Intra-osseous schwannoma is a rare mesenchymal tumor. Although, the head and neck region is one of the most common sites for schwannomas, its location at the skull bone is uncommon and accounted for less than 0.2% in the largest series of bone tumors ever reported. Furthermore, it is most often a benign tumor, malignant transformation is exceedingly rare.Clinical presentation is non-specific, most often symptoms are associated with compression and invasion of adjacent organs. Neuro-imaging features are non-specific and the diagnosis is based on histological examination with immunohistochemical study.Surgery remains the aim of treatment. However, radiation therapy could be an interesting therapeutic option in unresectable tumors.This systemic review offers new clinicopathological data useful for better defining the diagnosis and clinicopathological behavior of schwannoma. The purpose of this work is to raise awareness among clinicians adding this clinical entity as a differential diagnosis when a mass of skull bone is identified.
BackgroundRadiation-induced osteosarcomas are a recognized complication of radiation therapy. Owing to the fact that it is rare, publications on radiation-induced osteosarcoma of the skull base are limited to a small series and some case reports.Case presentationWe describe a rare case of a patient with a skull base radiation-induced osteosarcoma treated 11 years before with ionizing radiation for an undifferentiated carcinoma of the nasopharynx. The patient was treated with chemotherapy alone, but he died after the third cycle.ConclusionsRadiation-induced osteosarcoma of the skull base after treatment of nasopharyngeal carcinoma is a very rare but very aggressive complication with a poor prognosis. Chemotherapy gives bad results, and regular follow-up of treated patients should be considered.
Background: Squamous cell carcinoma of the rectum is a distinct entity. We report a rare case of squamous cell carcinoma of the middle and low rectum. Case presentation: The patient was a 60-year-old man who presented with a history of rectal Bleeding, constipation and pelvic painless. Rectoscopy and Colonoscopy revealed a polypoid tumour of the middle and low rectum. Biopsies of this mass revealed a poorly differentiated squamous cell carcinoma of the rectum. Pelvic Magnetic Resonance Imaging scan showed a polypoid, irregular and circumferential tumor in the middle and low rectum extending in length on 95mm. CT scan of the chest, abdomen and pelvis was negative for distal metastases. The patient received combined chemo-radiation. Overall treatment time was 45 days. After 6 weeks of the end of treatment, the revaluation clinical tests by pelvic magnetic resonnance imaging showed a poor response. After 3 months, Positron Emission Tomography with Fluorodeoxyglucose demonstrated a little hypermetabolic area with maximum standard up take value of 6,7 in the low rectum. Patient underwent a surgical resection. The postoperative histopathological findings were non specific and chronic inflammatory changes. At the time this report was written, the patient had 18 months of follow-up. No evidence of malignacy is found. Conclusion: Squamous cell carcinoma of the rectum is a distinct entity. Chemoradiation should be chosen as the first-line therapy for suqamous cell carcinoma of the rectum. However,a large study will be required to establish a safe and effective regimen.
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