Epidermoid cysts are rare benign tumors developed by ectodermic inclusions. They are usually located at the level of the pontocerebellar angle, the parasellar region and the temporal fossa. They exceptionally develop at the level of the fourth ventricle We report the case of a 47-year old woman admitted for intracranial hypertension syndrome associated with walking disorders. The diagnosis of fourth ventricle epidermoid cyst was evoked based on diffusion MRI data then confirmed intraoperatively and by histologic examination. Subtotal surgical excision was performed due to capsule adhesion to the upper part of the V4 floor. After a 36-month follow-up, the patient showed no signs of tumor recurrence.

Struma ovarii is a rare tumor, which accounts for 2.7% of ovarian teratomas and 0.01% of ovarian tumors. It usually affects women in the fifth decades of life and is most often detected incidentally during ultrasound and then confirmed histologically. The gold standard treatment is surgery and prognosis is excellent. We here report the particular case of a young female patient with giant struma ovarii whose radiological features were classified as unusual presentation. We match patient's data with those from the literature.

Parathyroid carcinoma is a very rare malignancy responsible for 0.4 to 5.2% of hyperparathyroidism. Clinical diagnosis is difficult and treatment should be codified. Surgery is the only curative treatment. We report the case of a female patient treated for malignancy-associated hypercalcemia revealing parathyroid carcinoma. The patient underwent surgery; after three months she developed lymphatic recurrence. Given the absence of other secondary involvement, bilateral lymph node dissection followed by chemotherapy was performed. Parathyroid carcinoma is often suspected on the basis of biological, radiological and especially intraoperative macroscopic criteria, but definitive diagnosis is made histopathologically. Surgery is currently the only curative treatment and the role of adjuvant therapy is to establish.

In France, determination of the mutation status of RAS genes for predictive response to anti-EGFR targeted treatments is carried out by public platforms of molecular biology of cancer created by the French National Cancer Institute. This study aims to demonstrate the feasibility of these analyses by a private pathology laboratory (MEDIPATH) as per the requirements of accreditation. We retrospectively studied the mutation status of KRAS and NRAS genes in 163 cases of colorectal metastatic cancer using the Cobas® technique. We compared our results to those prospectively obtained through pyrosequencing and allelic discrimination by the genetic laboratory of solid tumors at the Nice University Hospital (PACA-EST regional platform). The results of both series were identical: 98.7% positive correlation; negative correlation of 93.1%; overall correlation of 95.7% (Kappa=0.92). This study demonstrates the feasibility of molecular analysis in a private pathology laboratory. As this practice requires a high level of guarantee, its accreditation, according to the NF-EN-ISO15189 quality compliance French standard, is essential. Conducting molecular analysis in this context avoids the steps of routing the sample and the result between the pathology laboratory and the platform, which reduces the overall time of rendering the result. In conclusion, the transfer of some analysis from these platforms to private pathology laboratories would allow the platforms to be discharged from a part of routine testing and therefore concentrate their efforts to the development of new analyses constantly required to access personalized medicine.

Prognostic values of an early detection of a relapse after treatment of a localized rhabdomyosarcoma and the interest of performing systematic radiologic assessment after treatment have not yet been evaluated in Europe.

Reflectance confocal microscopy is a non invasive imaging technique which provides in vivo and real time images of different skin tissues with a resolution close to histology, however with a depth limited to superficial dermis.The first lesions that were morphologically analyzed are melanocytic lesions. Reflectance confocal microscopy has been used for about ten years in dermatology. Its progressive improvement over the years has allowed it to be an efficient tool for diagnosing cutaneous tumors. It has been developed for inflammatory dermatosis, cutaneous infections, angiomas, cosmetology. Furthermore, it is also used to delimit the edges of lesions or the area to biopsy. This cutaneous imaging technique represents a major innovation and has its place in dermatological practice.

Monoclonal antibodies targeted against the immune checkpoint molecules CTLA-4 and PD-1 have recently obtained approval for the treatment of metastatic melanoma and advanced/refractory non small-cell lung cancers and metastatic renal cancer. Besides their efficacy profile, these immune targeted agents also generate immune-related adverse events that may be life threatening if not anticipated and managed appropriately. This new family of dysimmune toxicities remains largely unknown to the broad oncology community. We propose here some practical guidelines for the oncologist to help in the clinical care of patients under immune checkpoint molecules.

Invasive breast cancer is the most common malignancy in women in industrialized countries. Three-quarters of breast cancers express estrogen and/or progesterone receptors and are considered endocrine-sensitive. Endocrine therapy reduces the risk of loco-regional, contralateral and distant recurrence. The management has become more complex with estrogen receptor inhibitors, aromatase inhibitors and ovarian function suppression. The choice of the regimen and its duration depend on the age, the menopausal status of the patient, her co-morbidities, the risk of cancer relapse and the tolerance. We summarize here the recent modifications of the endocrine therapy in early and advanced stage breast cancer.

Scrotales fistulas are rare and often represent secondary lesions of tuberculosis. Mucinous adenocarcinomas are tumors containing at least 50% of extracellular mucus. They occur most commonly in the rectosigmoid; scrotal location is rare. We report the case of a 54-year old patient, with no particular past medical history, with secondary mucinous adenocarcinoma of the scrotum revealed by scrotal fistulas. The patient had suffered from recurrent scrotal fistulas for two years, with no other associated signs. Clinical examination showed multiple scrotal fistulas with discharge of thick pus. Rectal examination was normal. Urological examinations (IVU, UCRM, cystoscopy, …) were normal, the assessment of infectious diseases as well as the detection of BK virus in urine and sputum were negative. Biopsy of sample of scrotal tissue was in favor of moderately differentiated mucinous adenocarcinoma. Immunohistochemical examination was in favor of primary colorectal cancer. Patient's evolution was marked by the occurrence of complex anal fistulas, which appeared on MRI as active, supplying several pelvic peritoneal collections resulting in fleshy buds. There is no consensus on the therapeutic approach due to the rarity of this cancer. Surgical resection is the treatment of choice for this disease. Preoperative chemotherapy and radiation therapy are recommended for this type of cancer, but their role is not well established. The patient underwent primary neoadjuvant chemotherapy and radiation therapy, before abdominoperineal excision.

Ameloblastoma is a benign aggressive odontogenic tumor which requires early diagnosis and appropriate treatment. It commonly affects the mandible and radical surgery is the gold standard treatment. We report the case of a patient with ameloblastoma in extremely advanced phase affecting the maxillary sinus who was treated with intensity modulated conformal radiation therapy. Patient's evolution was marked by complete remission maintained after 24 months follow-up. Maxillary ameloblastoma is not well documented in the literature. It is usually diagnosed at the later stage when optimal surgery cannot be performed. This case study aimed to demonstrate that radiation therapy is a real therapeutic alternative in the treatment of advanced and inoperable forms of ameloblastoma.