[Ewing sarcoma osseous and extra osseous: a clinicopathological study of 29 cases]

Ewing's sarcoma [ES] is a rare tumour accounting for 10% of primary malignant bone tumours in children and 3% of all childhood malignancies. ES belongs to a group of small round cell tumours. In this review, we will describe the main clinicopathological features of this rare tumour and discuss its prognosis. We report a retrospective study of 29 cases of ES, of which 4 were extraosseous, diagnosed over a period 11 years [January 1989 - December 1999]. Clinicopathological data were described. Hematoxylin-eosin staining and immunohistochemical study were reviewed. 12 patients were male and 17 were female [ratio: 0.8] with a median age of 16 years. 62.5% of tumours were located in flat bone and 33.3% in long bone. The medium size of the tumor was 10.6 cm [range:3-25cm]. 27.5% of patients presented with metastatic disease at time of diagnosis. Microscopically, tumour tissue was composed of round, small, blue cells with fine granular chromatin. Tumour cells strongly coexpressed CD99 and vimentin [100%]. Systemic treatment consisted of adjuvant chemotherapy [84.2%]. Local control was based on and surgery [57. 9%] or radiation therapy [36.8%]. A good response to chemotherapy was obtained in 37.5%; 13.7% of patients were alive without disease [medium follow up: 169 mois]; 34.5% of patients developed metastases [medium follow up: 23 months] and 10.3% developed recurrences [medium follow up :13 months]. Our study emphasizes two points: the great size of the tumor and the frequent location in flat bone which may explain the poor prognosis of Ewing sarcoma in our series despite the multidisciplinary treatment

[Breast cancer and pregnancy: a study of 3 cases]

Cancer is rare during pregnancy. Breast cancer is the most common cancer in pregnant women. We report 3 cases of breast cancer associated with pregnancy.The mean age was of 34 years. Cancer was detected during the second trimester of pregnancy in two patients. They were treated with mastectomy followed by 6 courses of adjuvant chemotherapy. The first course was given before delivery. Loco regional radiotherapy was given after the end of chemotherapy. The third patient presented with a bilateral breast cancer which was discovered 2 months after delivery. The patient was treated with mastectomy of the left breast and conservative surgery of the right one, associated with adjuvant chemotherapy and radiotherapy. Two patients died the course of the disease. Twenty months later, the third patient is still alive, free of all symptoms and signs. Based on our findings and through a review of literature, we try to determine the epidemiological and clinical features of this association as well the outcome of therapy and eventual prognosis