Primary breast leiomyosarcoma.

Primary leiomyosarcoma of the breast is an extremely rare neoplasm. Only few cases have been reported in the literature. We report here a case of breast leiomyosarcoma in a 44-years-old female and we discuss the data of the existing literature.

A Case of a Metastatic Disease to the Pancreas from a Small-Cell Lung Carcinoma Documented by a CT-Scan-Guided Trucut Biopsy: The Diagnostic Role of Cytomorphology and Immunohistochemistry.

Unlike primary pancreatic carcinoma, metastatic lesions of the pancreas are uncommon and account for approximately 2% of pancreatic malignancies. Small-cell lung carcinoma (SCLC) represents a group of highly malignant tumors giving rise to early and widespread metastasis at the time of diagnosis. However, the pancreas is a relatively infrequent site of metastasis by this neoplasm, and reports on metastatic small-cell carcinoma (SCC) in the pancreas, either of pulmonary or extrapulmonary origin, to be diagnosed by CT-scan-guided trucut biopsy (CT-TCB) are very rare. A 56-year-old man presented with a laterocervical lymphadenopathy associated to a mixed-density lung mass and a mass in the pancreatic body. CT-TCB slides from the pancreatic mass contained small, round tumor cells with extensive nuclear molding. The cytomorphological and histological diagnosis was metastatic SCC. Immunocytochemical staining showed that a variable number of neoplastic cells were positive for cytokeratin 7, TTF1, chromogranin A, and synaptophysin but negative for leukocyte common antigen and cytokeratin 20 with a very high expression of KI67. The transbronchial needle biopsy confirmed the diagnosis of an SCC. This case represents a rare metastatic lesion in the pancreas from SCLC, diagnosed by CT-TCB histological and immunohistochemical studies.

Signet Ring Cell Carcinoma of the Vater's Ampulla: A Very Rare Malignancy.

Most tumors affecting Vater's ampulla are adenocarcinomas, and other histological variants are less frequent. Signet ring cell carcinoma is more commonly found in the stomach than at other sites of the digestive system. Signet ring cell carcinoma of the Vater's ampulla is extremely rare, and only 15 cases have previously been described in the literature. It mainly occurs in elderly patients (median age = 57 years). We report a case of advanced signet ring cell carcinoma of the ampulla of Vater, with invasion of the duodenum (D3) admitted in the Medical Oncology Unit of HASSAN II University Hospital.

Visceral Kaposi's Sarcoma Related to Human Herpesvirus-8 in Liver Transplant Recipient: Case Report and Literature Review.

Background. Kaposi's sarcoma (KS) in transplant recipients is about 400 to 500 times rate in the general population. It is strongly associated to Human herpesvirus-8 (HHV-8) infection which has been found in 95% of KS lesions. The optimal approach to managing posttransplantation KS is to reduce or discontinue immunosuppressive therapy but this strategy carries a risk of the acute rejection of the graft. Recently, the use of an mTOR inhibitor has added new opportunities for KS treatment and prevention. Case Report. We report a case of 24 years-old Turkish woman with visceral HHV-8-associated Kaposi's sarcoma after orthotopic liver transplantation. Conclusion. Posttransplantation KS is considered an experimental model of virus induced tumor suggesting the usefulness of HHV-8 screening in transplant recipient and donor. Therapeutic approaches are complex and require a multidisciplinary team.

[Cardiovascular toxicity of anti-angiogenic therapy]. / Toxicité cardiovasculaire des thérapies antiangiogéniques.

The use of anti-angiogenic therapies has revolutionized the treatment of cancer. However, some of these drugs are associated with cardiovascular damage. An early detection and personalized management is necessary to screen and treat an increase in blood pressure, proteinuria or symptomatic left ventricular dysfunction. Angiotensin-converting enzyme inhibitors and angiotensin II antagonists are the first line treatment of this cardiotoxicity. The interruption of treatment is recommended if cardiac manifestations are uncontrolled, unless the expected benefit is greater than the risks.

[Epidemiological and biologic profile of breast cancer in Fez-Boulemane, Morocco]. / Le profil épidémiologique et biologique du cancer du sein à Fès-Boulemane (Maroc).

In a retrospective study of 265 patients with breast cancer over 3 years (January 2007-September 2009) we examined the epidemiological profile of breast cancer to determine the impact of biological and prognostic factors on survival over 3 years and on the epidemiology of this cancer. Estrogen (RE), progesterone (RP) and human epidermal growth factor receptors (HER2) were evaluated and RE/RP/HER2 status determined. The patients were young (median age 45 years). Invasive tumours were found in 95.5% of the women. The average tumour size was big [3.6 (SD 2.6) cm] and only 14% were histological grade 1. Large tumour size and high histological grade were independent of patient's age. Overall survival at 3 years was only 49% for the RE-/RP-/HER2- subtype and 75% for the RE-/RP-/HER2+ subtype, while it was 96% for the RE+/RP+/HER2- subtype. The young age, large tumour size and high histological grade in our population suggest a lack of awareness of women about breast cancer.

Small cell cancer of the bladder: pathology, diagnosis, treatment and prognosis.

Small cell carcinoma of the bladder (SCCB) is rare, highly aggressive and diagnosed mainly at advanced stages. In addition, coexistence of SCCB with other types of carcinoma is common. Hematuria is the main symptom of this malignancy. Histological tests show a tumour, which is indistinguishable from small cell lung carcinoma (SCLC). Then immunohistochemistry tests may be helpful for a more precise diagnosis. Pathogenesis is uncertain; however the multipotent stem cell theory applies best to this case. The most common staging system used is the two-stage system (limited-extensive). Because of the rarity of the disease, the management is extrapolated from that of SCLC. Limited-stage disease should be treated with etoposide-cisplatin chemotherapy in combination either with radiotherapy, or surgery or both. Extensive-stage disease should be managed by combined chemotherapy. Further research programmes are needed to improve the diagnosis and the treatment of SCCB tumour. This paper would provide a comprehensive review of the epidemiology, clinical features, diagnosis, pathologic features, histogenesis, molecular genetics, staging, treatment, and prognosis of SCCB.

Primary non-Hodgkin's lymphoma presenting as radicular syndrome: report of two cases.

We report two cases of primary Non-Hodgkin's Lymphoma in the spine leading to radicular compression secondary to infiltration of lumbar body vertebras. The two patients were free of either nodular or other extra-nodular disease. Treatment consisted of chemotherapy alone, one patient have had a cauda equina syndrome and surgical decompression was performed in emergency. The patients were in remission for 20 months after diagnosis. A review is given for the incidence of primary vertebral localization of lymphoma, its diagnosis, treatment and prognosis.

Non-germ cell tumours arising in germ cell tumours (teratoma with malignant transformation) in men: CT and MR findings.

PURPOSE: To describe the imaging findings of germ cell tumours (GCT) containing non-germ cell malignant components (also designated teratoma with malignant transformation or TMT). PATIENTS AND METHODS: The records of 14 male patients with GCT and a non-germ cell histological component TMT were retrospectively reviewed. All patients had computed tomography (CT) and/or magnetic resonance (MR) studies before and after initial surgery and chemotherapy, as well as during follow-up. Imaging findings were correlated with the response to treatment and with overall survival. Pathological evaluation, immunohistochemistry, serum alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) were also taken into consideration. Sarcoma was identified in 10 out of 14 patients, with rhabdomyosarcoma ranking first (n=4), followed by osteosarcoma (n=2), fusiform cell sarcoma (n=1), undifferentiated sarcoma (n=1), neurosarcoma (n=1) and myxoid sarcoma (n=1). Other histological types of malignant transformation included adenocarcinoma (n=3) and bronchoalveolar carcinoma (n=1). Overall, 9 patients relapsed at a median time of 84 months (range 60-168). RESULTS: Non-GCT malignant transformation was identified in the retroperitoneum (5), testis (3), mediastinum (3), peritoneum (2) and lungs (1). The CT and MR imaging findings before treatment and after relapse were evaluated with emphasis on imaging features that could possibly imply the presence of malignant transformation (heterogeneously enhancing soft-tissue masses, ossified masses with calcified lymph nodes, diffuse epiploic thickening associated with ascites and peritoneal nodules, pulmonary alveolar infiltration with septal thickening). All but 1 patient with TMT presented with nodal and distant metastases. The prognosis was poor: within a median follow-up of 59 months (range 3-180), 4 out of 14 patients were alive. CONCLUSION: TMT is rare and associated with poorer survival compared to GCT. Imaging can be useful as CT and MR findings may suggest this entity and lead to an early biopsy and appropriate treatment.