAs are the first-line treatment. HCL patients require long-term follow-up because of their relatively increased risk of second malignancies.
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http://dx.doi.org/10.1038/s41408-020-0328-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253459PMC
May 2020

Performance of CT Compared with F-FDG PET in Predicting the Efficacy of Nivolumab in Relapsed or Refractory Hodgkin Lymphoma.

Radiology 2020 06 14;295(3):651-661. Epub 2020 Apr 14.

From the Dept of Radiology, New York Presbyterian Hosp, Columbia Univ Medical Ctr, New York, NY (F.Z.M., L.D., A.C., L.H.S.); Dept of Radiology, Rangueil Univ Hosp, Toulouse, France (F.Z.M.); Dept of Radiology, First Affiliated Hosp of Nanjing Medical Univ, Nanjing, China (A.C.); Univ Lille, CHU Lille, EA 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, Lille, France (F.M.); Dept of Hematology, Centre Henri Becquerel, Rouen, France (A.S.); Dept of Hematology, Paoli-Calmette Inst, Marseille, France (J.M.S.d.C.); Dept of Nuclear Medicine, Saint-Louis Hosp, AP-HP, Paris, France (L.V.); Dept of Hematology, Univ Hosp of Dijon, Dijon, France (O.C.); Dept of Hematology, Univ Hosp of Besançon, Besançon, France (A.C.); Dept of Hematology, Univ Hosp of Reims, Reims, France (A.D.); Dept of Hematology, Leon Berard Ctr, Lyon, France (E.N.V.); Dept of Hematology, Univ Hosp of Lyon, Lyon, France (H.G.); Dept of Hematology, Univ Hosp of Angers, Angers, France (M.P.M.M.); Dept of Hematology, Bergonie Inst, Bordeaux, France (A.S.); Dept of Hematology, Saint-Antoine Hosp, AP-HP, Paris, France (R.D.); Dept of Hematology, Univ Hosp of Bordeaux, Bordeaux, France (K.B.); Dept of Hematology, Institut Universitaire du Cancer Toulouse-Oncopole, Toulouse, France (C.B.); Dept of Hematology, Univ Hosp of Limoges, Limoges, France (M.T.); Dept of Hematology, Cochin Hosp, AP-HP, Paris, France (B.D.F.); Centre Antoine Lacassagne, Nice, France (F.P.); Dept of Nuclear Medicine, Institut Curie, Paris, France (R.D.S.); Dept of Hematology, Univ Hosp of Rennes, Rennes, France (G.M., R.H.); INSERM, U1236, Rennes, France (G.M., R.H.); and UMR1015, Institut Gustave Roussy, Université Paris Saclay, Villejuif 94800, France (L.D.).

Background CT and fluorine 18 (F) fluorodeoxyglucose (FDG) PET/CT performances following immune therapy are not well known in patients with relapsed or refractory Hodgkin lymphoma (RRHL). Purpose To compare CT and PET/CT for prognostic value of early response evaluation following nivolumab therapy. Materials and Methods This retrospective study included patients from 34 institutions who underwent early imaging response evaluation from July 2013 to April 2017. Three experienced readers classified imaging response by using Cheson et al and 2016 Lymphoma Response to Immunomodulatory Therapy Criteria as follows: complete (metabolic) response, partial (metabolic) response, stable disease or no metabolic response, or progressive (metabolic) disease. Primary CT and PET assessments were performed at a median of 2.0 months (interquartile range, 1.7-3.7 months) after nivolumab initiation. Kaplan-Meier analysis was used to determine the relationship of primary CT and PET assessment response categories to overall survival (OS). Agreements between primary and secondary imaging assessments were assessed by using κ analysis. Results A total of 45 patients (median age, 37 years; range, 18-77 years; 25 men) underwent a primary assessment using CT and PET/CT; 36 patients also underwent a subsequent assessment. Eleven patients (24%) died after a median follow-up of 21.2 months. CT and PET response categories were associated with OS ( = .03 for primary CT assessment; = .02 for primary PET assessment). There was no pseudoprogression at primary CT and PET assessments. At the primary assessment, response categories by using CT were reclassified by using PET in 44% (20 of 45) of patients. Among these, 55% (11 of 20) were reclassified to complete metabolic response (complete metabolic response rate: 29% [13 of 45 patients] vs complete response rate: 4% [two of 45 patients]), with a 2-year OS probability of 100%. At the secondary assessment, complete response rate using CT increased to 17% (six of 36 patients), hence a better agreement with PET (κ = 0.78; < .001). Conclusion Early CT and PET/CT at a median of 2 months after initiation of nivolumab predicted overall survival in relapsed or refractory Hodgkin lymphoma. Early PET detected additional patients with complete metabolic response. © RSNA, 2020 See also the editorial by Scott and Wang in this issue.
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http://dx.doi.org/10.1148/radiol.2020192056DOI Listing
June 2020

Prognostic factors of myringoplasty: study of a 140 cases series and review of the literature.

Pan Afr Med J 2019 26;33:323. Epub 2019 Aug 26.

ENT Department Military Hospital Avicenna, Marrakech, Morocco.

Myringoplasty is one of the most frequent interventions in otology. It aims to restore the eardrum in order to protect against extrinsic contamination by water and to improve hearing. Our study aimed to analyze the factors that may affect anatomical and functional results of myringoplasty or type I tympanoplasty. A retrospective study was performed of a series of 140 cases of myringoplasty over a 6-years period from 2010 to 2015. The approach was post-auricular in 69% of cases and all the patients underwent an underlay technique. Temporal fascia was used in 90.71% of the cases. After an average follow-up of 13 months, the anatomical and functional results were acceptable, with a tympanic closure rate of 88% and an average audiometric gain of 14.22 dB. Several factors affected our results, including the location of the perforation, the active or inactive status of the chronic otitis media, the condition of the opposite ear and the graft material. In light of our results and those of the literature, we believe that the middle ear should be dry at least two months prior to surgery, use of cartilaginous graft material and underlay technique should be preferred and special precautions should be taken in case of anterior or contralateral perforation.
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http://dx.doi.org/10.11604/pamj.2019.33.323.18060DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6815508PMC
November 2019

Early F-FDG PET/CT Response Predicts Survival in Relapsed or Refractory Hodgkin Lymphoma Treated with Nivolumab.

J Nucl Med 2020 05 18;61(5):649-654. Epub 2019 Oct 18.

Department of Radiology, New York Presbyterian Hospital, Columbia University Medical Center, New York, New York

Monoclonal antibodies (mAbs) against programmed cell death 1 (PD-1), such as nivolumab and pembrolizumab, are associated with high response rates in patients with relapsed or refractory classic Hodgkin lymphoma (HL). To date, no prognostic factor for overall survival (OS) has been established with these agents in HL. We examined whether the first early response assessment evaluated using F-FDG PET/CT may be associated with OS in this setting. This retrospective study included 45 patients from 34 institutions. In a masked, centralized review, 3 independent radiologists classified PET/CT scans obtained at a median of 2.0 mo (interquartile range, 1.7-3.7 mo) after nivolumab initiation using existing criteria (i.e., 2014 Lugano classification and 2016 LYRIC). Patients were classified according to 4 possible response categories: complete metabolic response (CMR), partial metabolic response (PMR), no metabolic response (NMR), or progressive metabolic disease (PMD). Because the OS of patients with NMR and PMR was similar, they were grouped together. OS was estimated using the Kaplan-Meier method and compared between groups using log-rank testing. Eleven patients (24%) died after a median follow-up of 21.2 mo. The classification was identical between Lugano and LYRIC because all 16 progression events classified as indeterminate response per LYRIC were confirmed on subsequent evaluations. Both Lugano and LYRIC classified patients as CMR in 13 cases (29%), PMD in 16 (36%), NMR in 4 (9%), and PMR in 12 (27%). The 2-y OS probability was significantly different in patients with PMD (0.53; 95% confidence interval [95%CI], 0.32-0.87), NMR or PMR (0.80; 95%CI, 0.63-1.00), and CMR (1.00; 95%CI, 1.00-1.00) in the overall population ( = 0.02, 45 patients), as well as according to a landmark analysis at 3 mo ( = 0.05, 32 patients). In relapsed or refractory HL patients treated with anti-PD-1 mAbs, the first early PET/CT assessment using either Lugano or LYRIC predicted OS and allowed early risk stratification, suggesting that PET/CT might be used to develop risk-adapted strategies.
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http://dx.doi.org/10.2967/jnumed.119.232827DOI Listing
May 2020

Nasopharyngeal tuberculosis: report of four cases and review of the literature.

Pan Afr Med J 2019 27;33:150. Epub 2019 Jun 27.

ENT Department, Military Hospital Avicenna, Marrakech, Morocco.

Even if tuberculosis is a major cause of morbidity and mortality, nasopharyngeal location is unusual and extremely rare. We report four new cases observed with short time interval suggesting a trend towards increased frequency. The diagnosis was confirmed by histological analysis after a biopsy. The evolution was favorable after anti tuberculosis chemotherapy. In the light of those observations and a review of the literature, we will discuss different characteristics of this disease and we will highlight the need of a systematic biopsy in order to confirm diagnosis and exclude undifferentiated carcinoma especially in endemic regions for both diseases.
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http://dx.doi.org/10.11604/pamj.2019.33.150.15892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6754851PMC
October 2019

Genotype/phenotype correlations of childhood-onset congenital sideroblastic anaemia in a European cohort.

Br J Haematol 2019 11 23;187(4):530-542. Epub 2019 Jul 23.

CHU de Bordeaux, Hôpital Pellegrin, Bordeaux, France.

Congenital sideroblastic anaemia (CSA) is a rare disease caused by germline mutations of genes involved in haem and iron-sulphur cluster formation, and mitochondrial protein biosynthesis. We performed a retrospective multicentre European study of a cohort of childhood-onset CSA patients to explore genotype/phenotype correlations. We studied 23 females and 20 males with symptoms of CSA. Among the patients, the most frequently mutated genes were ALAS2 (n = 10; 23·3%) and SLC25A38 (n = 8; 18·6%), causing isolated forms of microcytic anaemia of varying severity. Five patients with SLC19A2 mutations suffered from thiamine-responsive megaloblastic anaemia and three exhibited the 'anaemia, deafness and diabetes' triad. Three patients with TRNT1 mutations exhibited severe early onset microcytic anaemia associated with thrombocytosis, and two exhibited B-cell immunodeficiency, inflammatory syndrome and psychomotor delay. The prognoses of patients with TRNT1 and SLC2A38 mutations were generally dismal because of comorbidities or severe iron overload. No molecular diagnosis could be established in 14/43 cases. This study emphasizes the frequency of ALAS2 and SLC25A38 mutations and provides the largest comprehensive analysis to date of genotype/phenotype correlations in CSA. Further studies of CSA patients with data recorded in an international registry would be helpful to improve patient management and establish standardized guidelines.
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http://dx.doi.org/10.1111/bjh.16100DOI Listing
November 2019

[Surgical management of hyperthyroidism: about 60 cases].

Pan Afr Med J 2018 20;31:43. Epub 2018 Sep 20.

Service d'Oto-Rhino-Laryngologie, Hôpital Militaire Avicenne, Marrakech, Maroc.

Hyperthyroidism includes several diseases characterized by high level of circulating thyroid hormones. Thyroidectomy is one of the main treatment options. We conducted a retrospective study to evaluate the epidemiological, clinical, therapeutic, evolutionary features of patients who had undergone surgery for hyperthyroidism in the ENT Department at the Avicenne Military Hospital in Marrakech. Data were collected from medical records of 60 patients. There was a female predominance and the average age was 52 years. Clinical manifestations were dominated by thyrotoxicosis in all patients. Clinical examination allowed the identification of 47 cases of toxic or pretoxic multiheteronodular goitre (78.33% of cases), 5 cases of Graves disease (8.33% of cases) and 8 cases of toxic adenoma (13.33% of cases). All patients underwent medical preparation. Total thyroidectomy was performed in 50 patients (83.33%) and loboisthmectomy in 10 patients (16.33%). Postoperative complications were: transient laryngeal paralysis in one case (1.6%), transient hypoparathyroidism in nine cases (15%), definitive hypoparathyroidism in one case (1.6%) and compressive hematoma in one case (1.6% of cases). Surgical treatment of bleeding and adherent toxic goiters should be performed by an experienced surgeon who must remain vigilant to minimize morbidity mainly caused by laryngeal paralysis and hypoparathyroidism.
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http://dx.doi.org/10.11604/pamj.2018.31.43.16695DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430848PMC
April 2019

Non syndromic childhood onset congenital sideroblastic anemia: A report of 13 patients identified with an ALAS2 or SLC25A38 mutation.

Blood Cells Mol Dis 2017 07 26;66:11-18. Epub 2017 Jul 26.

CHU de Rouen/Hôpital Charles Nicolle, Rouen, France. Electronic address:

The most frequent germline mutations responsible for non syndromic congenital sideroblastic anemia are identified in ALAS2 and SLC25A38 genes. Iron overload is a key issue and optimal chelation therapy should be used to limit its adverse effects on the development of children. Our multicentre retrospective descriptive study compared the strategies for diagnosis and management of congenital sideroblastic anemia during the follow-up of six patients with an ALAS2 mutation and seven patients with an SLC25A38 mutation. We described in depth the clinical, biological and radiological phenotype of these patients at diagnosis and during follow-up and highlighted our results with a review of available evidence and data on the management strategies for congenital sideroblastic anemia. This report confirms the considerable variability in manifestations among patients with ALAS2 or SLC25A38 mutations and draws attention to differences in the assessment and the monitoring of iron overload and its complications. The use of an international registry would certainly help defining recommendations for the management of these rare disorders to improve patient outcome.
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http://dx.doi.org/10.1016/j.bcmd.2017.07.003DOI Listing
July 2017

Cardiac iron overload in chronically transfused patients with thalassemia, sickle cell anemia, or myelodysplastic syndrome.

PLoS One 2017 3;12(3):e0172147. Epub 2017 Mar 3.

Hématologie clinique, Hôpital Saint Vincent de Paul, Université Catholique de Lille, Lille, France.

The risk and clinical significance of cardiac iron overload due to chronic transfusion varies with the underlying disease. Cardiac iron overload shortens the life expectancy of patients with thalassemia, whereas its effect is unclear in those with myelodysplastic syndromes (MDS). In patients with sickle cell anemia (SCA), iron does not seem to deposit quickly in the heart. Our primary objective was to assess through a multicentric study the prevalence of cardiac iron overload, defined as a cardiovascular magnetic resonance T2*<20 ms, in patients with thalassemia, SCA, or MDS. Patient inclusion criteria were an accurate record of erythrocyte concentrates (ECs) received, a transfusion history >8 ECs in the past year, and age older than 6 years. We included from 9 centers 20 patients with thalassemia, 41 with SCA, and 25 with MDS in 2012-2014. Erythrocytapharesis did not consistently prevent iron overload in patients with SCA. Cardiac iron overload was found in 3 (15%) patients with thalassemia, none with SCA, and 4 (16%) with MDS. The liver iron content (LIC) ranged from 10.4 to 15.2 mg/g dry weight, with no significant differences across groups (P = 0.29). Abnormal T2* was not significantly associated with any of the measures of transfusion or chelation. Ferritin levels showed a strong association with LIC. Non-transferrin-bound iron was high in the thalassemia and MDS groups but low in the SCA group (P<0.001). Hepcidin was low in thalassemia, normal in SCA, and markedly elevated in MDS (P<0.001). Two mechanisms may explain that iron deposition largely spares the heart in SCA: the high level of erythropoiesis recycles the iron and the chronic inflammation retains iron within the macrophages. Thalassemia, in contrast, is characterized by inefficient erythropoiesis, unable to handle free iron. Iron accumulation varies widely in MDS syndromes due to the competing influences of abnormal erythropoiesis, excess iron supply, and inflammation.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0172147PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336214PMC
August 2017

Cost savings of home bortezomib injection in patients with multiple myeloma treated by a combination care in Outpatient Hospital and Hospital care at Home.

Support Care Cancer 2016 12 15;24(12):5007-5014. Epub 2016 Aug 15.

Service d'Hématologie Clinique et Thérapie Cellulaire, CHU de Limoges, Limoges, France.

At home injectable chemotherapy for patients receiving treatment for hematological diseases is still in debate. Given the expense of new innovative medicines, at home treatment has been proposed as a suitable option for improving patient quality of life and decreasing treatment costs. We decided to assess the cost of bortezomib administration in France among multiple myeloma patients from an economic standpoint. Patients in this study were treated within a regional hematological network combining outpatient hospital care and Hospital care at Home administration. To make the cost comparison, our team simulated outpatient hospital care expenses. Fifty-four consecutive multiple myeloma patients who received at least one injection of bortezomib in Hospital care at Home from January 2009 to December 2011 were included in the study. The median number of injections was 12 (range 1-44) at home and 6 (range 0-30) in the outpatient care unit. When compared with the cost simulation of outpatient hospital care alone, bortezomib administration with combined care was significantly less expensive for the National Health Insurance (NHI) budget. The mean total cost per patient and per injection was 954.20 € for combined outpatient and Hospital care at Home vs 1143.42 € for outpatient hospital care alone. This resulted in an estimated 16.5 % cost saving (Wilcoxon signed-rank test, p < 0.0001). The greatest savings were observed in administration costs (37.5 % less) and transportation costs (68.1 % less). This study reflects results for a regionally implemented program for multiple myeloma patients treated with bortezomib in routine practice in a large rural area.
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http://dx.doi.org/10.1007/s00520-016-3363-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5082582PMC
December 2016

[Predictors of malignancy in the management of parotid tumors: about 76 cases].

Pan Afr Med J 2016 16;23:112. Epub 2016 Mar 16.

Service d'Oto-Rhino-Laryngologie, Hôpital Militaire Avicenne, Marrakech, Maroc.

Salivary gland tumor pathology is complex and poses a diagnostic and therapeutic problem. A good analysis of predictive factors for malignancy in parotid tumors seems currently necessary for better therapeutic planning. The aim of this study was to investigate the predictive factors for malignancy in parotid tumors through a retrospective study of 76 cases of parotid tumor treated in a service of Otorhinolaryngology and Cervico Facial Surgery of Avicenne military hospital of Marrakech between January 2000 and December 2012. The study involved 40 women and 36 men. The average age was 44 years for benign tumours whereas it was 50 years for malignant tumours. The median of consultation time was 24 months for benign tumors and 16 month for malignant tumours. Swelling in the area of the parotid was always a patient detecting sign. Malignancy is clinically suspected based on pain, facial paralysis, surface structure and deeper structure fixity and on the presence of adenopathy. MRI has become the methodology of choice for evaluating parotid tumors due to its good diagnostic value in the assessment of benignity and malignancy. Fine needle aspiration biopsy has no value unless it is positive. Explorative parotidectomy with extemporaneous anatomopathological examination remains the key to positive diagnosis. Parotid benign tumors represent the most frequent entity (80%) and pleomorphic adenoma remains the predominant histologic type (61%). With regard to malignant tumors, they are rare, mainly dominated by mucoepidermoid carcinomas (6,5%). Surgical treatment is the first choice and it is often associated with lymph node dissection and radiation therapy for malignant tumors. Facial paralysis is the most common complication of parotid surgery.
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http://dx.doi.org/10.11604/pamj.2016.23.112.8404DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4885702PMC
February 2017

[Analysis of predictors of malignancy of nodular goiters: about 500 cases].

Pan Afr Med J 2016 15;23:88. Epub 2016 Mar 15.

Service d'Oto-rhino-laryngologie, Hôpital Militaire Avicenne, Marrakech, Maroc.

Thyroid nodules are very common and less than 10% of them are malignant. They pose a serious diagnostic and therapeutic problem with respect to their benign or malignant nature. The study of some clinical and paraclinical factors for presumed malignancy makes it possible to codify appropriate therapeutic strategy. The aim of this study was to investigate predictors of malignancy in nodular goiters and to compare our results with those reported in the literature. This retrospective study consisted of 500 cases of nodular goiter operated in the Department of Otorhinolaryngology (ear, nose and throat or ENT) and Head and Neck Surgery at Avicenne military hospital in Marrakech between 2006 and 2012. The percentage of cancers was 6,8%. The average age of our patients was 46 years, with a sex-ratio of 5 (F/H). The hard nature of the nodule was present in 94,4% of the cases of cancer by palpation; irregular boundaries were present in 64.70% of the cases of cancer. Three nodules were fixed and malignant. Cervical lymphadenopathy were observed in 8 patients, 7 of which had cancer. Ultrasound examination showed hypoechoic appearance in 61,8% of the malignant nodules, with smooth-edges in 88,24% of the cases. Intranodular vascularization was found in 35,3% of the cases of cancers, with microcalcifications in 55,9% of the cases. Perinodular hypoechoic halo was incomplete in 73,5% of the cases of cancer. Our patients were euthyroid in 84,6% of the cases. Predictors of malignancy in nodular goiters were present in our first clinical study: patients over the age of 60 years, hard consistency of nodule, fixity, irregular and poorly defined character by palpation, as well as presence of cervical adenopathy on examination; and echographic features: hypoechoic character, smooth-edges, presence of microcalcifications and visualization of intranodular vascularization with or without peri-nodular vascularization. Although some of these factors are highly predictive of malignancy, only final histology provides certainty of diagnosis. Clinicians should base their clinical practice and patient management on a body of clinical arguments.
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http://dx.doi.org/10.11604/pamj.2016.23.88.8405DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4867181PMC
February 2017

About a rare tumor of the upper lip: the mucoepidermoid carcinoma.

Pan Afr Med J 2015 17;22:39. Epub 2015 Sep 17.

Stomatology and Maxillofacial Surgery Department, Military Hospital Avicenna, Marrakech, Morocco.

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http://dx.doi.org/10.11604/pamj.2015.22.39.7177DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4662528PMC
June 2016

Synthesis and structural studies of a new complex of catena-poly[p-anisidinium [[diiodidobismu-thate(III)]-di-μ-iodido] dihydrate].

Acta Crystallogr E Crystallogr Commun 2015 Nov 24;71(Pt 11):1352-5. Epub 2015 Oct 24.

Laboratoire de Matériaux et Cristallochimie, Faculté des Sciences de Tunis, Université de Tunis El Manar, 2092 Manar II Tunis, Tunisia.

A new organic-inorganic hybrid material, {(C7H10NO)[BiI4]·2H2O} n , has been synthesized by slow evaporation of an aqueous solution at room temperature. The anionic sublattice of the crystal is built up by [BiI6] octa-hedra sharing edges. The resulting zigzag chains extend along the a-axis direction and are arranged in a distorted hexagonal rod packing. The p-anisidinium cations and the water mol-ecules are located in the voids of the anionic sublattice. The cations are linked to each other through N-H⋯O hydrogen bonds with the water mol-ecules, and also through weaker N-H⋯I inter-actions to the anionic inorganic layers.
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http://dx.doi.org/10.1107/S2056989015019489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4645070PMC
November 2015

Giant adenoid cystic carcinoma of the sinonasal cavity.

Pan Afr Med J 2015 2;21:82. Epub 2015 Jun 2.

ENT Department, Military Hospital Avicenna, Marrakech, Morocco.

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http://dx.doi.org/10.11604/pamj.2015.21.82.5833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594981PMC
May 2016

Nodular lymphocyte predominant Hodgkin lymphoma: a Lymphoma Study Association retrospective study.

Haematologica 2015 Dec 1;100(12):1579-86. Epub 2015 Oct 1.

Department of Medical Oncology, Gustave Roussy, Villejuif, France

Nodular lymphocyte predominant Hodgkin lymphoma represents a distinct entity from classical Hodgkin lymphoma. We conducted a retrospective study to investigate the management of patients with nodular lymphocyte predominant Hodgkin lymphoma. Clinical characteristics, treatment and outcome of adult patients with nodular lymphocyte predominant Hodgkin lymphoma were collected in Lymphoma Study Association centers. Progression-free survival (PFS) and overall survival (OS) were analyzed, and the competing risks formulation of a Cox regression model was used to control the effect of risk factors on relapse or death as competing events. Among 314 evaluable patients, 82.5% had early stage nodular lymphocyte predominant Hodgkin lymphoma. Initial management consisted in watchful waiting (36.3%), radiotherapy (20.1%), rituximab (8.9%), chemotherapy or immuno-chemotherapy (21.7%), combined modality treatment (12.7%), or radiotherapy plus rituximab (0.3%). With a median follow-up of 55.8 months, the 10-year PFS and OS estimates were 44.2% and 94.9%, respectively. The 4-year PFS estimates were 79.6% after radiotherapy, 77.0% after rituximab alone, 78.8% after chemotherapy or immuno-chemotherapy, and 93.9% after combined modality treatment. For the whole population, early treatment with chemotherapy or radiotherapy, but not rituximab alone (Hazard ratio 0.695 [0.320-1.512], P=0.3593) significantly reduced the risk of progression compared to watchful waiting (HR 0.388 [0.234-0.643], P=0.0002). Early treatment appears more beneficial compared to watchful waiting in terms of progression-free survival, but has no impact on overall survival. Radiotherapy in selected early stage nodular lymphocyte predominant Hodgkin lymphoma, and combined modality treatment, chemotherapy or immuno-chemotherapy for other patients, are the main options to treat adult patients with a curative intent.
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http://dx.doi.org/10.3324/haematol.2015.133025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4666334PMC
December 2015

[Cholesteatomatous chronic otitis media in children: about 30 cases].

Pan Afr Med J 2015 8;21:24. Epub 2015 May 8.

Service d'Oto-rhino-laryngologie et Chirurgie Cervico-faciale, Hôpital Militaire Avicenne, Marrakech, Maroc.

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http://dx.doi.org/10.11604/pamj.2015.21.24.5689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561140PMC
May 2016

Malignant schwannoma of the infratemporal fossa: a case report.

J Med Case Rep 2015 Jul 4;9:153. Epub 2015 Jul 4.

ENT Department, Military Hospital Avicenna, Avenue Al Mouqaouama, Marrakech, 40000, Morocco.

Introduction: Malignant schwannomas or neurofibrosarcomas are rare nerve tumors of unknown etiology. These neoplasms are highly aggressive with a marked propensity for local recurrence and metastatic spread. Their management continues to be a challenge for pathologists and surgeons. Maxillofacial locations are very exceptional. We report the case of a patient with unusual malignant schwannoma of the infratemporal fossa discovered at a late evolving stage.

Case Presentation: A 56-year-old woman, of Moroccan nationality, presented to our hospital in 2013 with a large right-sided hemifacial swelling that had evolved over the previous 4 months, with a limitation of mouth opening, nasal obstruction and episodes of epistaxis. A CT scan and MRI showed a large and invasive tumor occupying her right infratemporal fossa and maxillary sinus, with sphenoidal, ethmoidonasal, nasopharyngeal and intraorbital extension. A nasal endoscopic biopsy was performed. Immunohistochemical examination concluded a diagnosis of malignant schwannoma, and a palliative radiotherapy was decided; however, our patient died 10 days later.

Conclusions: Malignant schwannoma of paranasal sinuses and the anterior skull base is a rare tumor that involves a high rate of local invasion. The prognosis is poorer compared to that occurring in the trunk and extremities.
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http://dx.doi.org/10.1186/s13256-015-0624-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501291PMC
July 2015

Association of laryngeal and nasopharyngeal tuberculosis: a case report.

J Med Case Rep 2015 Jan 6;9. Epub 2015 Jan 6.

ENT Department, Avicenne Military Hospital, Marrakech, Morocco.

Introduction: To the best of our knowledge, the association of nasopharyngeal and laryngeal tuberculosis has never been described before in the literature. We report here a first observation.

Case Presentation: We report the case of a 38-year-old Arab man who presented with an isolated hoarseness. Radiological and endoscopic examinations showed a thickening of the left lateral wall of his nasopharynx and the left vocal cord. Pathology revealed the diagnosis of tuberculosis of both localizations. He received a 6-month antituberculous chemotherapy with a satisfying uneventful evolution.

Conclusions: Tuberculosis should be considered in the differential diagnosis of soft tissue masses of the head and neck, particularly when the imaging findings and clinical presentation are atypical. The diagnosis of tuberculosis is mainly based on histopathological and/or bacteriological examination.
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http://dx.doi.org/10.1186/1752-1947-9-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4326367PMC
January 2015

[Diagnostic contribution of exploratory cervicotomy: retrospective study of 300 cases].

Pan Afr Med J 2015 14;22:364. Epub 2015 Dec 14.

Service d'Oto-rhino-laryngologie, Hôpital Militaire Avicenne, Marrakech, Maroc.

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http://dx.doi.org/10.11604/pamj.2015.22.364.8218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4789188PMC
December 2016

[Nasosinusal malignant tumors: about 32 cases and literature reviews].

Pan Afr Med J 2015 10;22:342. Epub 2015 Dec 10.

Service d'Oto-rhino-laryngologie, Hôpital Militaire Avicenne, Marrakech, Maroc.

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http://dx.doi.org/10.11604/pamj.2015.22.342.8220DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4779619PMC
December 2016

Intralaryngeal thyroglossal duct cyst.

Pan Afr Med J 2015 24;22:294. Epub 2015 Nov 24.

ENT Department, Military Hospital Avicenna, Marrakech, Morocco.

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http://dx.doi.org/10.11604/pamj.2015.22.294.8264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4769048PMC
December 2016

[Submandibular swellings: about 42 cases and review of the literature].

Pan Afr Med J 2014 14;18:302. Epub 2014 Aug 14.

Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-faciale, Hôpital Militaire Avicenne, Marrakech, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.18.302.4033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247903PMC
July 2015

Adenocarcinoma of the sphenoid sinus.

Pan Afr Med J 2014 10;18:284. Epub 2014 Aug 10.

ENT department, Avicenne Military Hospital, Marrakech, Morocco.

Adenocarcinomas of the sphenoid sinus are exceptional. In this paper, we report a new case with a review of the literature. Our patient was a 45-year-old man who presented with isolated retro orbital headache. CT and MRI suspected a malignat tumor of the sphenoid sinus. The patient underwent a debulking surgery. The final pathology carried out the diagnosis of primary adenocarcinoma. The patient died several months later from radiotherapy complications. Even if adenocarcinomas of the sphenoid sinus are exceptional, they should be considered in the differential diagnosis of sphenoid sinus masses. The prognosis is poor.
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http://dx.doi.org/10.11604/pamj.2014.18.284.4416DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247863PMC
July 2015

[Inverted papilloma: a retrospective study of 22 cases].

Pan Afr Med J 2014 16;17:208. Epub 2014 Mar 16.

Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale, Hôpital Militaire Avicenne, Marrakech, Maroc.

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http://dx.doi.org/10.11604/pamj.2014.17.208.3936DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4142633PMC
May 2015

Chondrosarcoma metastasis in the thyroid gland: a case report.

J Med Case Rep 2014 May 20;8:157. Epub 2014 May 20.

ENT department, Avicenne Military Hospital, Marrakech, Morocco.

Introduction: Chondrosarcoma metastases in the thyroid gland are exceptional. To the best of our knowledge, only two cases have been previously reported in the literature. Here we report the third case.

Case Presentation: We report the case of a 51-year-old Arab woman who presented in 2011 with a diaphyseal chondrosarcoma of her right tibia treated by surgery. In the last quarter of 2013, she presented a hard mass in her thyroid gland with dyspnea and a right laryngeal paresis. She underwent a debulking surgery with tracheostomy in order to prevent difficulty in respiration. The final pathology revealed the diagnosis of a chondrosarcoma metastasis within her thyroid gland. She died several days later.

Conclusions: Even if primary and metastatic chondrosarcomas of the thyroid gland are exceptional, they should be considered in the differential diagnosis of thyroid gland masses. The prognosis is poor but surgery may help preserve quality of life.
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http://dx.doi.org/10.1186/1752-1947-8-157DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4038081PMC
May 2014

CD68-positive tumor-associated macrophages predict unfavorable treatment outcomes in classical Hodgkin lymphoma in correlation with interim fluorodeoxyglucose-positron emission tomography assessment.

Leuk Lymphoma 2015 Feb 27;56(2):332-41. Epub 2014 Jun 27.

Department of Hematology, CHU Limoges, Dupuytren Hospital , Limoges, F-87042 , France.

Finding new prognostic factors to identify patients with Hodgkin lymphoma (HL) at risk of treatment resistance or relapse remains challenging in daily practice. We evaluated the relationship between CD68 expression, interim positron emission tomography (iPET) results and outcome in 158 patients with HL diagnosed from February 1995 to July 2011. Immunohistochemistry (anti-CD68) gave two groups: low with ≤25% positive cells (121 patients) and high with >25% (37 patients). Five-year overall survival was higher in the low group (88.4% vs. 63.2%, p=0.0151), as was progression-free survival (74.5% vs. 40.7%, p=0.0003). In 68 patients evaluable, iPET correlated with CD68: 13/52 patients (25%) in the low group had positive iPET as compared to 11/16 patients (68%) in the high group (p=0.0016). This study confirms the prognostic value of CD68 in HL. We found a correlation between CD68 and iPET suggesting potential for a better stratification.
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http://dx.doi.org/10.3109/10428194.2014.917636DOI Listing
February 2015
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