[Tripe palms and a hypertrophic osteoarthropathy syndrome revealing a neuroendocrine carcinoma of the lung]. / Pachydermatoglyphie associée à une ostéoarthropathie hypertrophique révélant un carcinome neuroendocrine du poumon.

BACKGROUND: Tripe palms is a rare cutaneous paraneoplastic syndrome, primarily evocative of lung and gastric neoplasia. Association of many paraneoplastic diseases has also been reported. PATIENTS AND METHODS: A 49-year-old man with a history of alcoholism and smoking addiction reported haemoptysis and thoracic pains present for one year. The physical examination showed left lung condensation. The skin examination revealed a thickened yellowish keratoderma with exaggerated skin ridges and digital clubbing. A diagnosis of paraneoplastic tripe palms was made, prompting repetition of the biopsy which ultimately revealed a neuroendocrine carcinoma. Skeletal scintigraphy showed periosteal proliferation with hypertrophic osteoarthropathy. COMMENTS: "Tripe palms" or "osteoarthritic acanthosis" is a paraneoplastic syndrome. It involves an acquired keratoderma taking on a yellow velvety appearance with accentuation of dermatoglyphic lines. Malignancy is discovered in over 90% of individuals with tripe palms. If malignancy is isolated, it mostly involves the lung (53%). Gastric cancer is associated in 77% of cases if the condition is associated with acanthosis nigricans. In approximately one third of cases, the keratoderma may resolve, generally after treatment of the tumour. The association of many paraneoplastic syndromes has also been reported, in particular digital clubbing and hypertrophic osteoarthropathy. At least 90% of cases of hypertrophic osteoarthropathy in adults occur in patients who have or will eventually develop a malignancy. It is characterized by periostosis of long bones, joint pain, and clubbing, and it is often seen on bone scintigraphy during staging of lung carcinoma.

[Neoadjuvant chemotherapy in non-small cell lung cancer: current state and future]. / La chimiothérapie néoadjuvante dans les cancers pulmonaires non à petites cellules : état des lieux et perspectives d'avenir.

Non-small cell lung cancer (NSCLC) continues to be the leading cause of cancer-related mortality in the world. The combination of chemotherapy and surgery is a standard of care for resectable NSCLC. If the adjuvant chemotherapy is a standard, the role of neoadjuvant chemotherapy is still debated. Most trials of neoadjuvant chemotherapy were closed when the positive studies of adjuvant chemotherapy were published. Only the Spanish trial NATCH, designed to compare the neoadjuvant chemotherapy in the adjuvant chemotherapy, was fully completed. Therefore, the trials of preoperative chemotherapy lack strength to become proof of concept. Confirmation will come from meta-analyses. Two of them are positive. Others are in progress. The current research is to select the patients according to predictive factors to chemotherapy response.