Seoud, Muhieddine

ABSTRACT Introduction: ASPS is a rare, soft tissue tumor which represents 0.2-1 % of soft tissue sarcomas. A characteristic nonreciprocal translocation is found in nearly all cases. The resulting ASPSCR1-TFE3 fusion gene is postulated to be involved in the pathogenesis of this tumor. Case report: 29 years-old female presented with abdominal pain for few months. MRI and CT revealed a large necrotic abdominopelvic mass, which is extra-uterine, extra-ovarian, and peritoneal nodules. Exploratory laparotomy revealed a large mass arising from the distal part of the descending colon involving the mesentery and the surrounding peritoneum. She underwent left colectomy with primary anastomosis, and resection of the involved adjacent peritoneal and mesenteric surface nodules. Histopathology revealed ASPS involving the outer serosal layer of the large bowel wall negative margins. It also involved the resected mesenteric fat, greater omentum, and peritoneum. No further treatment was received as the patient traveled to home country. Discussion: The treatment of early-stage ASPS involves radical surgical excision of the primary tumor. Traditionally, patients with advanced ASPS have limited therapeutic options because of the resistance of the tumor to conventional cytotoxic chemotherapy, however, it is a targetable sarcoma. The response rate of metastatic ASPS to targeted therapy is clinically meaningful, and comparable to that of first-line chemotherapy. Most patients who received targeted therapy achieved disease control. Patients who had refractory or progressive disease to one targeted agent demonstrated a response to other agents. More randomized trials are warranted to expand treatment options and compare them to standard care regimens. Conclusion: In conclusion, while radical surgical excision remains crucial for early-stage ASPS, the landscape for advanced cases is evolving with targeted therapies showing promising results. However, further randomized trials are necessary to broaden the treatment options available and to evaluate these new therapies against existing standard care regimens. This ongoing research is vital to improving outcomes for patients with ASPS and tailoring more effective treatment strategies. Highlights

AbstractObjectiveTo review our national cervical cancer screening program using existing Ministry of Public Health primary healthcare centers (PHCs) and report the impact of women's knowledge, attitude, behavior, and practices on screening uptake and outcome.MethodsA cross‐sectional study on cervical cancer screening offered to sexually active Lebanese women aged 21 years and above visiting PHCs. Exclusions were history of complete hysterectomy, gynecologic cancers, and current pregnancy. Data were collected through a questionnaire and conventional cervical smear performed by trained healthcare providers and sent to one centralized cytopathology laboratory.ResultsOf 12 273 eligible women, 1.7% had an abnormal cervical smear test including 161 atypical squamous cells (ASC) of undetermined significance, 6 atypical glandular cells of undetermined significance, 16 low‐grade squamous intraepithelial lesion (SIL), 17 ASC—cannot rule out high‐grade SIL, 11 high‐grade SIL, and one invasive carcinoma. Knowledge and attitudes significantly affected participation in screening; women lacking awareness had rarely undergone a cervical smear.ConclusionIn Lebanon, cytology‐based cervical cancer screening is feasible within the PHCs. Positive screen incidence was low. Despite previous campaigns, a low level of knowledge persists, and affects women's com with the screening guidelines. Advocacy and awareness activities by key healthcare providers may help to improve participation.