Systemic anaplastic Non-Hodgkin lymphoma in children: a 5 cases report

Anaplastic large cell lymphoma [ALCL] accounts for 10 to 15% of childhood non-Hodgkin's lymphomas. It is characterized by a high frequency of extranodal involvement, a wide morphological spectrum and the expression of CD 30. The therapeutic strategy is not yet well established. We report 5 cases of childhood ALCL diagnosed between 1999 and 2002 in the paediatric oncology and haematology department in Casablanca. Three patients presented with a bone lesion while the other 2 patients had both nodal and cutaneous involvement. The phenotype was T in 3 cases and null in 2 cases. All the patients were in stage III according to Murphy classification. The patients were treated according to the SFOP HM 91 protocol. Four patients are in CR with a follow-up of 41, 26, 18 and 11 months respectively. The fifth patient is lost to follow-up in CR. ALCL accounts for 10% of childhood NHL in our department. It is probably underestimated because of the lack of all monoclonal antibodies especially the ALK. All our patients achieved a CR and 4 of them are alive and disease free survivors. In conclusion, this type of childhood NHL seems to have a good prognosis in our context and more efforts have to be done in the diagnosis of this type of NHL

Adrenocortical tumors in children: a 2 cases report

Adrenocortical carcinoma is a very rare malignant tumour in children. It has bad prognosis and the treatment protocols are not well established. We report 2 cases of adrenocortical carcinoma in children. Case 1: A 30-month-old girl was hospitalized for clitorimegaly and pubic hair. The clinical examination found an abdominal mass with paraplegia. Abdominal ultrasonography found a heterogeneous calcified mass localised in the right suprarenal region. The diagnosis was confirmed by elevated urinary 17-ketosteroids. Complementary investigations showed pulmonary, medullar and vertebral metastasis. The treatment consisted of chemotherapy [Cisplatinum + Vepeside] with no efficacy. She died after 7 months follow up. Case 2: An 8-year-old boy was admitted for a pubic and axillary's hair, with acne and abdominal mass. The abdominal ultrasonography found a heterogeneous mass in the right suprarenal region. The diagnosis was confirmed by histology after complete resection. The patient was lost from follow-up and was seen one year later with abdominal mass associated to pulmonary and liver metastasis. He received only a palliative treatment. Comments: The adrenocortical carcinoma is a rare tumour in children [0.2% of solid tumours]. The malignant criteria and treatment protocols are not well established. The 5-year OS is 49%. The most important prognosis factor is total excision of the tumour