[Adjuvant treatment of early endometrial carcinomas]

Endometrial carcinoma is the most common gynaecological malignant disease in developed countries. About 80% of patients present with early stage disease can be diagnosed [limited uterine tumour stage I or II]. The surgery of first intention allows to individualize decisional prognosis factors of adjuvant therapy. Postoperative radiation therapy plays a major role in the management of stage I and II endometrial carcinoma, but the respective place of external beam radiotherapy and vaginal brachytherapy remains controversial. Several randomized studies have shown that adjuvant external beam radiotherapy reduces locoregional recurrences, but carries a risk of toxicity without overall survival benefits. This technique is restricted to patients with high risk endometrial cancer. For those with intermediate risk, exclusive vaginal brachytherapy ensure an excellent local control with less toxicity. The indication for adjuvant chemotherapy should be discussed in the group of patients with high risk endometrial cancer. But adjuvant hormone therapy is not recommended for early stage disease

[Desmoplastic small round cell tumor]

Desmoplastic small round cell tumor is a recently recognized and rare clinicopathologic entity with distinctive morphologic and immuno histochemical features .Moreover, specific cytogenetics abnormalities and molecular characteristics have been described and confirmed its identity. It is often located at the abdominal cavity, but can exceptionally be located at the cerebral level or some soft tissue and the bones of the members. We report a case of Desmoplastic small round cell involving gluteal muscle and iliac bone at a 25-year-old girl. Our patient had been treated by chemotherapy based on ifosfamide, doxorubicine, etoposide and cis platine. The evolution was marked by the tumoral progress and the death of the patient 18 months after the discovery of the disease. The second case is a 27-year old man .He had a retro peritoneal desmoplastic small round cell tumor treated by surgery alone. The evolution was marked by metastasis and the patient died 10 months after diagnosis. The prognosis of these tumors remains unclear in spite of the mulitidisciplinary treatment. Hence the necessity of new lines of therapeutic research

Isolate cerebellar metastasis from colonic adenocarcinoma

The hepatic and pulmonary are the preferential metastasis sites of colorectal cancer. Cerebral metastases are rare to see even exceptional when they are insulated. We report the case of a 47 years old patient having introduced a colic adenocarcinoma treated by surgery and chemotherapy. 18 months later he showed a cerebelleux syndrome with an intracranial hypertension. Cerebral tomodensitometry and magnetic imagery by raisonnance highlighted a double cystic and tissue component lesion of the left cerebellum hemisphere. Pulmonary radiography and abdominal ultrasound were without anomaly. The patient underwent total surgical remove of the lesion. The histology cal study of the operational part had revealed that it acted of a cerebellum metastasis of colic adenocacinoma. As an adjuvant treatment, a whole brain radiation was given with a boost to the posterior cerebral pit. The patient died 20 months after the diagnosis of the metastasis