Worldwide variation in the distribution of BRCA mutations is well recognised, and for the Moroccan population no comprehensive studies about BRCA mutation spectra or frequencies have been published. We therefore performed mutation analysis of the BRCA1 gene in 121 Moroccan women diagnosed with breast cancer. All cases completed epidemiology and family history questionnaires and provided a DNA sample for BRCA testing. Mutation analysis was performed by direct DNA sequencing of all coding exons and flanking intron sequences of the BRCA1 gene. 31.6 % (6/19) of familial cases and 1 % (1/102) of early-onset sporadic (< 45 years) were found to be associated with BRCA1 mutations. The pathogenic mutations included two frame-shift mutations (c.798_799delTT, c.1016dupA), one missense mutation (c.5095C>T), and one nonsense mutation (c.4942A>T). The c.798_799delTT mutation was also observed in Algerian and Tunisian BC families, suggesting the first non-Jewish founder mutation to be described in Northern Africa. In addition, ten different unclassified variants were detected in BRCA1, none of which were predicted to affect splicing. Most unclassified variants were placed in Align-GVGD classes suggesting neutrality. c.5117G>C involves a highly conserved amino acid suggestive of interfering with function (Align-GVGD class C55), but has been observed in conjunction with a deleterious mutation in a Tunisian family. These findings reflect the genetic heterogeneity of the Moroccan population and are relevant to genetic counselling and clinical management. The role of BRCA2 in BC is also under study.
Primary hydatid cyst in the head of pancreas is rare. We report a case of a 26-year-old patient, who presented with obstructive jaundice. The imaging studies, while demonstrating a fusiform dilatation of the common bile duct, was unhelpful in identifying the etiology. A pancreatic head cyst was discovered at the time of surgery. Diagnosis was confirmed by subsequent serology and identification of scolices on microscopic examination. From the reported data, we discuss the diagnostic and therapeutic modalities of this rare disease.
The main mediator of breast cancer (BC) angiogenesis is the vascular endothelial growth factor (VEGF). Variation of VEGF-A gene may influence the BC susceptibility. The present case-control study investigated the association of the four commonly studied single nucleotide polymorphisms (SNP) of VEGF-A, namely: -1154A/G (rs1570360), -2578C/A (rs699947), -634G/C (rs2010963) and -460T/C (rs833061) with BC susceptibility and aggressiveness in Moroccan women. After genomic DNA extraction, genotyping was performed by TaqMan SNP assays on 70 BC patients and 70 healthy women. The χ2 test was used to detect differences in the genotype frequencies of VEGF between the groups and to stratify genotypes by the clinico-pathological characteristics in patient's group. Women carriers of -1154AG + AA and -2578AC + AA VEGF genotypes had a reduced risk to develop BC [p = 0.018, OR 2.25 95 % CI (1.14-4.42) and p = 0.022, OR 2.26 95 % CI (1.12-4.58), respectively]. Carriers of -460CT and CT + CC genotypes had also a reduced risk to develop BC [p = 0.045, OR 2.63 95 % CI (1.19-5.84) and p = 0.043, OR 2.12 95 % CI (1.01-4.43), respectively]. Moreover, the A-1154A-2578G-634C-460 haplotype seems to have a protective effect against BC risk [p = 0.007, OR 2.41 95 % CI (1.27-4.55)]. Stratification for BC patients according to clinico-pathological characteristics reveals no association with any of VEGF-A SNPs. In conclusion, the data indicated significant associations of VEGF -1154A/G, -2578C/A and -460T/C polymorphisms with BC susceptibility in Moroccan individuals. These VEGF-A polymorphisms can be useful as predisposing genetic markers for BC. Further larger-scale studies are necessary to confirm our finding.
Les tumeurs annexielles cutanées sont des tumeurs primitives cutanées à la fois rares et hétérogènes. Elles sont le plus souvent bénignes et rarement malignes. Elles sont dominées du point de vu morphologique par leur polymorphisme lésionnel. Le but de cette étude est de relever le profil épidémiologique et les différents aspects anatomopathologiques de ce groupe de tumeurs dans une cohorte de population marocaine et de les comparer avec les données de la littérature. Il s'agit d'une étude rétrospective de 96 cas de tumeurs annexielles cutanées colligées au service d'anatomie et de cytologie pathologique de l'Hôpital Militaire d'Instruction Mohammed V de rabat durant une période de 6 ans, de Janvier 2009 à Décembre 2014. Le pic de fréquence est situé entre 31 et 40 ans. L’âge moyen est de 36 ans avec une prédominance masculine (63,5%). Le siège de prédilection est la région de la tête et cou (47,9%). Les tumeurs bénignes (97,9%) sont plus fréquentes que les tumeurs malignes. La différenciation est folliculaire dans 51% des cas, eccrine/apocrine dans 44,8% des cas et sébacée dans 4,2% des cas. Le type histologique le plus fréquent est le pilomatrixome (33,4%) suivi par l'hidradénome (12,5%) et le spiradénome eccrine (11,5%). Les tumeurs annexielles cutanées sont rares et très variées. Le profil épidémiologique et les aspects anatomopathologiques qui ressortent sont globalement superposables à ceux rapportés dans la littérature. Elles sont majoritairement bénignes, à prédominance masculine et dominées par le pilomatrixome et l'hidradénome nodulaire. Les tumeurs malignes sont rares, agressives et surviennent à un âge plus avancé.
We report on the case of a 15-year-old girl with a voluminous gastric trichobezoar imaged by CT. The absence of any attachment of the mass to the gastric wall and the presence of air within the mass are very suggestive for diagnosis.
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