Myositis ossificans circumscripta after surgery and radiotherapy and during sunitinib treatment: a case report.

BACKGROUND: Myositis ossificans circumscripta is a self-limiting, benign, ossifying lesion that can affect any type of soft tissue. It is most commonly found in muscles as a solitary lesion. A history of recent trauma has been reported in approximately 50% of cases. Clinically, MOC presents as a painful swelling, which rapidly increases in size. The pain and inflammatory symptoms spontaneously disappear after approximately 2-6 weeks, and the mass stabilizes or decreases. Radiologically, myositis ossificans circumscripta can be divided into two phases. The first is the acute phase, which is followed by the mature phase 2-6 weeks later. During the acute phase, the radiological aspect does not show any specific abnormality. In the mature phase, plain radiographs and computed tomography show blurred calcifications around a hypodense center. We describe here the first case of myositis ossificans circumscripta, with appropriate follow-up, occurring during sunitinib exposure. CASE PRESENTATION: We report a case of myositis ossificans circumscripta in a 34-year-old man (ethnicity unknown) receiving sunitinib for metastatic alveolar soft part sarcoma of the left thigh after surgery and radiotherapy. Four months after the first dose of sunitinib, the patient experienced painful swelling in the surgical scar area. Magnetic resonance imaging showed diffuse and marked edema of the anterior compartment of the thigh, without nodular lesions circumscribing a central core, and without bone signal abnormality. The increased visibility of the intermuscular fascia and convergence of normal muscle fibers (black hole effect), without the displacement seen in tumors, were suggestive of myositis. Therefore, antiangiogenic treatment was discontinued, and the symptoms rapidly resolved within a few days. Three weeks after the discontinuation of sunitinib, the inflammatory findings completely disappeared. Two months after the diagnosis of myositis ossificans circumscripta, plain radiographs and computed tomography showed an extensive calcified mass measuring > 12 cm. The continuation of favorable clinical outcomes was confirmed. CONCLUSIONS: To the best of our knowledge, this is the first case of myositis ossificans circumscripta with appropriate follow-up occurring during sunitinib exposure. Owing to multimodal treatment of sarcoma, we cannot rule out the radiotherapy and surgery causality.

Comparison of compressed sensing and controlled aliasing in parallel imaging acceleration for 3D magnetic resonance imaging for radiotherapy preparation.

Magnetic resonance imaging (MRI) for radiotherapy is often based on 3D acquisitions, but suffers from low signal-to-noise ratio due to immobilization device and flexible coil use. The aim of this study was to investigate if Compressed Sensing (CS) improves image quality for 3D Turbo Spin Echo acquisitions compared with Controlled Aliasing k-space-based parallel imaging in equivalent acquisition time for intracranial T1, T2-Fluid-Attenuated Inversion Recovery (FLAIR) and pelvic T2 imaging. Qualitative ratings suffered from large inter-rater variability. CS-T1 brain MRI was superior numerically and qualitatively. CS-T2-FLAIR brain MRI was numerically superior, but rater equivalent. CS-T2 pelvic MRI was equivalent without gain.

A New Paradigm in Managing Advanced Ovarian Cancer: Differentiating Patients Requiring Neoadjuvant Treatment from Primary Cytoreduction.

Our study aims to evaluate the comparability of primary debulking surgery (PDS) and neoadjuvant chemotherapy (NACT) patients. This single-center retrospective study includes all patients treated for advanced stages high-grade serous ovarian carcinomas (HGSOC) between 2007 and 2017. Preoperative characteristics and postoperative outcomes were compared after a propensity score matching analysis. Of the 221 patients included, 38% underwent PDS, and 62% received NACT. There was no age difference at diagnosis; however, CA125 levels, PCI score levels, and rates of stage IV were higher in the NACT group. There were no differences concerning the rate and the severity of complications (p = 0.29). The propensity score distribution showed a broad distinction between PDS patients and NACT patients with no significant overlap. Survival analyses demonstrate, after a median follow-up of 66.5 months, an overall survival (OS) of 105.9 and progression-free survival (PFS) of 29.2 months in the PDS group, compared to OS of 52.8 and PFS of 18.9 months in the NACT group. Advanced HGSOC is a heterogeneous population, in which inoperable patients should be differentiated from PDS patients based on many factors, primarily tumor burden.

[Magnetic resonance imaging of desmoid-type fibromatosis: Current evaluation criteria]. / Imagerie par résonance magnétique des tumeurs desmoïdes : critères d'évaluations actuels.

The management of desmoid-type fibromatosis has considerably evolved these last years, toward first-line active surveillance then systemic or local symptomatic treatment in case of aggressive tumor. Magnetic resonance imaging is the modality of choice in each of these treatment settings. It needs multiparametric approach taking into account mainly the tumor size, and T2-weighted signal that is correlated with histological composition and clinical behavior. A volumetric approach should be favored for the evaluation of tumor size change. The interest of paramagnetic contrast injection and tumor enhancement requires further investigation.

[French program of breast cancer screening: Radiologist viewpoint]. / Dépistage organisé du cancer du sein : point de vue du radiologue.

French program of breast cancer screening is implemented since15 years and results are in adequation with international guidelines except for participation. To answer to recurrent controversies about breast cancer screening, publications from National Institute of French cancer registry confirm the positive impact of screening on decreasing mortality for participating women. The harms of mammography (and not from screening) need to be communicated to the invited women to help them to make decision about participation but also the risk of worse prognosis in case of symptomatic cancer. The future of screening will be different and works are in progress to find new ways to select women who will beneficiate for screening and whose cancer needs to be treated. Until then, the only way to screen for breast cancer stays the mammographic process as well as other technics in case of dense breast or in case of family history of breast cancer.