[Multifocal osteosarcoma. A case report]. / Ostéosarcome multifocal. A propos d'un cas.

UNLABELLED: Multifocal osteosarcoma is an uncommon and aggressive presentation of osteosarcoma. CASE REPORT: We report a case of multifocal osteosarcoma in a 12-year-old boy who was admitted for a tumor of the skull, associated with pleural and pulmonary nodules. A computed tomography scan of the head showed a calcified lesion with intra- and extracranial extent. A biopsy of the skull tumor showed an osteoblastic osteosarcoma. Three weeks later, the patient developed two other tumors of the skull, a tumor of the left shoulder and a pelvic pain. Radiographic studies confirmed the presence of further lytic lesions at these sites. The patient was unresponsive to chemotherapy (high dose methotrexate and doxorubicin) and died nine months later. COMMENTS: Multifocal osteosarcoma, or osteosarcomatosis, is a highly aggressive form of osteosarcoma. The multiple lesions can all arise synchronously as primary tumors, or appear to be one dominant site with early and rapid appearance of secondary lesions. The incidence is reported to be between 1 and 10% of osteosarcoma. The histology shows an osteosarcoma of osteoblastic type in most cases. CONCLUSION: Despite intensive chemotherapy, the prognosis remains poor. The debate remains as to whether or not this clinical presentation represents true multifocality of the disease or a relatively unusual metastatic pattern of osteosarcoma.

[Hodgkin's disease in the very young child. Apropos of 11 cases]. / La maladie de Hodgkin du très jeune enfant. A propos de 11 cas.

Hodgkin's disease (HD) in children of 4 years of age or younger is seldom reported. It seems more frequent in developing countries. We report on 11 cases out of 115 cases of HD in patients of 15 years of age or younger observed between 1980 and 1991. The youngest patient was 29 months old and the median age was 2 years 11/12. The male/female ratio was 2.6. Mixed cellularity was found in six cases, lymphocytic predominance in two cases and nodular sclerosis in two cases. B symptoms were observed in four cases. Four patients had stage II, three stage III and four stage IV disease. Chemotherapy consisted of MOPP/ABVD in all cases. One patient received mantle field radiation therapy. Of ten evaluable patients, seven achieved complete remission, three patients were lost to follow-up in partial remission before achieving the treatment program. There were no relapses so far and no death attributable to toxicity. The follow-up ranges from 2 to 8 years. These data indicate the high frequency of HD in very young patients and suggest that chemotherapy alone is very efficient in this subset of patients.

Cytogenetic survey of 53 Moroccan patients with acute myeloblastic leukemia.

We present a cytogenetic survey of chromosome aberrations for 53 Moroccan patients with acute myeloblastic leukemia (AML). Our 53 patients were 2 to 70 years old with 31 men and 22 women. The cytogenetic study was performed with the following three methods: first, relative proportion of normal (N) or abnormal (A) metaphases; second, presence of specific or random abnormalities; and third, karyotype complexity. Among 36 patients (67%) with a chromosomal abnormality, 18 (34%) showed a specific aberration. We have found t(9;22) in three patients (5%), chromosome 5 or 7 abnormality in six (11%), del(11)(q23) in three (6%), +21 in four (8%), and +8 in two (4%). Specific translocations associated with FAB type were found: t(8;21) with AML2 in 12 patients (23%) and t(9;11) with AML5 in one (2%). Rare abnormalities were also found: one patient with t(7;21) associated with AML2 and another patient with r(1) ring associated with AML1. We concluded that our study in a Moroccan population confirmed the relation between some specific abnormalities and the FAB classification. We have found a higher incidence for t(8;21) than usually described. Finally, we have identified chromosomal abnormalities t(7;21)(q22;p11) and r(1), rarely described before.