Non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP) still spark controversy regarding histological diagnostic criteria and therapeutic management.

In Réunion Island, the standardized mortality rate for cervical cancer is 4.8/100,000 women, while it is 2.2/100,000 in France. A previous study, before 2016, showed that the absence of brachytherapy and non-compliance with recommendations could contribute to this increased mortality. The objective of the study was to analyze the management of invasive cervical cancers since 2016 in Reunion.

Merkel cell carcinoma (MCC) is a rare skin cancer that mainly affects the elderly, and whose incidence is increasing. Although the exact origin of this cancer remains uncertain, research in recent years has revealed that MCC develops through two oncogenesis pathways: virally induced by the Merkel polyomavirus (80% of cases) and induced by mutations linked to ultraviolet rays (20% of cases). MCC is an aggressive cancer, with a high mortality rate and limited therapeutic options in advanced stage. In localized stages, the recommendations remain surgical excision, with almost systematic additional treatment by radiotherapy to reduce the risk of recurrence; there is currently no approved recommendation for adjuvant immunotherapy at this stage. In advanced stages, PD-1/PD-L1 inhibitors as monotherapy have considerably improved the prognosis of patients and are recommended as first-line therapy. However, more than 50 % of patients have primary or secondary failure of these treatments, with no satisfactory option available to date. The use of dual immunotherapy ipilimumab/nivolumab in these refractory patients, or new strategies such as adjuvant or neoadjuvant immunotherapy, are the strategies currently being explored. This article will review the current guidelines on the management of MCC with a summary of the most recent scientific advances.

Patients who develop Ewing sarcoma with extra-pulmonary metastasis have a poor prognosis. A recent French protocol, CombinaiR3, was set up to evaluate the efficacy of induction chemotherapy followed by high-dose chemotherapy and metronomic maintenance treatment. It is now closed for inclusions and while waiting for the results, we propose a French consensus guideline for the management of patients diagnosed with Ewing sarcoma with extra-pulmonary dissemination. Main recommendations include induction chemotherapy with nine cycles of vincristine/doxorubicin/cyclophosphamide alternating with ifosfamide/etoposide. In case of insufficient response, other chemotherapy combination or inclusion in a clinical trial should be considered. Induction chemotherapy should be followed by local treatment, consisting of surgery and/or radiotherapy. Optimal local treatment is a milestone in the management of patients with Ewing sarcoma and should be discussed with experts and surgeons/radiotherapists working in the sarcoma network. High-dose chemotherapy (HDC) containing busulfan and melphalan followed by autologous stem-cell transplantation is still unclear, with contradictory results. HDC will then be discussed in national tumor board and administered to patients when compatible with local treatment. Given the high relapse rate observed among these metastatic patients, maintenance chemotherapy (so called metronomic regimen) will then be given for two years.

Osteosarcomas of the mandible represent 3-8% of osteosarcomas. The rarity of this anatomic site and its specific treatment explain that only retrospective and a few prospective studies are available in literature. However, there is a consistent evidence on the natural history and treatment of these tumors, which clearly differentiates them from osteosarcomas of the long bones. The aim of this study was to draw up recommendations based on these data and on a retrospective study by the French Sarcoma Group (GSF-GETO). Osteosarcomas of the mandible should be centrally reviewed by an expert pathologist. MDM2, GNAS and RASAL1 status should be checked, and a fragment should be frozen. Complete surgical resection with wide margins is the cornerstone of treatment. Mandibular reconstruction techniques can reduce the sequelae. Contrary to the validated treatment for osteosarcomas of limbs, the role of chemotherapy to prevent metastasis or local recurrence has yet to be clarified for mandibular osteosarcomas. The role of postoperative radiotherapy, in adults, should be discussed for these tumors, whose wide soft-tissue resection may be difficult to confirm. In children, adjuvant chemotherapy is preferable in cases of uncertain/possibly incomplete resection. Relapse of mandibular osteosarcomas is primarily local. Pulmonary metastases are delayed and less frequent than in long-bone osteosarcomas. The overall survival rate at five years is about 70%.

West Guiana is characterized by a precarious, poor, dispersed population, exposed to infectious and chemical factors. Prostate cancer is the leading cancer in terms of incidence in men. We examined its characteristics, management and main exposomes in this context.

Myelolipoma is a rare, benign, usually adrenal. tumor, In rare cases, it may be extra-adrenal, for example thoracic.

Pancreatic cancer is a serious pathology whose incidence is increasing. Advances in imaging have made it possible to fortuitously highlight more and more cystic pancreatic lesions, some of which have a malignant potential, leading to the consideration of prophylactic excision. The various known precancerous lesions of the pancreas as well as current management recommendations are here reviewed.

Radial scars (RS) are benign lesions, but their imaging appearance can mimic that of carcinoma. Traditionally, most RS were surgically excised due to the risk of underestimation. However, guidelines now exist allowing for their surveillance. The objective of this study was to evaluate the risk of underestimation and, secondarily, to identify associated risk factors, as well as to describe the proportion of women who developed breast cancer during follow-up.

Tobacco addiction is prevalent in South and Southeast Asia. This study aimed to assess upper gastrointestinal (GI) tract changes in smokeless tobacco (SLT) users through upper GI endoscopy (UGIE).

Prostate cancer is the third leading cause of cancer-related death among men in developed countries. Hormone and chemotherapy are the standard of care for advanced prostate cancer, but most patients develop resistance. Therefore, new therapeutic strategies are needed to improve the clinical management of prostate cancer. Low circulating levels of the secosteroid hormone vitamin D, and reduced expression of its receptor in prostate epithelial cells correlate with prostate cancer severity. However, the mechanisms underlying the anticancer effects of vitamin D are poorly understood. Our recent work demonstrates the therapeutic effects of a vitamin D analog on the tumor microenvironment in Pten(i)pe-/- mice, a mouse model of prostate cancer. In addition, we have shown that the combination of a vitamin D analog with the chemotherapeutic agent docetaxel, overcomes chemoresistance in primary prostate cancer spheroids, and in xenografts derived from a patient with prostate cancer resistant to docetaxel and to androgen deprivation. Therefore, therapeutic strategies based on the use of vitamin D analogs represent new avenues for advanced prostate cancer.

The management of melanoma has evolved significantly over the past decade with the advent of immunotherapies and BRAF/MEK inhibitors, which have changed the prognosis for patients with advanced disease. Having demonstrated their efficacy in advanced disease, these treatments have been evaluated and shown to be effective in adjuvant treatment at earlier stages, first in stage III and then in stage IIB-IIC. Alongside the development of these adjuvant treatments, which have become the standard of care, new therapeutic strategies have emerged. Neoadjuvant treatments have been shown to be superior to adjuvant treatments in phase II and III trials. These neoadjuvant strategies will undoubtedly become the new standard for patients with macroscopic lymph node disease. However, there are still many unanswered questions regarding the optimal treatment regimen. Should mono- or bi-immunotherapy be used? Can surgery be de-escalated? Is additional adjuvant treatment essential or can it be withheld in the event of a major pathological response? Should patients with BRAFV600 mutations switch to targeted therapies in the event of pathological non-response? Should we switch to targeted therapies in the event of pathological non-response in BRAFV600 mutant patients? Therapeutic strategies, which are becoming increasingly personalised, are evolving very rapidly, with a trend towards de-escalation. We still lack robust biomarkers for patient selection.

The detection of circulating tumor DNA (ctDNA) has made significant advances in oncology in recent years. ctDNA offers a range of applications, including the identification of theranostic mutations, monitoring of tumor recurrence, and assessing treatment efficacy. In breast cancer, several ctDNA-based tests for detecting relapse during follow-up are currently under validation, with some already available in countries like the United States. In metastatic breast cancer, ctDNA levels and their dynamics during treatment have prognostic value. The PADA-1 trial demonstrated that a therapeutic adaptation based on the detection of a circulating subclone via circulating tumor DNA (ctDNA) was feasible and potentially beneficial for patients. This review will explore the methods for ctDNA detection and discuss the potential benefits of incorporating this technology into breast cancer monitoring and management across various clinical scenarios.

Cystic neoplasms are frequently observed on the skin. These can be classified into three categories: (1) malformative/dysembryoplastic cysts, (2) acquired cysts (constantly cystic tumors) of epidermal or folliculo-sebaceous differentiation, (3) acquired cysts of sweat differentiation, which must be distinguished from sweat tumors, sometimes harboring cystic changes. The aim of this session is to present the most frequent cystic lesions, those associated with a genetic syndrome (notably cancer predisposition syndromes), and malignant tumors that may simulate cysts.

Conventional chondrosarcoma is the most common primary malignant bone tumor in adults. Dedifferentiated chondrosarcomas represent 10 to 15% of conventional chondrosarcomas and constitute a high-grade subtype with a poor prognosis, with a 5-year survival rate of 24%. These tumors are characterized by a mutation in one of the isocitrate dehydrogenase (IDH) 1 or 2 genes in 70% of cases. Histological diagnosis requires a biphasic morphology combining a low-grade conventional chondrosarcoma component with a high-grade non-cartilaginous sarcomatoid component. In the literature, this dedifferentiated component most often corresponds to an osteosarcoma or an undifferentiated sarcomatous component. This article describes three cases of dedifferentiated chondrosarcomas: two with bone localization and one with laryngeal cartilaginous localization presenting a rare dedifferentiation component, either epithelial or rhabdomyosarcomatous, which may pose a diagnostic challenge, particularly in micro-biopsy samples. The mechanism of dedifferentiation is still poorly understood, and the origin of the dedifferentiated component remains controversial.

This work describes a case of hepatocellular adenoma with β-catenin mutated discovered during imaging follow-up of hyperplastic regeneration nodules in patient with cirrhosis due to a a Budd-Chiari syndrome. This case highlights the importance of using imaging protocols in the follow-up of patients with hepatic vascular diseases to identify adenomas at an early stage and differentiate them from large regenerative nodules, as well as to provide a complete immunohistochemical profile of all biopsied hepatocellular lesions. Indeed, since the early 2000s, the identification of genetic alterations associated with immuno-histochemical markers has allowed the classification of hepatocellular adenomas into six molecular subtypes. Each subtype presents different histological, clinical, radiological and evolutionary characteristics, all important for the management of the lesion. Furthermore, the risk of malignant transformation of an adenoma is not limited to the subtype β-mutated catenin, lesion size and male sex, but hepatic vascular disorders also appear to be another major risk factor.

Retinal vasoproliferative tumor, otherwise known as retinal reactive astrocytic tumor, is a rare entity presenting as a mass in the inferior peripheral retina, associated with vascular abnormalities, and usually accompanied by exudative manifestations that affect the visual prognosis. The precise etiology is unknown, but the predominantly astrocytic and reactive nature of these lesions now appears to be established. It is classified as primary or secondary, and numerous associated ocular conditions have been reported, including pigmentary retinopathy, pars planitis and Coats' disease. The main differential diagnosis is the retinal capillary hemangioblastoma in von Hippel-Lindau disease. There is currently no consensus on the ideal treatment, and numerous therapeutic modalities have been described in limited case series, with variable success rates. Nevertheless, treatment is essential when there is a visual risk and is based on a combined, thoughtful approach to the various therapeutic modalities available, depending on the individual characteristics of the tumor. Conservative treatments such as laser photocoagulation, cryotherapy and/or photodynamic therapy are generally preferred for small tumors, while more invasive treatments such as brachytherapy are proposed for large lesions or tumors for which the exudative activity cannot be controlled. Vitreoretinal surgery is frequently required for complications such as retinal detachment, epiretinal membranes or vitreous hemorrhage. Intravitreal anti-VEGF injections are an adjuvant treatment for the macular edema frequently associated with the disease.

The aim of this study was to compare the prognosis of Gleason Score (GS) 7 (3+4) prostatic adenocarcinoma with a low percentage of grade 4 to that of GS6 (3+3) prostatic adenocarcinoma.

To update the recommendations issued by the National Cancer Institute (INCa) on the management of women with abnormal cervical cytology.

In the event of a prevascular mediastinal mass, knowledge of the anatomy and content of the mediastinum is an essential prerequisite to establish a differential diagnosis. The «4T» rule is applicable because it is a simple and effective mnemonic. It groups together; thyroid goiter, terrible lymphoma, teratoma and thymoma. The reference imaging technique is computed tomography with injection of iodinated contrast media, allowing the analysis of the lesion as well as its topography and its relationship with adjacent structures. Concerning the case of a lymphoma, PET/CT is the reference examination, as it allows a precise assessment of extension and can establish a target lesion for excisional biopsy which will make the definitive diagnosis. PET/CT is also used for therapeutic monitoring.