Primary neuroendocrine breast carcinomas are rare and little-known tumors. Only a limited number of studies on neuroendocrine breast carcinomas have been reported in the literature, and the vast majority of them are small retrospective series or case reports. According to the World Health Organization (WHO), they account for only 2 % to 5 % of breast cancers. Their diagnosis relies on the presence of a neuroendocrine architecture and the expression of neuroendocrine markers (chromogranin A and/or synaptophysin). The revised 2012 WHO classification subdivides them into three categories: (i) well-differentiated neuroendocrine carcinomas, (ii) poorly differentiated neuroendocrine carcinomas or small-cell carcinomas, and (iii) invasive breast carcinomas with neuroendocrine differentiation. Their clinical features and radiological characteristics are not different from those of other types of breast cancer. Because of discordant results, their clinical outcome is still poorly defined. So far, no standard treatment has been established, and most clinicians draw on their experience of invasive ductal cancer. The role of specific treatments like platinum-based chemotherapy, somatostatin analogues, peptide receptor radionucleide therapy or temozolomide remains unclear. A better knowledge of the molecular pathways involved in their carcinogenesis could help to identify new potential therapeutic targets. The efficacy of targeted therapies has to be studied.

Chronic prurigo may reveal several internal diseases. Its association with a solid neoplasia is rare. We report an exceptional case of chronic prurigo revealing surgically curable adenocarcinoma of the ampulla of Vater. Our study involved a 70-year old patient, with no particular previous history, who was hospitalized for etiological assessment of prurigo lasting for 06 months associated with non-documented weight loss. The lesions were isolated and involved the trunk and the limbs (A); initial assessment was strictly normal. Given the lack of patient's improvement with symptomatic treatment, additional exams were performed, including thoracoabdominopelvic CT scan, which objectified a tumor of the biliopancreatic junction measuring 2 cm, suggesting the diagnosis of ampulloma (B). The patient underwent surgical excision of this adenocarcinoma of the ampulla of Vater followed by regression of the skin lesions without further treatment. At 1-year follow-up, there was no evidence of recurrence of the skin lesions and the patient achieved complete remission of adenocarcinoma.

Multiple lung carcinomas are 5 to 11,5% of lung carcinomas. The distinction between primary lung carcinomas from carcinomas with intrapulmonary metastasis is essential for optimal patient management. The histopathological analysis is very useful but it has to be completed by genotypic assessment using molecular biology (NGS). Molecular biology can also identify genetic alterations with therapeutic implications. We present the case of a patient with a history of surgery for multiple lung carcinomas diagnosed from 2013 to 2017.

When ageing, cells profoundly reprogram to enter a state called senescence. Although the link between senescence and cancer is well established, the nature of this link remains unclear and debated. We will describe in this article the properties of senescent cells and make clear on how they could promote or oppose to cancer initiation and progression. We will also consider senescence as a response to classical anti-cancer therapies and discuss how to take advantage of senescence to improve the efficacy of these therapies while decreasing their toxicity.

Expression IV survey evaluated the patients' expectations to a maintenance therapy.

Adrenal gland hemangioma is a very rare histologic entity belonging to the group of incidentalomas. It is often asymptomatic, unexpectedly detected during imaging examination and resulting from another abdominal affection. We here report a single case to further enrich international case series which are still very limited.

Adrenal myelolipoma is a rare benign non secreting tumor. It is often unexpectedly detected. Pathophysiologically, it is adrenal cortex cell metaplasia into reticuloendothelial cells, resulting from infection, chronic stress or adrenal gland degeneration. The mean age at diagnosis is late forties. Histologically, the tumor is composed of mature fat tissue associated with normal haematopoietic tissue. Tumor echogenicity depends on the predominance of the greasy or myeloid component. Its diagnosis is based on CT scan that identifies the fat percentage. However, these radiological aspects may lead to diagnostic confusion with kidney angiomyolipoma, lipoma and liposarcoma, hence the key role of MRI. Surgical resection of myelolipoma is usually performed and is indicated when tumor is voluminous, compressive or at risk of hemorrhage. We here report the case of AL A, 75 years old, hospitalized for adrenal mass revealed by right back pain radiating to the right hypochondrium, without signs of endocrine hypersecretion. Clinical examination showed sensitivity of the right lumbar fossa. Pheochromocytoma and corticosurrenaloma assessment was without abnormalities, including 24-hours urinary methoxyl derivatives and dexamethasone suppression test. The patient underwent coelioscopy; anatomo-pathological examination showed adrenal myelolipoma.

We report the case of Ms. A.A, a primiparous woman aged 21 years presenting (4 months after delivery) with an increase in left breast volume occurred 1 week after delivery associated with fever. The patient was put on amoxicillin, protected by suspending breast-feeding for several weeks without improvement. Clinical examination showed febrile patient with a temperature of 39°, an increase in left breast volume, inflammatory signs especially at the level of internal quadrants (A). Palpation showed a painful, hot collection adherent to the skin, measuring 16 cm, at the level of the internal quadrants, invading the external quadrants, without axillary adenopathies, suggesting breast abscess. Ultrasound (B) showed voluminous solidocystic predominantly liquid echogenic mass with thick walls and buds up to 46 mm, classified as ACR4. Puncture biopsy collected grayish green liquid, sent for bacteriological examination; antibiotic therapy with quinolones was started. Follow up of patient, after 3 days, showed reduction of the inflammatory signs and bacteriological examination of the liquid found no germ. After 15 days of antibiotic therapy, the inflammatory signs had disappeared and the volume of the mass had reduced enough, hence the indication for cystectomy. Cystectomy with simple enucleation was performed (C); surprisingly, the histological examination showed cystic fibroadenoma (D).

We here report the case of a 64-year old woman followed up for cirrhosis due to hepatitis C virus who didn't respond favorably to antiviral treatment. During her last follow-up visit, she reported the occurrence of painful anterior chest hump. Physical examination showed hard immobile mass at the level of the manubriosternal joint. The patient underwent sternoclavicular CT scan, which objectified expansive osteolytic lesion centered upon the sternal manubrium invading the soft tissues (A, B). The biopsy revealed malignant papillary epithelial tumor expressing pancytokeratin and CK7. Patient's profile suggested the presence of a metastasis from cholangiocarcinoma or osteophilic tumor. Gynecological examination, associated with mammogram and breast ultrasound, excluded a gynecological origin. The diagnosis of thyroid tumor was excluded on ultrasound. Chest CT scan showed multiple secondary pulmonary nodules. Abdominal angioscanner revealed the presence of a tissutal hepatic mass measuring 6 cm invading the portal bifurcation with portal vein thrombosis, suggesting hepatocellular carcinoma (HCC) (C). Given the discrepancy between anatomopathological data and morphological data, immunohistochemical study of the anti-Hep-Par-1 was performed, showing antibody expression on tumor cells. The diagnosis of manubriosternal metastasis from poorly differentiated hepatocellular carcinoma was retained. The patient was recommended to undergo chemotherapy. Bone metastases revealing HCC are exceptional. However, HCC should be suspected in patients with lytic bone lesion, especially in patients with chronic liver disease. Given its poor prognosis, treatment is based on palliative therapy with the aim of improving mainly the quality of life of patients.

Cutaneous squamous cell carcinoma is a malignant tumor developed from the epidermis or the squamous mucosa. It may occur de novo or, most often, on precancerous lesions, including actinic keratoses. This tumor can sometimes be secondary to physical or chemical hazardous conditions encountered during the professional activity. We here report the case of a 40-year old mechanic presenting with ulceration of the dorsal side of his right wrist, evolving over 6 months. The lesion had first appeared as a small keratosic lesion that had transformed into an erosion and then into an ulceration increasing rapidly in size. The patient had no initial trauma and he had no particular previous history except the handling of chemicals (fuels, mineral oil, paint) without gloves for about the last 30 years. Physical examination showed a large sized ulcero-budding tumor (5 × 6 cm) on the dorsal side of his right wrist (A), associated with diffuse multiple actinic keratosis lesions on his two forearms and on the back of his hands (B). The patient also had two painless hard mobile adenopathies measuring 1.5 cm in diameter, on the ipsilateral epitrochlear and axillary regions. The remainder of the clinical examination was normal. Viral hepatitis serology test, treponemal test and retrovirus (HIV) test were negative. Histological examination of a biopsy sample confirmed the diagnosis of well differentiated and infiltrating squamous cell carcinoma. The biopsy of the axillary adenopathy objectified ganglionic metastasis with capsular break-in and extension to the periganglionar tissue. The remainder of the staging was without abnormalities. The patient underwent wide resection of the lesion with lymph node dissection followed by radiation therapy. Patient's evolution was marked by early local recurrence (two months later) requiring reoperation. The postoperative course was uneventful.

The management of patients having a bone lesion requires in many cases the realization of a histological sample in order to obtain a diagnosis. However, with the technological evolution, CT-guided biopsies are performed more frequently, often in outpatient clinics. Interpretation of these biopsies constitutes new challenges for the pathologists within the wide spectrum of bone entities. The purpose of the document is to propose guidelines based on the experience of the French committee of bone pathologists of the reference network on bone tumors (RESOS) regarding the indications and limitations of the diagnosis on restricted material.

During the esmo congress that took place from 08 to 12 September 2017 in Madrid, non-small cell lung cancer (NSCLC) was the subject of various communications and posters. We selected the most innovative and most likely to change our daily practice These updates presented concerned both localized and metastatic lung cancers. For completely resected localized stages minimal monitoring by annual CT scan is recommended, in stage III after radio chemotherapy durvalumab treatment provides better progression-free survival (PFS). For metastatic stages, pembroluzumab immunotherapy plus platinum-based chemotherapy in first-line is superior to chemotherapy alone in terms of response rate, second-line treatment with nivolumab provides better overall survival (OS) at 3years, the duration of 1year is characterized by a PFS lower than a continuous treatment. In EGFR mutated NSCLCs, the best choice between 3rd and 1st generation EGFR antigen has generated a lot of debate after the interesting results in terms of progression-free survival (PFS) of osamertinib in 1st metastatic line as well as for NSCLC with ALK rearrangement, alectinib was superior to crizotinib in the first metastatic line even in the presence of brain metastases.

Macrocystic lymphatic malformations (MLMs) constitute a circumscribed variation in deep lymphangiomas. They are characterized by a rare occurrence in adults, by their rapid expansion and by their frequent occurrence at the level of the cervicofacial region (75%) and axillary region (20%). They rarely occur in lower limbs. The diagnosis of MLMs is primarily based on clinical examination. Ultrasound has a valuable role in positive diagnosis and sometimes in differential diagnosis. MRI has a role in the diagnosis and the assessment of tumor extent, thus making a valuable contribution to surgery. Therapeutically, MLMs are mainly treated by sclerotherapy; surgery is rarely indicated. We report the case of 26-year old man with a one-year history of huge painless and rapidly evolving subcutaneous swelling in the right thigh. Clinical examination showed circumferential compressible non-beating infiltrated mass, surmounted by vegetative and ulcerated lesions. The remainder of the clinical examination showed the presence of inguinal ipsilateral lymphadenopathy, with mobility limitation of the right knee. Angio-MRI objectified diffuse heterogeneous gadolinium-enhancing cutaneous, subcutaneous thickening of the right thigh with perimuscolar aponeurotic involvement. Lymphoscintigraphy showed asymmetry of the accumultion of radiopharmaceutical kinetics that was reduced in the right lower limb in favor of an overload of the lymphatic system at rest. Given the clinico-radiological data, the diagnosis of MLM was retained. Given the seat of the lymphangioma and its extent, after consultation with the surgeons there was no indication for surgery. Immobilization with a removable bandage was indicated for our patient.

Multiple adenofibromas or adenofibromatosis is characterized by the presence of at least 3 mono- or bilateral adenofibromas increasing significantly in size, causing trophic disorders. We report the case of a 46-year old female patient who had been followed up since she was 30 years old for bilateral adenofibromatosis that required 4 surgical procedures. Patient's medical data were collected in the Department of Respiratory Diseases at the Ibn Rochd University Hospital Center, Casablanca. Basing on preoperative assessment before bilateral mastectomy, the patient underwent chest X-ray that showed opaque right hemithorax exerting compression on the mediastinum. Clinical examination showed effusion syndrome in the right hemithorax and left supraclavicular cervical adenopathy. Pleural puncture biopsy confirmed the presence of poorly differentiated invasive carcinoma in the pleura, supporting breast origin. Bronchoscopy after pleural puncture objectified infiltration of the whole bronchial tree; biopsies confirmed the anatomopathological results. The recommended treatment strategy was based on multidrug chemotherapy. Patient's evolution was marked by the occurrence of hepatic metastases. This study shows that adenofibromas require regular monitoring given the risk of trasformation to breast cancer, which is a frequent cause of pleuropulmonary metastases.

Soft tissue melanoma was first described by Enzinger in 1965 under the name of clear cell sarcoma. In 1983, Chung and Enzinger renamed it soft tissue melanoma due to its immunohistochemical similarities with melanoma. We here report the case of a 22-year old young man with this rare type of melanoma, presenting with molluscoid lesion on his ankle without any clinical sign of malignancy. Histology examination confirmed the diagnosis of soft tissue melanoma.

Mastocytosis is a rare disease characterized by the abnormal accumulation of mast cells in the skin and possibly in other organs. It can occur in a variety of forms; xanthelasmoid mastocytosis(XM) is a very rare form classified as papulo-nodular. Clinically, it appears as buff-yellow soft papules or nodules of variable size. Triggerings are those of classic mastocytosis. Darier's sign is often absent. Histology shows dense infiltrate of mast cells in the deep dermis. This clinical form can be singled out because of the persistence of lesions beyond puberty without the additional risk of systemic involvement. We here report the case of a 18-month old female infant, with no previous medical history. Maculopapular, intensely pruritic, ovalaires, brownish lesions with a buff-yellow centre, with elastic consistency and different sizes first occurred at the age of 8 months. The initial interview of parents revealed that the infant had had episode of flush especially caused by warmth. Darrier's sign was negative. Skin biopsy showed dermal infiltrate of mast cells, allowing to retain the diagnosis of xanthelasmoid mastocytosis. Complementary examinations as well as trypsin dosage were normal. Treatment was based on the exclusion of drugs and of factors participating in mast cells degranulation and antihistamines.

Synovial sarcoma (SS) is a rare tumor. It is characterized by various sites of occurrence but rarely involves the chest. The tumor may be wrongly diagnosed as benign due to its slow growth. Less than 10% of patients present with metastatic cancer. Endobronchial metastases are exceptional. Immunohistochemical examination and cytogenetic analysis allow to distinguish it from other mesenchymal tumors. The presence of SYT-SSX fusion transcript allows the diagnosis. Surgery is used for localized tumors that can be treated with radiation therapy while chemiotherapy is used for metastatic tumors. The average rate of locoregional or metastatic recurrence two years after SS is 50%. We report the case of a 28-year old patient with metastatic SS characterized by its uncommon metastatic site. He presented with endobronchial metastasis revealing his disease, that had evolved for more than 2 years. The SS is life-threatening due to its slow and insidious growth. Prognosis is guarded. This study aimed to emphasize this atypical site for metastatic synovial sarcoma as well as to insist on the role of early diagnosis and treatment.

Benign metastasizing leiomyoma (BML) is a rare condition characterized by histologically benign "metastatic" smooth muscle tumors, which can affect women with history of uterine surgery. We report the case of a patient with bone metastases of BML.