肿瘤外科档案

Pseudomyxoma peritonei (PMP) is a rare associated diagnosis of peritoneal carcinomatosis which, classically, has been characterized by a slowly progressive disease process. More recently, Ronnett et al., have histologically classified PMP into the slow growing disseminated peritoneal adenomucinosis (DPAM), the much more aggressive and invasive peritoneal mucinous carcinomatosis (PMCA) and an intermediate group (ID). Recent studies have shown that most cases of PMP arise from ruptured appendiceal tumors with dissemination of mucin producing epithelial cells into the peritoneal cavity. PMP, contrary to popular belief, almost never arises from a ruptured primary ovarian mucinous tumor, corroborated by two of the largest series on ruptured borderline mucinous ovarian neoplasms. A small number of cases have been reported, however, with peritoneal carcinomatosis secondary to rupture of an ovarian mucinous tumor associated with a mature cystic teratoma. These are usually CK7 negative and CK20 positive, and are immunohistochemically consistent with intestinal type of mucinous tumors that arise from intestinal elements of the teratoma. Other malignancies such as squamous cell carcinomas, malignant endodermal sinus tumors and chorio-carcinomas have been shown to arise from a mature teratoma. We present a case report describing one such rare case of DPAM arising from a ruptured borderline mucinous ovarian tumor in the background of a cystic teratoma.

Background: The Moroccan perspective on quality of life (QOL) in lung cancer has not been studied adequately in a country where the disease represents the leading cause of cancer among men.
Methods: Data on Health Related QoL were collected within a Moroccan multicenter prospective study in patients with lung cancer. We used the EORTC QLQ–C30 and the lung specific module (EORTC QLQ–LC13) to highlight the health-related QOL of Moroccan patients with lung cancer. We also assessed the socio-demographic and clinical variables that predict the scales of the QLQ–C30 and QLQ-LC13.
Results: The mean age of the 497 participants was 61.24 ± 10.55 years. The majority of patients (91.8%) were male and 76.9% had stages III and IV disease. Patients study reported an impaired HRQoL as compared to the normal population with an exception for social functioning, where the mean score was higher (77.7 vs. 71.3)). For the QLQ-LC13, Moroccan patients seemed to have more severe symptoms compared to the normal population especially for dyspnea, coughing and chest pain. Patients with low performance status and advanced stage disease had poorer HRQOL scores.
Conclusion: This was the first HRQoL study in lung cancer patients in Morocco. The combination of an advanced disease, aging and low performance status along with poor quality of life emphasizes the importance of supportive care in this group of patients.