Therapeutic modalities for metastatic breast cancer have not stopped progressing in recent years, in particular hormonotherapy targeting hormonal receptors (HR), and targeted therapies targeting Human Epidermal Growth Factor Receptor-2 (HER2), which allowed to improve the overall survival of patients over expressing these receptors, however, the high risk of metastatic relapse makes the prognosis remain impaired. Among the causes of these relapses, the phenotypic instability, which would be at the origin of expression change of the HR and HER 2 on the surface of tumor cells.This discordance of phenotypic expression between the primary tumor and the metastatic relapse leads to an assessment of therapeutic modalities initially undertaken? Through this work, we will compare our study about 17 female flight crew with metastatic breast cancer, conducted at the aerospace medical center of the military hospital Mohamed 5 of Rabat, with literature data

A 68-year-old postmenopausal woman presented with pain lower abdomen and a palpable mass. Physical examination and radiological findings were suggestive of a large calcified fibroid uterus. Patient was taken up for total laparoscopic hysterectomy with bilateral salpingoopherectomy after all necessary pre-operative work up. To, our surprise, the fibroid was extremely hard, as a result we failed to morcellate or cut it even with high voltage pure cutting current. So, we did a mini-laparotomy to remove the fibroid. Blood loss was minimal. The size of the extracted fibroid was 1 kg. The patient was discharged in stable condition on post-operative day 4. The histopathological examination was suggestive of extensively calcified intramural fibroid and other rare finding of cavernous hemangioma in one of the ovaries. The extensively calcified fibroid in postmenopausal patient and the presence of cavernous hemangioma are rare findings with very few cases reported till date. We managed the case laparoscopically followed by mini laparotomy to retrieve the specimen with the advantages of minimal blood loss, need for blood transfusion and early recovery.

The prevalence of Polycystic Ovarian syndrome is very common nowadays. In this syndrome there is marked decrease in the female characters with irregular or no menstruation, excess hairs on face, chest, stomach, thumbs, or toes, decrease in breast size, hair loss, acne, depression, weight gain, pelvic pain and infertility. It affects mainly the females of reproductive age. If left untreated, may result in infertility and even uterine cancer. Very little is known about status of lipid profile in this syndrome so the objective of the study was to compare lipid Profile in women suffering from polycystic ovarian syndrome and healthy women. The study comprised of 200 women of same reproductive age. Out of which 100 were healthy women and 100 were women suffering from polycystic ovarian syndrome. Lipid Profile was tested on auto analyzer by available commercial kits. Student t test were applied to determine difference between the two. SPSS software 20.0 was used for statistical analysis. We found the women suffering from polycystic ovarian syndrome had dyslipidemia as comparison to healthy women. This shows that dyslipidemia can be a risk factor for developing polycystic ovarian syndrome

Annex torsion is a true surgical emergency, it is a rare pathology, secondary to the total or partial rotation of the appendix around its vascular axis, which can lead to hemorrhagic necrosis of the ovary. Its frequency is estimated at 1/5 000 pregnancies. It can occur during the entire pregnancy, although the increase in the size of the uterus in the 2nd-3rd trimester reduces the mobility of the appendix. Its clinical signs are usually acute and sudden pain, nausea and vomiting secondary to peritoneal irritation and the existence of an adnexal mass. Ultrasound is the paraclinical reference examination, it allows to visualize an annexial pathology that can be at the origin of the torsion and look for the indirect signs of ischemia. The treatment of appendix torsions during pregnancy can be done by laparoscopy, while respecting the safety instructions in relation to the pregnant uterus, laparotomy remains the most evaluated surgical technique. The treatment must be conservative if the recovery of the appendage after untwisting allows it. Only an ipsilateral recurrence can make discuss prevention by an annexed pexy