Secondary cardiac tumors constitute a rare and severe pathology usually associated with an advanced-stage of the primary cancer and consequently correlated to dark prognosis. Clinical presentations are variable and potentially misleading. We present the case of a 76-year-old woman in whom initial echocardiographic presentation evocated left atrial myxoma though the final diagnosis was pulmonary adenocarcinoma invasion. We describe the clinical scenario, the management and we perform a brief littérature review.

The planning target volume is an essential notion in radiotherapy, that requires a new conceptualization. Indeed, the variability and diversity of the uncertainties involved or improved with the development of the new modern technologies and devices in radiotherapy suggest that random and systematic errors cannot be currently generalized. This article attempts to discuss these various uncertainties and tries to demonstrate that a redefinition of the concept of planning target volume toward its personalization for each patient and the robustness notion are likely an improvement basis to take into account the radiotherapy uncertainties.

Le système lymphatique associé au système nerveux central (SNC) regroupe les vaisseaux et ganglions lymphatiques qui sont impliqués dans le drainage du liquide céphalorachidien (LCR) et la clairance du parenchyme cérébral [1-3].

Synchronous metastatic breast cancer accounts for 5 to 6% of all breast cancers in Western countries, which corresponds to nearly 2500 new cases per year in France. Irradiation of the primary tumour in cases of metastatic disease at diagnosis was historically reserved for palliative indications. However, progress in systemic treatments, a better understanding of the biological basis of metastatic dissemination, the genesis of the concept of oligometastatic disease and ablative treatments directed towards metastases are revolutionizing the management of patients with de novo stage IV breast cancer. Survival of these patients has improved markedly over the years, and several studies have investigated the carcinological benefit of local treatment of the breast tumour in patients with advanced diseases at diagnosis. This article provides an update on the role of irradiation of the primary tumour in breast cancer with synchronous metastases, and discusses its interest through published or ongoing trials.

Advances in the reconstructive surgery and minimally invasive endonasal endoscopic surgery of head and neck is poorly evaluated in terms of their impact on radiotherapy planning and outcomes. These surgical advances have resulted in reduced morbidity with equivalent or better tumor control. In the absence of a recommendation on how to delineate target volumes in patients with flaps or to consider margins after endoscopic endonasal surgery, radiotherapy practices are inevitably heterogeneous. Efforts are needed to increase the therapeutic index of postoperative radiotherapy in these situations. We analysed the rare existing literature and outlined a preliminary basis for a recommendation. Strengthening of multidisciplinarity to accurately define target volumes in these complex and relatively new situations, and "delineation concertation meetings" between radiologists, surgeons and radiation oncologists could probably contribute to improved outcomes.

Kaposi´s sarcoma is a tumor characterized by purple or brownish lesions affecting the skin. It is most commonly associated with human herpes virus type 8 (HHV-8) infection and may be secondary to malignant hemopathy, including lymphomas. We here report a new case of a very rare combination: Kaposi´s disease-multiple myeloma. The study involved Mr. aged 67 years, treated for Kaposi´s disease in the Department of Dermatology. Serological test for HHV-8 was positive; it was associated with stage I multiple myeloma IgG Lambda with a poor prognosis. We here report this 21st case of Kaposi-Kahler in order to highlight Kaposi-human herpes 8 virus variant involved in the pathophysiology of multiple myeloma. More studies are needed in order to establish this exceptional link.

Adult onset Still's disease (AOSD) and lymphomas are diseases characterized by very similar clinical and histopathological manifestations. The association between these diseases has rarely been reported in the literature. We here report the case of a 26-year old patient diagnosed with adult onset Still's disease. She had been previously treated for large B-cell Non-Hodgkin lymphoma (LBCNHL) with chemotherapy and haemopoietic stem-cell autograft with complete remission. The association between AOSD and lymphoma is rare and in all cases AOSD has been diagnosed before lymphoma. The peculiarity of this study lies in the succession LBCNHL- AOSD and raises several hypotheses on the association between these two diseases. The association between non-autoimmune diseases and lymphoid hemopathies have been widely demonstrated, whether it is the progression of autoimmune diseases vs lymphoma or non-autoimmune disease manifestations occurring in patients with this disease. This study highlights the difficult distinction between these diseases.

Cystic hygromas are congenital malformations affecting the lymphatic system. These are rare benign dyssembryoplastic lesions mainly affecting the head and neck, in particular the posterior triangle of the neck. They usually occur during childhood and exceptionally in adults. We here report a clinical case of cystic hygroma of the neck in a 22-year old subject.

Breast cancer is a major public health challenge. The purpose of this study is to describe the sociodemographic profile, toxic habits and diet profile of patients suffering from breast cancer treated in the Mohammed VI Cancer Treatment Center, in Casablanca.

Angiosarcoma is a rare tumor which can affect multiple sites. However, it most commonly arises from the skin. Then symptoms have been associated with clinical polymorphism. This tumor has a poor prognosis due to its high tendency to local recurrence and distant metastases. We here report the case of a 72-year old man in whom an angiosarcoma of the shoulder arose from a trauma which occurred one year before it was accidentally detected. The patient presented with persistent pain in a swelling area at the posterior portion of the shoulder involved in the trauma. Clinical examination showed previous and partially calcified hematoma. Diagnosis was based on puncture biopsy of the mass collecting 5 cc of blackish blood and on ultrasound. Shoulder x-ray was normal. An assessment of the swelling was performed. This helped to highlight and resect some reddish, significantly bleeding friable tissue hardly managed for two days and complicated by poorly tolerated anemia corrected with two blood transfusions. Anatomopathological examination of the resected tissues showed moderately differentiated angiosarcoma unfortunately without healthy margins. Staging evaluation was performed in order to detect metastases. No local recurrence was reported over a period of three months and the patient was referred to a specialized center in Lusaka for complementary radiotherapy. The purpose of this work is to report a rare case of angiosarcoma accidentally detected in a patient with a history of trauma to the left shoulder and to highlight the therapeutic features, while conducting a literature review.

Breast angiosarcoma is a rare vascular endothelial connective tissue tumor. It is primitive in young patients and radio-induced in older subjects. It is a malignant tumor and it manifests with polymorphic clinical and radiological features. Its prognosis is poor due to the frequent occurrence of visceral metastases and fast recurrence. We here report a case of breast angiosarcoma in a female patient aged 43 years, with a history of breast cancer, treated by conservative surgery and adjuvant radiotherapy. The purpose of this study is to highlight the epidemiological diagnostic and therapeutic features of these rare aggressive tumors.

Brachytherapy is part of the treatment of locally advanced cervical cancers, accounting for about half of the total delivered dose. The benefit of dose escalation is the most important in advanced cases or if the tumor has responded poorly. The use of interstitial implantations makes it possible to reach doses of the order of 85 to 90Gy (including external beam radiotherapy contribution) in most patients, through image-guided approaches. Brachytherapy delivery is one of the quality criteria for patient care. To date, no data allow us to consider as an alternative the use of external boost through intensity-modulated or stereotactic body radiotherapy. Indeed, the doses delivered to the tumor and the capacity to spare normal tissues remains lower, as compared to what is permitted by brachytherapy. It is therefore appropriate for centers that do not have access to the technique to establish networks with centers where brachytherapy is performed, to allow each patient to have access to the technique. It is also necessary to promote brachytherapy teaching. The issue of reimbursement will be crucial in the coming years to maintain expertise that is today insufficiently valued in its financial aspects, but has a very high added value for patients.

Primitive adenocarcinoma of the bladder is a rare form of bladder tumor accounting for less than 2% of bladder cancers. It mostly affects male sex, with a sex ratio of 3/1 and an average age of onset between 60 years and 70 years. Clinical manifestation is non-specific and dominated by haematuria. Endoscopic resection of the bladder with anatomo-pathological examination allows the diagnosis. Treatment of primitive adenocarcinoma of the bladder is controversial due to the rarity of cases reported in the literature. However, the treatment of choice seems to be radical cystectomy with extended lymphadenectomy. We report a series of 6 cases of adenocarcinoma treated and followed-up in our hospital. Our analysis is based on the evaluation of the epidemiological, clinical, pathological and therapeutic features of adenocarcinoma of the bladder as well as on the study of the evolutionary features and prognostic factors.