Cerebellous metastases in patients with uterine cervical cancer. Two cases reports and review of the literature

Brain metastases from cervical cancer are extremely rare. We report on two patients who developed cerebellous metastases following uterine cervical cancer. The interval between diagnosis of the primary cancer and diagnosis of brain metastasis was 8 months. The main complaint was symptoms of increased intracranial pressure and cerebellous syndrome. Surgical excision of the brain lesion followed by radiation therapy was performed in the first case. The second patient received palliative radiation therapy. The first patient died 8 months after diagnosis. The second patient is alive 2 months after diagnosis.

Lymphome angiocentrique de la face : à propos de 2 cas

Angiocentric lymphoma of the face is a rare malignancy. During 11 years, only two patients were treated for a lymphoma of the face. The first patient, 31-year-old, had an angiocentric lymphoma of the nasal cavity, the second patient, 40-year-old, had an angiocentric lymphoma of the nasopharynx and the maxillary sinuses, with an extension the hard palate. According to the Ann Arbor classification, the disease was stage IEab and stage IIEbb, respectively. The first patient was treated by chemotherapy alone (COP regimen) and the second patient underwent combined chemotherapy (CHOP) and radiotherapy. The follow-up was marked by progression of the disease 7 and 9 months after the end of the treatment in the two cases. For the angiocentric lymphoma, treatment based on radiotherapy or chemotherapy alone or combined does not often provide local control and the overall survival rate does not exceed 40% at 5 years.

[Primitive intracranial adenoid cystic carcinoma. A case report]

We report the case of a 50-year-old woman presenting a primitive adenoid cystic carcinoma of the middle part of skull base diagnosed by transphenoidal biopsy. She was treated by exclusive radiation therapy with cobalt 60 1.25 MeV and the dose received was 66 Gy in 33 fractions. Our patient remains alive 50 months after the completion of treatment. Adenoid cystic carcinoma is a slow growing malignant tumor with perineural invasion which arises more frequently from salivary glands. The occurrence of primary intracranial adenoid cystic carcinoma is exceptional. The best treatment is radical surgery followed by radiotherapy. Chemotherapy is rarely used. Prognosis is worse than for salivary glands.

[Primary squamous cell carcinoma of the breast. Report of three cases]

Primary squamous cell carcinoma of the breast is a rare neoplasma included in metaplastic breast cancer. The histogenesis remains unknown. Clinical and radiological appearances are not specific. Nodal involvement is rare and hormones receptors are negative. The treatment is based on surgery associated to radiation therapy and chemotherapy. Prognosis seems to be similar to others breast carcinoma. We report three cases of primary squamous cell carcinoma of the breast recruited at National Institute of Oncology with review of the literature.

Male breast cancer. A report of 71 cases

Male breast cancer is rare; it constitutes 0.2-1.5% of all malignant tumours in men and 1% of all breast cancers. The goal of this retrospective study is to analyse the epidemiologic, clinic, therapeutic and evolutive profiles of this disease in 71 cases collected at the National Institute of Oncology in Rabat, Morocco, between the years 1985 and 1998. The median age was 60 years. No significant risk factor was found. The average consultation's delay was 35 months. The main clinical complaint was a mass beneath the areola in 86% of the cases, associated with ulceration in 18% of the cases. For that, the disease was diagnosed at an advanced stage. Infiltrating ductal carcinoma was the most frequent pathologic type (91.5% of cases). Management consisted especially of radical mastectomy, followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy. It was possible to follow 58 of the patients. The median of follow-up was 30 months. The evolution has been characterized by local recurrence, after a median delay of 36 months, in five cases (8.5% of all patients). Metastasis occurred, after a median delay of 12 months, in 14 cases (24% of all patients). The site of metastasis was the bone in six cases, lung in five cases, liver in one case, liver and skin in one case and pleura and skin in one case. There were three cases of death. In one case, death was related to lung metastases. In the two remaining cases, death was due to comorbid disease. Progression was observed in one case.

[Primary adenocarcinoma of the male urethra. A case report]

Primary adenocarcinoma of the male urethra is very uncommon, accounts for 5% of primary urethral cancers. All types of urethral carcinomas account for less than 1% of urinary malignancies in man. The prognosis remains poor despite the wide surgical treatment. The place of chemotherapy combined with radiotherapy must be defined by other studies. We report a case of primary locally advanced adenocarcinoma arising in the bulbo-membranous urethra. The patient was 29 years old, without any previous history of venerian disease. He was treated by combined external beam radiotherapy (total dose 67Gy) and chemotherapy (Cisplatinum). A marked reduction of tumor volume has been noted but the patient died because of the appearance of bone metastasis which failed to the systemic therapy.

[Central nervous system germinoma: retrospective study of six cases]

PURPOSE

Retrospective analysis of six patients with intracranial germinoma treated in INO and a literature review.

MATERIALS AND METHODS

Six patients were treated from 1993 to 1998, for histologically verified primary intracranial germinoma. Median age was 18 years (range: 14-26 years). All patients received chemo-radiotherapy (4FP + radiotherapy from 30 to 50 Gy).

RESULTS

4 tumours were in complete remission. Two patients have kept non-evolutive residual cyst. Five patients are alive with non-evolutive disease after 15-40 months of follow-up (average: 27 months). One patient was lost to follow-up, 14 months after treatment, without disease.

CONCLUSION

The treatment of intracranial germinoma is currently first line chemotherapy followed by low-dose and limited irradiation.

[Intracranial Hodgkin disease: case report]

Hodgkin disease intracranial lesions are uncommon. We report the case of a 24-year-old man who presented with an intracranial relapse without other evidence of disease 24 months after multiple drug therapy and extended field radiation therapy for stage III Bb type 3 Hodgkin disease. The patient was treated by whole brain irradiation (40 Gy/20 fractions/4 weeks). Six months after completion of therapy, the patient had a second relapse, with bilateral inguinal metastatic nodes, which were treated by a second line polychemotherapy. The patient was free of disease 9 months later.

[Non-Hodgkin's lymphoma of the uterus: apropos of 4 cases and review of the literature]

The primary non hodgkin's lymphoma of the uterus is rare. This rarity explains of one part certain difficulties of the histological diagnosis and on the other hand the absence of a therapeutic strategy clearly established. We report 4 cases of primary non-hodgkin lymphoma of the uterus. Two patients had a cervical location, the two other had corpus location. The average age of our patients is of 59 years (extremes: 54-68). Histological diagnosis was confirmed by biopsy for the cervical location. For the corpus location, it is study of the uterus after hysterectomy which retained the diagnosis of lymphoma. The type of the lymphoma was low grade in two cases and high grade in the two other cases. The disease was limited to the pelvis for all our patients (stage IE according to Ann-Arbor's classification). The treatment consisted of an association of chemotherapy and radiotherapy in both cases of lymphoma of the cervix and in a radical hysterectomy followed by chemotherapy for the two cases of lymphoma of the corpus. Our patients are regularly followed, with an average follow-up of 56 months. Two patients are in disease free, the third patient presented a dissemination of the disease and the fourth patient presented a squamous cell carcinoma of the lung.

A rare case of angiosarcoma of the breast in a man: case report

This is a case report of a 57-year-old man who had primary angiosarcoma of the left breast. Five months after detecting a mass in his breast, he underwent mastectomy with biopsy of the ipsilateral axillary lymph nodes. Three years later, he is still alive without any recurrence. Angiosarcoma of the female breast is rare and exceptional in males. It is a condition with a poor prognosis and there are as yet no established chemotherapeutic regimens.

[Paratesticular malignant mesothelioma. Presentation of a case]

We report a case of malignant mesothelioma of tunica vaginalis in a 65-year-old man. The clinical course was marked by local relapse and distant metastases. Based on a review of the literature, the authors discuss the clinical, epidemiological and therapeutic aspects.

Combined flow cytometry and immunohistochemistry analyses for the assessment of nasopharyngeal carcinoma cell kinetics by in vivo bromodeoxyuridine infusion

Thirty-eight previously untreated patients with a histologically proved diagnosis of nasopharyngeal carcinoma were evaluated for in vivo cell kinetics before treatment by conventional radiation therapy. Thirty-seven tumors were analyzed by flow cytometry. Values of median potential doubling time (Tpot), labelling index (LI), and duration of S phase (Ts) were, respectively, 10.9 days, 3.8%, and 10.8 hours. In 35 cases, the results obtained from two biopsies of the same tumor were compared. A good reproducibility was obtained for LI and Tpot (P < 0.01). Thirty-one tumors were analysed by immunohistochemistry and labelling index (HLI) was determined in 24 tumors with a percentage of labelled cells varying from 6.1% to 39.2% (median value = 18.5%). No correlation was found between LI and HLI, but when observations were focused on the restricted group of DNA aneuploid samples, mean values of LI and HLI were closer (respectively, 12.8 +/- 4.5% and 18.3 +/- 7.7%) and a good correlation was obtained (P = 0.01). Moreover, no difference in proliferation was found between diploid and aneuploid tumors. Considering these results, a combined Tpot was calculated that allowed classification of tumors as highly or slowly proliferative.

[Non Hodgkin's malignant lymphoma of the uterine cervix. Apropos of a case]

The authors report a case of a 61-year-old woman presenting a primary cervical non Hodgkin's lymphoma, FIGO stage IIIA and Ann Arbor stage IE. The patient was successfully treated by combination of multiple drug therapy and pelvic external radiation therapy. Twenty-eight months later, the patient is in good general health and complete remission.

[Spermatocytic seminoma. Apropos of a case and review of the literature]

We report a case of sperm cell seminoma caused by trauma. The data in the literature indicate the frequency is less than 5% of all seminomas. This case was exclusively located in the gonads and was a pure form. Orchidectomy with high ligature of the cord and adjuvant radiotherapy at the dose of 25 Gy centered on the para-aortic and subdiaphragmatic chains is adequate treatment. When inguinoscrotal surgery is performed, this zone must be irradiated with 25 Gy. Prognosis is satisfactory: 5-year survival is 100% with this protocol.