Search

Le léiomyosarcome superficiel est une tumeur maligne des tissus mous se développant à partir des cellules musculaires lisses, rare, représentant 2 à 3 % des sarcomes superficiels pour laquelle il n'est retrouvé que peu d'articles dans la littérature. Il s'observe chez des patients autour de 50–60 ans et affecte de manière équivalente les hommes et les femmes, pour le sous-type sous-cutané, et majoritairement les hommes pour le sous-type cutané. Cette étude vise à observer la clinopathologie et les résultats thérapeutiques des patients atteints d'un léiomyosarcome. Il s'agit d'une étude rétrospective descriptive portant sur 26 cas de léiomyosarcomes cutanés et sous-cutanés, avec confirmation histologique. Nous avons retrouvé 10 (38,5 %) de léiomyosarcomes sous-cutanés et 16 (61,5 %) cutanés. La majorité des tumeurs sont localisées au niveau des membres inférieurs 13 (50 %). Concernant le suivi, 6 patients ont présenté une récidive et 7 une métastase dont 2 des 7 patients présentaient une marge d'exérèse R0. Parmi ces patients, 3 patients sur 6 des récidives et 3 patients sur 7 des métastases étaient des léiomyosarcomes sous-cutané. Le délai d'apparition moyen des récidives est de 6,2 ans. Le risque de métastases et de récidives, malgré des marges chirurgicales saines, observé dans les léiomyosarcomes cutanés et sous-cutanés, ainsi que leur délai d'apparition justifie un suivi prolongé des patients. Le poumon, les os et le foie sont identifiés comme les sites préférentiels de métastase. Superficial leiomyosarcoma is a rare malignant soft tissue tumor arising from smooth muscle cells, accounting for 2–3% of superficial sarcomas, with limited literature available on the subject. It is typically observed in patients aged 50–60 years and affects both men and women equally in the subcutaneous subtype, whereas the cutaneous subtype predominantly affects men. This study aims to examine the clinicopathological features and therapeutic outcomes of patients with leiomyosarcoma. This is a descriptive retrospective study of 26 cases of cutaneous and subcutaneous leiomyosarcomas, with histological confirmation. We identified 10 (38.5%) subcutaneous leiomyosarcomas and 16 (61.5%) cutaneous leiomyosarcomas. The majority of tumors were located in the lower limbs, accounting for 13 (50%) cases. During follow-up, 6 patients experienced recurrence, and 7 developed metastases, including 2 of the 7 patients who had R0 resection margins. Among these, 3 out of the 6 recurrent cases and 3 out of the 7 metastatic cases were subcutaneous leiomyosarcomas. The average time to recurrence was 6.2 years. The observed risk of metastases and recurrences, despite clear surgical margins, in both cutaneous and subcutaneous leiomyosarcomas, along with the delayed onset of these events, justifies prolonged patient follow-up. The lungs, bones and liver have been identified as the most common site of metastasis. [ABSTRACT FROM AUTHOR]

Prostate cancer is the second cause of cancer death in men. Often, initialy hormono-independent, escape from anti-androgen therapy is a key event of tumoral progression showing an hormone-independent phenotype. To study morphological, genetic and molecular bases associated with the hormono-dependence escape, a new model of human adenocarcinoma prostate xenograft, PAC120, was established with its hormono-dependent and independent variants. Its growth was strongly inhibited by surgical castration or by administration of the new gonadotrophin-releasing hormone antagonist, FE 200486 (Ferring, San Diego, CA). Evolution to hormono-independence was frequently associated with a mucoid differentiation or a neuroendocrine-like pattern, with the apparition of new chromosomic alterations and variations of human gene expressions. PAC120 xenograft is a new model of hormone-dependent prostate cancer, opening the oppotunity to study the hormone dependence escape mechanism and to evaluate the efficacity of new therapeutics. [Copyright &y& Elsevier]

Abstract: Fatty tissues lesions are the most frequent of both benign (lipoma) and malignant tumor (liposarcoma) of soft tissues in the adult. We here describe the case of female patient having a fatty tissue mass of the ankle corresponding to an hemosiderotic fibrohistiocytic lipomatous lesion (HFHLL). This very rare tumour of recent description is specific of the ankle/foot area of the middle age women. These lesions are always benign and frequently recur following incomplete resection. This tumor may have invasive local growth and metastases have not been described so far. We describe the anatomopathologist''s key points of their diagnostic. We discuss the main differentials diagnosis and treatment. [Copyright &y& Elsevier]

Abstract: Purpose: To analyse the prognostic factors for patients treated with limb sparing surgery and radiation for extremity soft tissue sarcoma (E-STS). Patients and methods: Medical records of 87 patients with limb sparing surgery and radiation for E-STS were reviewed retrospectively. Disease-free survival (DFS) and disease-specific survival (DSS) were estimated and factors potentially influencing these outcomes were analysed. Results: With a mean follow-up of 69months, most recurrences occurred within the first 2years. Extent of resection margin was found to improve DFS (P =0.002) and DSS (P =0.002). Brachytherapy combined with external beam radiotherapy (EBRT) improved DFS (P =0.034) and DSS (P =0.019). Tumor size (<10cm) was related to DSS (P =0.043) and its relation to DFS was almost significant (P =0.057). Short time interval between surgery and radiotherapy (≤50days) had an impact only on DSS (P =0.030). Conclusion: Extent of resection margin and use of brachytherapy combined with EBRT seem to improve the prognosis of E-STS. Small tumor size and short time interval between radiotherapy and surgery seem also to improve the outcome of E-STS. This study was limited by inadequate power and low number of recurrences. Larger randomised studies are needed to confirm these results. [Copyright &y& Elsevier]

Résumé: Une perte de substance (PDS) étendue de la racine de la cuisse nécessite un geste chirurgical de couverture. La présence d’un lymphœdème chronique (LC) rend plus aléatoire les suites opératoires avec un délai de cicatrisation plus long. Nous rapportons un cas original de reconstruction de PDS étendue de la racine de la cuisse par un lambeau Deep Inferior Epigastric Perforator (DIEP) pédiculé. Il s’agissait d’une femme de 22ans présentant un angiosarcome survenu sur lymphœdème hémicorporel. La PDS générée par l’exérèse carcinologique était de 16×24cm. Il a été réalisé un lambeau DIEP pédiculé. La cicatrisation a été obtenue en 30jours malgré une discrète désunion latérale. La cicatrisation du site donneur a été obtenue en 15jours. Le lambeau DIEP pédiculé permet une couverture efficace de PDS étendue de la racine de cuisse y compris sur membre lymphœdèmateux. [Copyright &y& Elsevier]