Background: Breast cancer is the most common and costly disease in Lebanon, but data on cancer stage and mortality are scarce. Aims: This study aimed to assess the effect of mammography screening campaigns in reducing the breast cancer stage at diagnosis. Methods: A secondary analysis was conducted of data from the Ministry of Public Health’s Cancer Drug Scientific Committee database. The medical files of 3320 newly diagnosed breast cancer patients between 2012 and 2017 were reviewed. Demographic and pathology characteristics, cancer stage at diagnosis and presence of receptors were extracted and analysed. Results: The median age of the patients was 53 (interquartile range 36–72) years. Most patients had positive estrogen and progesterone receptors. Patients < 35 years mostly lived in South Lebanon, had advanced stages of cancer (III and IV) at diagnosis and were more likely to have triple negative breast cancer than the older groups (31.3% versus 16.7%). Advanced stage at diagnosis was common outside Beirut (60.4% in Bekaa and 54.7% in North Lebanon). In the period 2012–2017, the trend in early stages (I and II) at diagnosis decreased from 55.6% to 41.9%, while advanced stages (III and IV) increased from 44.4% to 57.9%. Conclusion: Efforts to downstage breast cancer through mammography screening in Lebanon have not succeeded. Implementation of genetic testing and tailored approaches for Lebanese women are recommended for future campaigns.

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Immunological phenomena have been described in infections such as infective endocarditis. However, none has been reported in the context of Babesiosis. Babesiosis is a tick-borne illness caused by the protozoa of the genus Babesia and causes infections that range from asymptomatic to severe and sometimes are fatal. This report presents the first case of ANCA/ANA positive severe babesiosis in an asplenic patient treated with repeated red blood cell exchange transfusion.

Patient: Male, 57 Final Diagnosis: Perforated diverticuli Symptoms: Asymptomatic Medication: — Clinical Procedure: — Specialty: Surgery Objective: Rare co-existance of disease or pathology Background: Perforation of the colon is associated with high mortality and requires early diagnosis. However, the diagnosis of perforation from atypical causes can be a diagnostic challenge. This report is of a rare case of recurrent sigmoid colonic perforation in a patient with diverticular disease who did not present with an acute abdomen but who had pemphigus vulgaris treated with immunosuppressive therapy. Case Report: A 57-year-old man with pemphigus vulgaris was treated with steroid s, non-steroidal anti-inflammatory drugs (NSAIDS), and azathioprine. He had episodes of abdominal bloating but denied any other symptoms. He was diagnosed with spontaneous sigmoid diverticular perforation without presenting with an acute abdomen. Conclusions: Diverticular perforation can be asymptomatic in patients on immunosuppressive therapy. Therefore, there should be a high index of suspicion for bowel perforation in patients with abdominal symptoms who are treated for skin diseases, such as pemphigus vulgaris, and are on steroids and other immunosuppressive treatments.

Introduction: Morel–Lavallée (MLL) is an uncommon entity that is missed by many physicians, it is the result of a shearing force that leads to degloving of the subcutaneous fat from the underlying deep fascia. Case Report: We present a case of a 15-year-old male patient who presented 3 months after the initial crush injury with a large MLL lesion at the lateral aspect of the right proximal thigh. He was treated with incision and drainage with compressive dressing and a negative pressure drain. Conclusion: Diagnosis of MLL is usually clinical and can be aided with radiological tools like MRI that is the gold standard of imaging in this lesion. Several treatment options are available, ranging from conservative treatment with compressive bandages to percutaneous drainage, injection of sclerotic agents, and surgical treatment with incision, drainage, and debridement. Diagnosis and treatment should be familiar to all caregivers to prevent further complications that could be life or organ-threatening. Keywords: Morel–Lavallée, thigh trauma, chronic Morel–Lavallée, thigh mass.