The accurate diagnosis of Xp11‐translocation renal cell carcinoma (RCC) in adults is challenging. TFE3 (located on chromosome X) fuses with a partner gene generally located on another chromosome. In rare cases TFE3 may fuse with a neighboring gene: RBM10. Because TFE3 false‐positive immunostaining is a common pitfall in many laboratories, demonstration of the chromosomal rearrangement is required in order to ascertain the diagnosis. Fluorescence in situ hybridization (FISH)—that has been considered as the gold standard method—reaches its limits for detecting small Xp11 paracentric inversions. We performed a comprehensive clinical, histological and genomic study of six novel cases of RCC with RBM10‐TFE3 fusion. Using FISH, TFE3 rearrangement was equivocal in one case and negative in others. RBM10‐TFE3 fusion was discovered using targeted RNA sequencing (RNASeq). As all the previously reported cases (mean age: 50), the six patients were adults (mean age: 42), suggesting an epidemiologic difference between RBM10‐TFE3 RCC and tumors harboring some other partner genes, such as ASPSCR1 that rather occur in children. Array‐comparative genomic hybridization showed several alterations, notably a gain of 17q in four cases with papillary features and loss of 3p in one case with clear cells. Our study demonstrates that, though rare among adult cases of RCC, RBM10‐TFE3 fusion is not exceptional and warrants appropriate molecular detection. Notably, it would be worthy to systemically investigate by RNASeq challenging RCC with type‐2 papillary features and 17q gain.

There are few studies available on melanoma in Afro‐Caribbean and Amerindian populations of South America. French Guiana deserves a study due to its specific health system and diversity of phototypes. The objectives of this study were to evaluate the incidence, histological and clinical characteristics of melanoma in French Guiana. A retrospective study was conducted from October 2007 to January 2018 on all primary melanomas observed at the Cayenne Hospital Centre. Thirty‐nine patients were included. The incidence rate (1.61/10 6 inhabitants/year) was low compared with mainland France. Median age was 58, and gender ratio 1 : 16. Clear phototype (I/II) patients were the most frequent (38.5%), but a significant amount of melanoma also occurred in darker skin. Median Breslow was higher in dark phototypes than in fair‐skinned patients. Superficial spreading melanoma (SSM) was the most common histological type (33.3%), particularly in patients with clear phototype (61.5%). Acral lentiginous melanoma was found only in darker‐skinned patients (29.1%). The trunk was involved in 66.6% in the clearest group whereas foot was the most common location in the darkest group (60% in V/VI phototypes). Surgery was the most frequently used treatment (79.5%). At the end of the study period, 53.8% had been lost to follow‐up. In conclusion, the incidence of melanoma in French Guiana is lower than in mainland France but remains a public health concern, as dark‐skinned populations often present with advanced diseases. Awareness and prevention in these communities must be improved.

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Little information is available on the management of cancer in equatorial areas, and specifically the management of elderly cancer patients. We have retrospectively reviewed the clinical files of 71 patients older than 70 years with cancer who were treated in the Cayenne Hospital in French Guiana. The population is that of an equatorial country with the health organization of a European country. We found that oncogeriatric evaluation was feasible but is far from being routinely used. The selection of screening tools of frailty is likely to be useful in making decisions for these patients. However, specific problems are emerging: cultural mediation; low income; illegal immigrants; comorbidities; specific tropical diseases; and the incidence of HIV, human T-lymphotropic virus Type 1 and hepatitis infections. This led us to expand the study to the whole cancer patient population and to implement specific information in the database used for follow-up. These preliminary observations should be relevant for other countries.

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