Rhabdomyosarcoma is the more frequent mesenchymal tumor in children and in adolescents. It accounts for 60 -70% of mesenchymal tumors and approximately 5% of all solid tumors occurring at these ages. Almost half of rhabdomyosarcomas occur in the head and the neck. We report the case of a 20-year old patient with a new histological, aggressive temporo-parietal rhabdomyosarcoma.

We report the case of a Caucasian 73-year-old woman, without medical history, who is operated of two lesions of the forehead and the scalp measuring 0.4 and 1cm. There is no adenopathy. Histopathological examination revealed a diffuse vascular proliferation of the dermis and the hypodermis composed of small vessels bordered of plump "epthelioid" endothelial cells. There is no mitotic figure. The stroma is slightly fibrous accompanied by a polymorphic inflammatory infiltrate rich in lymphocytes, sometimes arranged in lymphoid follicles, plasma cells and eosinophils. The proposed diagnosis is angiolymphoid hyperplasia with eosinophilia. This is a rare vascular tumor, benign according with the OMS classification and preferentially observed in the skin. We report a cutaneous case, clinical and histopathological data of the reported cases and present the main differential diagnoses.

Brain metastases occur in 1 to 4 % of patients with colorectal cancer and are unique in 0.5 % of them. Because of their infrequent nature, brain imaging is not recommended in the systematic follow-up of these patients. We report here an exceptional case of a unique brain metastasis in a very unusual position. An 82-year-old patient with a colorectal cancer of the splenic angle that was treated with surgery and adjuvant chemotherapy, developed a series of neurological symptoms over four to six weeks: difficulty swallowing, loss of strength in the four limbs and balance disorders. These symptoms urged the performance of a nuclear magnetic resonance to exclude a central neurological lesion. MRI revealed a nodular tumor of 20 millimeters in the major transverse axis and 17 millimeters in the cerebro-caudal axis, located on the ventral portion of the protuberance. Because of its localization, surgery was not possible and the lesion was treated with Cyberknife radiosurgery. Thanks to the treatment, the lesion decreased in size and the symptoms improved significantly. Despite an initially very poor prognosis in view of the localization of the metastasis, the patient is alive and in excellent general condition more than eight months after the diagnosis of recurrence.

The primary vaginal melanoma is a rare aggressive tumour with a poor prognosis. The average age at diagnosis is 60, and there are no known risk factors. The establishment of a classification system and treatment protocols are made difficult because there are so few cases. The 5-year survival rate is estimated at no more than ten per cent. We report a case of an inoperable primary vaginal melanoma in a 58-year old woman. There were metastatic lymph nodes in the lumbo-aortic region, but no extension to bone or viscera. She was treated with nivolumab as monotherapy. Clinical and radiological evolution were both favourable, and the treatment was well tolerated.

Mature ovarian teratoma is the most frequent benign tumor in premenopausal women. It is usually asymptomatic but complications are possible such as adnexal torsion, infection, malignant transformation or cystic rupture. The latter can be spontaneous or more often occurs during surgery of excision of dermoid cyst. It can rarely result in chemical peritonitis, which is due to the irritation of the peritoneal serosa by the aseptic content of the tumour. We report the case of a patient who undrewent an emergency laparotomy for a chemical peritonitis following a spontaneous rupture of a dermoid cyst. Afterwards, she developed an acute respiratory distress syndrome that required an admission in the intensive care unit and subsequent surgery.

Adrenal cysts are a rare entity which makes their treatment somewhat tough. Discovered in a fortuitous way or in the course of explorations for very aspecific symptoms, it is necessary to decide on a case-by-case basis, and after a careful clinical examination, whether the lesion is to be treated through surgery or if a follow-up iconography is sufficient. Three main parameters will influence this choice: the functional status of the cyst, its malignant potential and the potential complications related to the cyst. Current recommendations suggest a surgical treatment for all symptomatic cysts, for functional cysts, for cysts with a diameter exceeding 5 cm, for hemorrhagic cysts and for cysts with malignant imaging potential. The progress and surgical advantages brought by the development of laparoscopy make it the first technique to be chosen.

We conducted a retrospective study of 35 patients with subungual exostosis of the hallux, also known as Turrett's exostosis, in the Department of Orthopedics and Traumatology at the Senior Military Hospital of Instruction of Tunis over the period between 1995 and 2015. We here summarize the outcomes of patients treated for this disease. The average age of patients was 29 years, with a sex ratio of 1.7. The median consultation time was six months. This delay in consultation was caused by a diagnostic error due to clinical picture resemblance with ingrown nail. Diagnosis was always confirmed by frontal and profile X-ray of the involved hallux. Treatment was based on total resection of the exostosis either through large ungual window or by latero-ungual approach. Anatomo-pathological examination was performed systematically. It allowed to confirm the benignity of the disease in all cases. All patients recovered and returned to their previous activity, on average, in 2 months. No patient had a recurrence.

Meningeal melanocytomas are rare pigmented tumors affecting the central nervous system and developing in the cerebrospinal leptomeninges. We report two cases of meningeal melanocytomas showing very marked disparity in their evolution: a very long-term development of meningocerebral lesion, with malignant transformation resulting in the death of the first patient after 32 years and intramedullary ectopic location with very fast massive meningeal diffusion in the second patient. These two cases show the uncertain evolutive profile of meningeal melanocytomas. These lesions may become aggressive with poor prognosis despite an intensive therapeutic strategy.

Superficial circumscribed lymphangiomas are predominantly benign lesions occuring in the cervicofacial area. These malformations of the lymphatic vessels are frequently diagnosed in children. We report the clinical case of lymphangioma of the tongue that occurred in an old man. The differential diagnosis was made primarily with Kaposi's disease, circumscribed angiokeratoma and metastases of a solid tumor. The patient had a biopsy that confirmed the diagnosis. The decision was abstention and supervision since the patient was not embarrassed.

At diagnosis, about 15% of patients with pancreatic cancer present with a resectable tumour, 50% have a metastatic tumour, and 25% a locally advanced tumor (non-metastatic but unresectable due to vascular invasion) or borderline resectable. Despite the technical progress made in the field of radiation therapy and the improvement of the efficacy of chemotherapy, the prognosis of these patients remains very poor. Recently, the role of radiation therapy in the management of pancreatic cancer has been much debated. This review aims to evaluate the role of radiation therapy for these patients.

Small cell lung cancer accounts for 14% of all lung cancers. It remains a major challenge for oncology as the progresses made in the past three decades are modest. After a rapid overview of current knowledge regarding somatic genomic alterations, this state-of-art addresses pathways to improve small-cell lung cancer outcome such as the targeting of DNA damage repair mechanisms firstly anti-PARPs, inhibitory molecules of EZH2, derepression of the NOTCH pathway, rovalbituzumab-tesirine, inhibition of serine/threonine Aurora A kinase, temozolomide and its dependence on methylation of the MGMT promoter. This first chapter suggests the beginning of precision medicine in small cell lung cancer. The last section focuses on the development of immuno-oncological agents and the information collected from phase 1 and 2 studies: the low intensity of PD-L1 tissue expression and the possible relationship of the activity of these agents as a function of tumor mutational burden are pointed out.

Histiocytoma or dermatofibroma (DF) is a common benign skin tumour with several clinical and histopathological variants. Sebaceous induction overlying a dermatofibroma is rare and infrequently reported. Using a detailed clinical case, herein the semiological and dermoscopic features of this lesion are described and illustrated, and the differential diagnoses presented.

Large granular lymphocyte leukemia (LGL) are chronic lymphoproliferative disorders classified into three main groups: T-cell LGL leukemia (T-LGL), aggressive NK-cell leukemia and chronic lymphoproliferative disorder of NK cells (NK-LGL). Patients with LGL leukemia exhibit chronic (>3 months) and moderate (<1G/L) to substantial monoclonal expansion of large granular lymphocytes in the peripheral blood. Cytologically, large granular lymphocytes are medium to large cells which are further characterized by an eccentric nucleus and a slightly basophilic cytoplasm containing azurophilic granules. Typically, T-LGL (CD3-and mostly CD8+) can be differentiated from NK-LGL disorders (CD3-) based on flow cytometry analysis. However, distinction between LGL leukemias can be tricky. We report here the case of a 47-year-old woman patient diagnosed with large granular lymphocytes leukemia associated with atypical CD3-CD56- immunophenotyping and clinical manifestations of pseudo-Felty's syndrome.

Low-grade eosinophilic unclassified renal cell carcinoma is a rare kidney tumor recently described, not included in the WHO classification, which is very close to oncocytoma. It is unknown to most pathologists and clinicians. From a histopathological point of view, this tumor is composed of oncocytic cells arranged in a diffuse and solid pattern, without cell nests, that makes it possible to differentiate it from oncocytoma, and expresses cytokeratin 7 (CK7) heterogeneously. We report a case with a cranial vault metastasis, and present the features to differentiate this entity from oncocytoma. Furthemore, we discuss about unclassified renal cell carcinomas with oncocytic cells.

Primary lung lymphomas are rare tumors representing less than 1% of malignant tumors of the lung. The most frequent form is the mucosa-associated lymphoid tissue (MALT). Ocular involvement is also rare and it is mostly located in the lachrymal glands. We report the case of a patient with pulmonary MALT lymphoma associated with synchronous involvement of the lachrymal glands. This study illustrates the nonspecific clinical, radiological and evolutionary features of this disease.

Bladder exstrophy is rare malformation pathology with an incidence of about 1 in 50,000 newborns. Not treated in time exposes to two main complications: kidney failure and bladder plaque cancer with a risk up to 200 times normal, which usually occurs around the fourth and fifth decade. In 95% it is adenocarcinoma and 5% squamous cell carcinoma. We present a rare case of adenocarcinoma developed on a bladder exstrophy in a 61-year-old patient who underwent an excision of the bladder plate carrying the whole tumor mass with a non-continent urinary diversion type bricker.

Orbital tumors in children are characterised by a wide histological diversity due to the architectural complexity of the orbit. Several classifications may be proposed according to their location, histologic type and malignant or benign character. The most common clinical manifestation is the leukocoria. Diagnostic delay of these tumors, even if they are benign, may affect prognosis and lead to a loss of vision and/or a morphological deformation. Imaging plays an important role in positive diagnosis, in the differentiation between benign processes and potentially malignant processes, in the assessment of local and loco-regional staging and in follow-up monitoring under treatment. This study aimed to highlight the radiological features of primary intra-orbital tumors in children which are, in general, different from those of adults, by conducting a retrospective study of 40 medical records whose data were collected in the Division of Pediatric Radiology at the Mohammed VI University Hospital in Marrakech, Morocco over a period of 4 years (2014-2017).