Aim: Ovarian corticosteroid-producing tumors are exquisitely rare. Our aim was to describe the first case observed in our practice. Case history: A 34-year-old female was referred for Cushing's syndrome (CS) occurring in the postpartum period. Clinical examination showed severe CS with diabetes mellitus, hypertension, and a large mass in the right lower abdomen. Biochemistry demonstrated corticotropin (ACTH)-independent CS (cortisol = 1900 ng/mL (n = 50-250), ACTH < 10 pg/mL (n = 20-46)) with estradiol and testosterone overproduction. Investigations: Abdomen CT scan revealed a 14 cm right ovarian mass and small adrenal glands. Surgical exploration found the ovarian tumor with hemoperitoneum and enlarged lymph nodes. Histological study confirmed adrenocortical tumor located in the ovary with a Weiss score >5, associated with peritoneal and lymph node metastases. Immunohistochemical staining was positive for inhibin-α, melan-A, and SF1, demonstrating tissue of adrenal origin. After surgery, plasma glucose level spontaneously returned to normal. However, the patient died on the second post-surgical day due to catastrophic pulmonary embolism. Conclusion: In this reported case, clinical, hormonal, histological, and immunohistochemical findings confirmed a cortisol and sex hormone-producing ovarian tumor with peritoneal and lymph node metastases, a very rare but important condition to recognize.

In North Africa, nasopharyngeal carcinoma (NPC) is characterized by a bimodal distribution involving a juvenile (≤ 30 years old) and an elder population (>30 years old). The Epstein Barr virus oncogene LMP1, the anti-apoptotic Bcl-2 protein and the tumor suppressor p53 have recently emerged as biomarkers of the disease. EGFR/ErbB1 expression is detected in the majority of NPC tumors with advanced disease. To obtain greater insight into the potential oncogenic mechanisms specific to these two NPC populations, we examined the correlation between EGFR expression and patient age, and determined the molecular profiles of its associations with the biomarkers of NPC. We performed an immunohistochemical analysis of the latter molecules in NPC specimens from eleven Algerian patients (six patients ≤ 30 years of age and five patients >30 years of age) using the LSAB method. Evaluation of the biopsies, based on the intensity of staining and the percentage of positive cells, showed that LMP1 expression was higher in patients under 30 years of age. Conversely, EGFR, like Bcl-2 and p53, was significantly up-regulated in tumors from elderly patients. Analysis of all tumors showed that EGFR expression was constantly (100%) associated with high p53 nuclear accumulation and Bcl-2 expression in LMP1-positive tissues. Biopsies negative for Bcl-2 staining were found to display low amounts of p53 (100%), and to be constantly negative for EGFR (100%). Molecular classification of all NPC tissues showed that the majority of patients displaying a EGFR+/LMP1+/Bcl-2+/p53-high molecular pattern were in the older age group. On the other hand, the most of the EGFR negative results were associated with the juvenile form of the disease and were characterized by an important diversity of molecular patterns. Our preliminary results suggest that in Algerian patients, the bimodal distribution of NPC might be related to distinct expression profiles of viral and cellular biomarkers of NPC.

e12080 Background: Evaluation of the histological response after neoadjuvant chemotherapy with Docetaxel-carboplatin and bio similar Trastuzumab (CANMAB 150mg) in Her2 positive breast cancer. The primary end point was pathologic complete response (pCR) rate, determined from surgical specimens. Methods: Between March 2017 and June 2018, we treated 39 patients with Her2-positive breast cancer satge II (61,5%), III (38,5%), with a neoadjuvant schedule of docetaxel (75 mg/m2), carboplatin (AUC 6) and biosimilar trastuzumab (CANMAB 150mg: 8 mg/kg loading dose then 6 mg/kg) every 3 weeks. Patients were diagnosed at a mean age of 48 years; 52,28% had hormone receptor-positive tumors and 87,17% of patients were node positive. All pts received 6 cycles of chemotherapy followed by surgery and one year of biosimilar trastuzumab. Results: We report the preliminary results of a prospective study on the use of the biosimilar trastuzumab combined with preoperative chemotherapy in Her2 positive breast cancer. Thirty nine patients (100%) completed six cycles of therapy. Surgery was breast conservative in 6 (15,38%) of 39 patients. Fifteen of the Thirty one patients (48%) achieved a pCR, Twelve of the twenty six node-positive patients (46,15%) experienced nodal conversion. There was a significantly lower response in HR-positive patients compared to HR-negative ones (26,7 vs 73,33%). No case of congestive heart failure was observed. Conclusions: The use of biosimilar trastuzumab with docetaxel and carboplatin achieved promising efficacy, with a good pCR rate (48%) in stage II or III Her2-positive breast cancer.