[Abrikosoff's tumor: a clinicopathologic study of nine cases]

Abrikossoff's tumour or granular cell tumor or is a benign neurogenic tumour. It is ubiquitous with the most frequently affected site is the head and neck region. To report a series of granular cell tumors and to discuss its clinicopathologic features and histogenesis. We report a series of nine cases diagnosed between January 2004 and December 2006 in the Pathology Department of the University Hospital of Sfax. We have collected the clinical aspects and we have proceeded on a pathological, cytochemical [PAS and PAS diastasis] and immunohistochemical study. Nine cases of TCG are presented: 5 females and 4 males. The median age was 33.9 years [extremes: 7 and 53 years]. All tumours were unique. The most common localization was in the head and neck region [5 cases]. The diagnosis was suspected using standard histologic criteria and confirmed by immunohistochemistry: tumour cells expressed vimentine [90%], S100 protein [100%] and neuron specifique enolase [80%]. In all cases patients were treated by excisional resection and had a benign course with no evidence of recurrence [median follow up: 2 years]. Granular cell tumours are rare neoplasm which must be recognised because they demonstrate a benign behaviour after their surgical excision. Histological features of granular cell tumours are commonly characteristic but some times they can be misdiagnosed as malignant tumours especially when the biopsy is superficial. The staining for neurogen markers and PAS are useful tools

[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

[Polymorphous low grade adenocarcinoma: about two cases]

Polymorphous low-grade adenocarcinoma [APBG] is a variant of malignant tumour of minor salivary glands usually arising in the palate. Our aim is to discuss morphology, evolution and differential diagnosis of this rare tumour. The first case interested a 65-year-old-woman admitted for a two-months-history of a right submaxillary swelling. Examination found a tumour of the right side of the palate. A biopsy concluded to a pleomorphic adenoma. Giving that the mass enlarged, a surgical resection carrying off the thyroid with a bilateral neck dissection was performed. Diagnosis was an APBG partially resected with lymph node metastasis. The patient received adjuvant radiotherapy. Local recurrence appeared 28 months after treatment. The second case interested a 57-year-old-woman who consulted for a 12-year-history of a swelling of the lower lip. Clinical examination showed a painless nodule measuring 2 cm located in the mucosal side of the lower lip. An excisional biopsy was performed. Pathologic examination concluded to an APBG completely resected. The patient had no evidence of disease with a follow-up of 54 months. APBG is characterised by a morphologic diversity and a cytologic uniformity that may cause a diagnostic dilemma especially with adenoid cystic carcinoma and pleomorphic adenoma. Its aggressiveness is assessed by its local infiltrative growth pattern requiring a wide surgical excision

[Scalp metastasis from small cell carcinoma of the rectum: an unusual case]

Cutaneous metastasis of rectal carcinoma is a rare event. It occurs in 4%of all patients with rectal cancer. Skin metastasis of rectal cancer are usually detected near the initial tumor. especially in the periumbilical region; but they rarely occur in the scalp. To report a new case of scalp metastases from rectal tumor. Our patient was a 63-year old male with a history small cell carcinoma of the rectum who subsequently developed s single nodule of the scalp of 4cm. Histopathological analysis revealed a small cell carcinoma infiltrating the dermis am subcutaneous tissue. The patient underwent palliative chemotherapy but his disease continued to progress. In contrast to the prior cases of scalp metastases reported in the literature, ours is the first documentation of such occurrence from rectal small cell carcinoma. The early diagnosis of skin metastases in these patients is very important because it can alter treatment

[Fibrocystic mastopathy and Cancer of the breast. About 111 cases]

Objective: Our aim was to identify the predictive factors of degeneration of the fibrocystic mastopathy

Methods: This work is a retrospective survey of I 1 1 observations of isolated fibrocystic mastopathies or associated to a breast cancer among 542 women admitted for tumor of the breast during one period of 13 active years from 1991 to 2003. The diagnosis has been gotten by anatomo-pathologic exam in 95, 5% [106cas] on the operative piece and 4,5% [Scas] on a material of biopsy

Results: The fibrocystic mastopathy represented 30 % of the set of the benign tumors of the breast. They were associated to a breast cancer in 45 cases [40,5%]. The isolated benign fibrocystic mastopathy was observed in 66 cases with a middle age of 37 years. whereas the shapes associated to a breast carcinoma were noted in 45 cases. The middle age was 53 years. The non proliferative fibrocystic mastopathy is the most frequent histological type and repre-sent 54,6 % of the cases. The proliferative form with atypies was observed at 21 women [46,8%]. The carcinoma the more frequently associated to the fibrocystic mastopathy was the infiltrating canalled carcinoma in 91% of cases, with a pre-dominance of the 11 rank [SBR]

Conclusion: The discovery of a mastopathy must search a luteal failure and risk factors of breast cancer notably a proliferative shape of mastopathy with atypies