We report a rare case of ethmoidal metastasis from a prostatic carcinoma in an elderly patient. This metastasis was revealed solely by exophthalmos, with no associated nasal symptoms. Radiological and histopathological analyses confirmed the unusual diagnosis of a sinus metastasis from a prostatic adenocarcinoma. This case highlights the importance of a thorough diagnostic approach in the presence of an uncommon unilateral orbitopathy.

Molecular analyses performed on cell and tissue samples play a major diagnostic, prognostic, and theragnostic role. Their complexity and diversity, as well as that of the biological matrix involved (formalin-fixed paraffin-embedded tissue, frozen tissue, cytological sample, liquid biopsy), are increasing. The tumor cell content of the sample is an important limiting factor as well as the quality and quantity of nucleic acids extracted from the initial matrix. Therefore, it is crucial to understand and manage the conditions of sample preparation and storage, as those will directly impact the quality of the extracted material and constrain the types of analyses that will be performed. This article highlights the key pre-analytical steps as well as the limitations and interpretative biases that may result from mishandling of the samples.

Oral adjuvant hormone therapy for early breast cancer, despite its proven importance in terms of survival and prevention of recurrence, does not fall within the scope of clinical pharmacy programs set up for oral anticancer drugs, even though issues of therapeutic adherence have been clearly identified. The aim of our study was to explore the perception of healthcare professionals regarding the prescription and dispensing of this hormone therapy, in order to identify the risks for these patients and determine the clinical pharmacy actions that could address these risks.

Lipomas are mesenchymal neoplasms that affect the head and neck region in about 13% of cases. However, they are rarely reported in the pediatric population. We here report the case of a 6-month-old infant with no notable medical history, admitted for the management of a large left lateral cervical mass that had been progressing for 4 months. Ear, nose and throat (ENT) examination revealed a large left lateral cervical mass extending to the submental area, approximately 7cm in length, with no signs of compression. Cervical CT scan showed a fat-density mass, consistent with a lipoma. The patient underwent exploratory cervicotomy with excision of the mass. Histological analysis confirmed the diagnosis of lipoma. The clinical outcome was favorable, with no recurrence after 15 months of follow-up. Although rare in the pediatric population, cervical lipomas should be considered in infants with a cervical swelling. Its clinical manifestation is similar to that of a cystic lymphangioma.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare CD-30+/ALK- T-cell lymphoma. The combination of a textured breast implant, bacterial contamination and genetic predisposition appears to be necessary for the development of BIA-ALCL. The National Comprehensive Cancer Network (NCCN) has established guidelines for both diagnosis and treatment. Early detection of the disease is essential to ensure a cure. At an early stage and for the vast majority of patients, treatment consists of implant removal with associated total capsulectomy. We share our experience with the presentation of a case of BIA-ALCL discovered following the appearance of a periprosthetic seroma, 19 years after the fitting of breast implants.

We report the case of a 24-year-old patient affected by Epstein syndrome, in whom a CT scan performed in a traumatic context revealed numerous splenic lesions. After hemostatic splenectomy, the pathological examination showed splenic well-limited, non-encapsulated nodules, consisting of dilated venous sinuses, filled with red blood cells with inter-connected anfractuous vascular structures. These lesions had the following double endothelial and histiocytic immunohistochemical profile: CD31+, Factor VIII+, CD34+, ERG+, D2/40-, CD68+, CD21+/-. This is the second case reported in the literature of littoral cell angioma in association with Epstein syndrome.

The national investigators group for ovarian and breast cancer studies (GINECO) is an academic clinical research group specialized in gynecological oncology. Within the translational research group, the pathologists have several roles, including qualifying samples from patients included in clinical trials (tumor surface and cellularity). Since 2015, several clinical trials have required the qualification of tissue material, leading to a substantial database gathering tumor surface and cellularity associated with the concentration and quantity of DNA/RNA extracted. The main objective of this study was to investigate variations in nucleic acid concentration and quantity depending on the tumor cellularity and surface, using 1734 formalin-fixed, paraffin-embedded (FFPE) specimens from several GINECO clinical trials. The quantities of DNA and RNA extracted appeared to correlate well with tumor surface. The amount of RNA extracted also appeared to correlate with tumor cellularity. An optimal DNA concentration (>50ng/μL) was achieved with a tumor surface of at least 51-100mm2 and a tumor cellularity of at least 20%. An optimal RNA concentration (>100ng/μL) was obtained with a tumor surface of at least 26-50mm2 and a tumor cellularity of at least 51%. These data underline the importance of sending FFPE material with the highest tumor surface and cellularity when including patients in clinical trials. Inclusion in clinical trials enables patients to benefit from innovative therapeutic management.

Monocytes, circulating mononuclear phagocytes, play a fundamental role in innate immunity and the maintenance of tissue homeostasis. Using advanced technologies like flow cytometry, the characterization of monocytes has evolved from a simplistic view of a homogeneous population to a more complex understanding of a heterogeneous system comprising three main subtypes: classical monocytes (CD14++CD16-), intermediate monocytes (CD14++CD16+), and non-classical monocytes (CD14+CD16++). The identification of these subpopulations has enabled precise characterization of their functional profiles, enhancing the understanding of their roles in various pathological contexts, particularly in oncology. While anti-tumoral functions of monocytes have been clearly established in certain categories of cancers through tumor antigen presentation, induction of cytotoxic responses, and inhibition of metastatic progression, their role in promoting the development and progression of other cancers has also been highlighted during recent years. The utilization of monocytes in cancer immunotherapy presents promising opportunities, particularly by reprogramming their activity to enhance anti-tumoral responses or suppress their pro-tumoral functions. This review provides a comprehensive analysis of recent advances in the phenotypic and functional diversity of monocytes and their role in tumor progression, while highlighting emerging therapeutic strategies targeting these cells to optimize cancer treatment.

The prognosis for patients with high-risk neuroblastoma in the event of disease relapse/progression after first line therapy remains poor. However, over the past decade, new therapies have emerged that offer physicians, families and patients the hope of tumor control and, in some cases, a cure. Given the rapid evolution of new therapies in this field, it is strongly recommended that such cases be discussed at a multidisciplinary level and with patients/families regarding treatment options based on existing data. We summarize here the recommendations of the Neuroblastoma Committee of the Société Française de lutte contre les Cancers et les leucémies de l'Enfant et de l'adolescent (SFCE) for the treatment of patients with high-risk neuroblastoma in relapse/progression in France. These recommendations concern chemoimmunotherapy, the combination of ALK inhibitors with chemotherapy, and consolidation treatment options in the absence of tumor progression, as well as the place for early clinical trials.

The most common cancer in women is breast cancer (BC). MicroRNA-21 was one of the first oncomiRs to be found at elevated levels in a number of malignancies, including gliomas, BC, and colorectal cancer (miR-21). MiRNA is associated with processes such as apoptosis, invasion, metastasis, and proliferation, which are known features of cancer. This study aimed to investigate the molecular basis and clinical significance of miR-21 in BC, as microRNAs play a critical role in this disease.

To establish clinical practice guidelines for the management of women with cervical cancer.

Over the past decade, targeted therapies have significantly improved the prognosis of metastatic breast cancer. CDK4/6 and PARP inhibitors are now gaining traction in the adjuvant setting, and their potential use in the neoadjuvant context is also being explored. This review presents an analysis of the current scientific evidence and associated clinical perspectives. CDK4/6 inhibitors act on cell cycle dysregulation, commonly observed in hormone receptor-positive breast cancers. In the adjuvant setting, abemaciclib and ribociclib have shown improvements in progression-free survival (PFS) in the monarchE and NATALEE trials, respectively, leading to their approval by the European Medicines Agency. In the neoadjuvant context, although these agents have demonstrated a reduction in proliferation markers such as Ki67, their impact on clinical practice remains limited to date. PARP inhibitors are based on the concept of synthetic lethality, specifically targeting cancers with germline BRCA1 or BRCA2 mutations. In the adjuvant setting, the OlympiA trial demonstrated a significant improvement in both PFS and overall survival (OS). In the neoadjuvant setting, these agents have also shown effects on pathological markers, though the clinical relevance of these findings has yet to be clearly established. Overall, these results underscore the growing role of targeted therapies in the adjuvant management of breast cancer. The identification and validation of predictive biomarkers will be crucial in optimizing their use, both in adjuvant and neoadjuvant settings.

The indications for axillary lymph node dissection (ALND) have been reduced in breast cancer surgery. At the same time, maintenance treatments have become more complex. This paradox makes it essential to assess whether de-escalation might underestimate lymph node invasion, resulting in a loss of chance for patients eligible for these treatments. The aim is to determine the factors for lymph node invasion ≥4N+ in primary surgery, and for complete histological lymph node non-response in neoadjuvant chemotherapy, and then to assess the proportion of patients with an indication for ALND, and the proportion of patients eligible for enhanced maintenance treatment, in 2023. This is a single-centre retrospective study conducted at the Centre Antoine Lacassagne, involving patients treated for breast cancer with subclinical lymph node involvement between 2014 and 2020. In primary surgery, 62.9% had lymph node involvement <4N+. The predictive factor for lymph node involvement ≥4N+ was loss of ovality on ultrasound (P=0.01). After neoadjuvant chemotherapy, 45.7% had a complete histological lymph node response. MRI of the breast and axilla was the best predictor of this response (P=0.007). Twenty-nine percent of primary surgery patients were eligible for sentinel node therapy, with only one eligible for maintenance treatment. After neoadjuvant chemotherapy, 46% could have avoided ALND without compromising maintenance treatments. Under the new recommendations, 35% of patients could have avoided ALND. Ultrasound is the best preoperative examination for primary surgery. MRI is preferable for predicting response to neoadjuvant chemotherapy. There is no loss of chance for patients eligible for the new adjuvant treatments.

In this review we summarised published clinical trials evaluating neoadjuvant treatment with imatinib for locally advanced gastro-intestinal stromal tumours. We illustrate the practice through a clinical vignette, allowing us to highlight practical suggestions.

Breast cancer is the second most common cause of brain metastases, after lung cancer. The risk of developing brain metastases varies according to the molecular subtype of breast cancer, with a higher incidence for triple-negative or HER2-positive cancers. The discovery of brain metastases, whether synchronous or metachronous, is a turning point in oncology management, and requires discussion at a neuro-oncology multidisciplinary consultation meeting to assess the value and modalities of local treatment by surgery and/or radiotherapy (stereotactic or total brain). Systemic treatments also play a major role in the control of breast cancer brain metastases. The most abundant literature on brain metastases concerns HER2-positive breast cancers, with robust data on the intracerebral efficacy of tyrosine kinase inhibitors (tucatinib, neratinib) and drug-conjugated antibodies (trastuzumab deruxtecan). The size of the brain metastases, whether they are stable or progressive, any previous irradiation, whether the brain involvement is symptomatic or not, the extracerebral evolution of the disease, the patient's general condition and the systemic options available must all be taken into account before deciding on a therapeutic strategy. This article does not deal with the specific management of leptomeningeal disease, which will be the subject of a separate article.

Hormone therapy is essential in the adjuvant management of early-stage HR+ breast cancer. Risk assessment for recurrence is a fundamental pillar in guiding therapeutic strategies and personalizing patient care. Tumors with a low risk of recurrence, eligible for treatment de-escalation, can be managed with standard hormone therapy. High-risk or intermediate-risk tumors warrant intensified approaches, including targeted therapies. This article reviews recent questions regarding the extension of hormone therapy to ovarian suppression and current strategies, with a focus on clinical studies such as OlympiA, monarchE, and NATALEE, which currently guide therapeutic decisions.

Adjuvant radiotherapy for breast cancer has demonstrated its benefit both in terms of local control and overall survival. However, it now appears possible to de-escalate both the indications and the technical modalities of treatment. Some of these new approaches are already validated, while others require further studies. Hypofractionation has been the subject of several trials, which have shown that shorter regimens (42.5Gy in 16 fractions, 41.6Gy in 13 fractions, or 40Gy in 15 fractions) are equivalent to longer schedules. It can be proposed for almost all patients and can be complemented, if necessary, by a boost to the original tumor volume. Accelerated partial breast irradiation, which can be used in patients with favourable local prognosis (tumor size≤3cm, unifocal, hormone receptor-positive, no HER2 overexpression), is ideally delivered via interstitial brachytherapy, as accelerated 3D radiotherapy has not yet shown benefit in this setting. However, partial breast irradiation can be delivered using moderate hypofractionation with 3D radiotherapy. Intraoperative radiotherapy, which has more restrictive indications, is an interesting alternative for elderly patients. Patient selection for these approaches must be rigorous and depends partly on the technique chosen. Patients should be fully informed about the potential side effects of each technique.

Past decade was marked by development of several new drug for HR+/HER2- metastatic breast cancer leading to several major question in terms of strategy. We propose here to review state of art in terms of targeted therapy for advanced luminal breast cancer and how treatment strategy will be more and more personalized in a near future.

The diagnosis of B- and T-cell lymphomas relies on a multidisciplinary approach that combines morphological, immunological (via flow cytometry - FCM), and genetic analyses. The integration of cytological evaluation from tissue biopsy imprints with FCM enables rapid diagnostic orientation, which is valuable for guiding further complementary investigations. This atlas illustrates the main types of B- and T-cell lymphomas using cytology images, FCM data, and histological analyses derived from lymph node and splenic samples. The FCM profiles were established using routinely employed antibody panels. While results may show slight variations depending on the cytometer settings and fluorochromes used, they remain generally comparable across different instruments. An orientation panel consisting of 16 antibodies is used for the initial classification of lymphomas, with specific markers allowing for subsequent assessment of antigen expression according to cell type and pathological context. The combined study of cytological and histological features provides an integrated perspective of lymphoid pathology.

The incidence of kidney cancer is rising. It is the 7th most common cancer in men and the 10th most common in women. Diagnosis is based on imaging (thoraco-abdominopelvic computed tomography scan +/- abdominal magnetic resonance) and histopathology. Clear cell carcinoma is the most frequently observed histological subtype. Management of localized kidney cancer involves surgery or ablative treatments. Active surveillance is indicated in the indolent oligometastatic setting with local treatment in case of localized progression. Apart from this specific situation, two first-line therapeutic strategies are recommended in the metastatic setting : a dual immunotherapy regimen or the combination of immunotherapy with an antiangiogenic tyrosine kinase inhibitor. Both combinations have demonstrated superior survival outcomes compared to sunitinib, the previous standard of care until 2019. Treatment selection should be individualized, considering the characteristics of the disease (histology, tumour burden, location of metastases and if they are threatening, speed of progression), potential side effects of the treatments, the patient's general health, comorbidities and preferences.