Faced to an undetermined ovarian mass on ultrasound, an MRI is recommended and the ROMA score (combining CA125 and HE4) can be proposed (grade A). In case of suspected early stage ovarian or fallopian tube cancer, omentectomy (at least infracolonic), appendectomy, multiple peritoneal biopsies, peritoneal cytology (grade C) and pelvic and para-aortic lymphadenectomy are recommended (grade B) for all histological types, except for the expansive mucinous subtype where lymphadenectomy may be omitted (grade C). Minimally invasive surgery is recommended for early stage ovarian cancer, if there is no risk of tumor rupture (grade B). Laparoscopic exploration for multiple biopsies (grade A) and to evaluate carcinomatosis score (at least using the Fagotti score) (grade C) are recommended to estimate the possibility of a complete surgery (i.e. no macroscopic residue). Complete medial laparotomy surgery is recommended for advanced cancers (grade B). It is recommended in advanced cancers to perform para-aortic and pelvic lymphadenectomy in case of clinical or radiological suspicion of metastatic lymph node (grade B). In the absence of clinical or radiological lymphadenopathy and in case of complete peritoneal surgery during an initial surgery for advanced cancer, it is possible not to perform a lymphadenectomy because it does not modify the medical treatment and the overall survival (grade B). Primary surgery is recommended when no tumor residue is possible (grade B).

Anti-PD1 immunotherapies have become an essential treatment for bronchial cancer. According to published studies, PD1 and PD-L1 inhibitors have a better toxicity profile than chemotherapy. Nevertheless, some immune related toxicities can be potentially severe, such as induced interstitial lung disease (ILD). Currently, ILD patients are excluded from clinical trials using immunotherapy in lung cancer. IPF is the most frequent and severe form of ILD. Lung cancer represents a major complication of this disease and to date few data exist on the safety of immunotherapy in this context. We report 3 cases of IPF with lung cancer treated by nivolumab. All had a clinically mild to moderate IPF. The patients had received at least one line of chemotherapy before nivolumab and had progressive, metastatic lung cancer. Two patients experienced rapid cancer progression without immune toxicities. The third had a partial response but developed grade III immune colitis that led to discontinuation of the treatment. None developed lung toxicity or worsening of IPF on CT during follow-up, and death was always related to progression of the cancer. In our series of three patients with IPF, nivolumab was well tolerated with regard to their pulmonary condition. As inflammation and autoimmunity are probably marginal mechanisms in the pathogenesis of IPF, we do not believe that the presence of IPF should definitely disqualify potential candidates for treatment with nivolumab. Decisions should be taken, case-by-case, in selected patients without severe IPF and with no evidence of autoimmunity. In view of the epidemiology of lung cancer in IPF and the critical role of immunotherapy in the management of lung cancer, studies of prospective cohorts are urgently needed in this population.

The natural history of orphan lung diseases is often unclear. We report the long-term follow-up of a case of bronchiectasis due to pulmonary non amyloid light chain deposition disease (LCDD).

To define follow-up modalities after an epithelial ovarian, tubal or primitive peritoneal cancer. To define possibilities of hormone replacement therapy (HRT) and contraceptive use after treatment.

Locally advanced oesophageal cancer treatment requires a multidisciplinary approach with the combination of chemotherapy and radiotherapy for preoperative and definitive strategy. Preoperative chemoradiation improves the locoregional control and overall survival after surgery for locally advanced oesophageal cancer. Definitive chemoradiation can also be proposed for non-resectable tumours or medically inoperable patients. Besides, definitive chemoradiation is considered as an alternative option to surgery for locally advanced squamous cell carcinomas. Chemotherapy regimen associated to radiotherapy consists of a combination of platinum derived drugs (cisplatinum or oxaliplatin) and 5-fluorouracil or a weekly scheme combination of carboplatin and paclitaxel according to CROSS protocol in a neoadjuvant strategy. Radiation doses vary from 41.4Gy to 45Gy for a preoperative strategy or 50 to 50.4Gy for a definitive treatment. The high risk of lymphatic spread due to anatomical features could justify the use of an elective nodal irradiation when the estimated risk of microscopic involvement is higher than 15% to 20%. An appropriate delineation of the gross tumour volume requires an exhaustive and up-to-date evaluation of the disease. Intensity-modulated radiation therapy represents a promising approach to spare organs-at-risk. This critical review of the literature underlines the roles of radiotherapy for locally advanced oesophageal cancers and describes doses, volumes of treatment, technical aspects and dose constraints to organs-at-risk.

No studies of French hospital registries for prostate cancer (PCa) have been published since the 2012 USPSTF recommendations.

Median raphe cysts are rare benign lesions of the male genitalia. They may be present along the entire raphe, from the urethral meatus to the anus, in the median position. We report herein a case of median raphe cyst with an atypical clinical and histological presentation.

Basal cell carcinoma (BCC) is the most frequent skin cancer. It never affects the mucosa. It is characterized by a local malignancy with an extremely rare risk of developing distant metastasis and the lowest mortality. However in the absence of diagnosis and early surgery, BCC can be locally invasive and result in severe tissue destruction. It can ulcerate and its growth can be extensive and destructive: terebrant tumors affecting the structures of the muscles and the bone. We here report the case of a 80-year old woman living in an isolated rural areas, presenting with ulcerated exudative and smelly burgeoning lesion in the pretragal and the parotid regions. Locoregional examination was unremarkable and histology showed infiltrative BCC. Staging evaluation objectified no bone invasion. The patient was referred to the Division of Plastic Surgery for carcinologic treatment.

Brain tumors are the most diagnosed solid tumors in children under the age of 15 years worldwide. However, the epidemiological and anatomopathological profile of these tumors has been poorly described in African and, particularly, in Moroccan literature. This study highlights the epidemiological and anatomopathological peculiarities of primary brain tumors in children living in the region of Marrakech (south Morocco). We conducted a retrospective study in the Division of Anatomic Pathology at the Mohammed VI University Hospital, Marrakech from 2004 to 2016. One hundred and thirty-six patients were diagnosed with primary brain tumor, a mean of 11.33 cases per year. The average age of patients was 8.28 years. Sex-ratio (M/F) was 1.6 with a slight male predominance. Infratentorial tumors were found in 61,53% of cases while supratentorial tumors were found in 38.47% of cases. Infratentorial tumors mainly occurred in the cerebellar hemisphere (61.4%). Eighteen histological types were diagnosed. Astrocytoma and medulloblastoma accounted for 46,32% (29.41% and 16.91%, respectively). In our context, the majority of brain tumors in children was predominant in both age groups: 5-9 years and 10-15 years. The epidemiological data of these tumors from south Morocco are mostly consistent with those already published in North Country's literature and in other non-african countries' literature.

Smoking is the leading cause of preventable death worldwide, it is responsible for 90% of bronchopulmonary cancers and is the main cause of chronic bronchitis and emphysema, two disorders which contribute to chronic obstructive pulmonary disease (COPD). We here report the case of a 58-year old not weaned chronic tabagic patient with a 2-month history of diffuse abdominal pain evolving in a context of alteration of the general state. Clinical examination showed generally poor health. Pleuropulmonary examination objectified reduction of vesicular breath sounds in the right hemithorax and diffuse abdominal susceptibility and massive left subclavicular lymphadenopathy. Thoraco-abdominal CT scan showed pleural, intra-abdominal and retroperitoneal tissue infiltration and diffuse bilateral lung emphysema (Figure). Bronchial fibroscopy objectified bud obstructing the orifice of the apical bronchus of the right upper lobar bronchus. Anatomopathologic study of bronchial biopsy and lymph node biopsy showed non-differentiated carcinoma. Evolution was marked by patient's death after two weeks. This study aims to highlight fatal outcome due to these two complications due to tobacco use in the same patient in order to emphasize the importance of prevention awareness of the damages of tobacco use and on smoking cessation.

We aimed to evaluate the impact on the thyroid function of hypofractionated adjuvant radiotherapy of localized breast cancer.