Adjuvant radiation therapy for malignant Abrikossoff's tumor: a case report about a femoral triangle localisation.

BACKGROUND: Granular cell or Abrikossoff's tumors are usually benign however rare malignant forms concern 1 to 3% of cases reported. Pelvic locations are exceptional. CASE PRESENTATION: We report a case of a 43-years-old patient who had a benign Abrikossoff's tumor localized in the right femoral triangle diagnosed at the biopsy. The patient underwent a surgical tumorectomy and inguinal lymph nodes resection. Histologically, the tumor showed enough criteria to give diagnosis of malignancy: nuclear pleomorphism, tumor cell spindling, vesicular nuclei with large nucleoli. Moreover, five lymph nodes were metastatic. Immunohistochemistry findings confirmed the diagnosis of granular cell tumor which is positive for S100 protein and CD68 antibodies. The mitotic index was nevertheless low with a Ki67 labeling index of 1-2%. A large surgical revision with an inguinal curage following radiotherapy were decided on oncology committee. Adjuvant radiotherapy on the tumor bed and right inguinal area of ​​50 Gy in conventional fractionation was delivered with the aim of reducing local recurrence risk. There was no recurrence on longer follow-up (10 months post radiotherapy). CONCLUSIONS: Adjuvant radiotherapy seems an appropriate therapeutic approach, even if controversial, given that some authors report effectiveness on local disease progression.

[Anti-smoking campaign in an average French department, la Drôme; epidemiological analysis and prospects for the future]. / Lutte et prévention anti-tabac. A l'échelon d'un département français moyen, la Drôme, analyse épidémiologique et perspectives d'avenir.

The campaign against smoking requires a dynamic attitude in the field. With this in mind, a study was conducted in 14 to 16 year old school-children in the Drôme region and a questionnaire was sent to all doctors in the region. The school survey confirmed the results obtained previously in similar studies, such as the high proportion of girls who smoke and the essential role of the family. There was no valorising element associated with cigarettes in young people. The aim of the questionnaire, which was sent to all doctors registered in the Drôme region (more than 800), was to encourage them to adopt a dynamic attitude towards smoking in their professional practice. The high reply rate was encouraging, even if not all of the doctors are ready for an aggressive campaign.