We investigated on the added prognostic value of a three-scale combined molecular imaging with 68 Ga-DOTATATE and 18 F-FDG PET/CT, (compared to Ki-67 based histological grading), in gastroenteropancreatic neuroendocrine neoplasia patients. 85 patients with histologically proven metastatic gastroenteropancreatic neuroendocrine neoplasias, who underwent combined PET/CT imaging were retrospectively evaluated. Highest Ki-67 value available at time of 18 F-FDG PET/CT was recorded. Patients were classified according to World Health Organization/European Neuroendocrine Tumor Society histological grades (G1, G2, G3) and into three distinct imaging categories (C1: all lesions are 18 F-FDG negative/ 68 Ga-DOTATATE positive, C2: patients with one or more 18 F-FDG positive lesions, all of them 68 Ga-DOTATATE positive, C3: patients with one or more 18 F-FDG positive lesions, at least one of them 68 Ga-DOTATATE negative). The primary endpoint of the study was Progression-Free Survival, assessed from the date of 18 F-FDG PET/CT to the date of radiological progression according to Response Evaluation Criteria In Solid Tumors version 1.1. Classification according to histological grade did not show significant statistical difference in median Progression-Free Survival between G1 and G2 but was significant between G2 and G3 patients. In contrast, median Progression-Free Survival was significantly higher in C1 compared to C2 and in C2 compared to C3 patients, revealing three distinctive imaging categories, each with highly distinctive prognosis. Our three-scale combined 68 Ga-DOTATATE/ 18 F-FDG PET imaging classification holds high prognostic value in patients with metastatic gastroenteropancreatic neuroendocrine neoplasias. www.oncotarget.com
Granulosa cell tumors is classified into juvenile and adult types and comprise less than 5% of ovarian tumors in women and are much rarer in men which only 45 have been previously reported. We report here a 40-year young man with a left testicular adult type granulosa cell tumor. The tumor measured 5.5X5X4cm; Immunohistochemical stains showed the tumor diffusely positive for inhibin and vimentin. Post operative CT scans shows a lomboaortic lymphnodes treated by four cycles of chemotherapy type BEP (bleomycin, etoposide, cisplatin). The thoraco abdominal CT scans post chemotherapy shows the disappearance of the right testicular nodule and the lomboaortic lymphnodes. 2 years after treatment, the patient is alive and well with no signs of recurrence. Our report highlights one more case of this very rare tumor of the testis, which is quite problematic In terms of prognosis and management, and for this reason seems to have attracted the interest of many researchers recently.
Le cancer du sein chez l'homme est une affection rare représentant environ 1% de tous les cancers du sein et moins de 1% de l'ensemble des néoplasies masculines. L'objectif de notre étude est de décrire les différents aspects cliniques, histologique, pronostic et thérapeutiques de cette tumeur rare afin de contribuer à l'amélioration de la prise en charge de cette affection. Il s'agit d'une étude rétrospective portant sur 40 patients colligés au Centre Mohamed VI pour le traitement des cancers de Casablanca de Janvier 2000 à Décembre 2012. L'âge médian a été de 62 ans, le délai moyen de consultation a été de 12 mois, l'autopalpation d'un nodule péri aréolaire a été le principal motif de consultation dans 90% des cas. Le carcinome canalaire infiltrant a été le type histologique prédominant dans 90% des cas. La prise en charge thérapeutique multimodale a consisté en une mastectomie suivie d'un traitement adjuvant à type de chimiothérapie, radiothérapie et/ou hormonothérapie en fonction du stade de la tumeur et des caractéristiques histologiques. Le suivi moyen a été de 38 mois, l'évolution a été caractérisée par une rémission complète chez 16 patients (soit 40%), rechute locale chez 3 patients (soit 7.5%) et par une rechute métastatique chez 5 patients (soit 12.5%). Le site métastatique le plus fréquent a été l'os (62%), suivi par le poumon et le foie. Le décès était survenu chez 10 patients (25%). Le cancer du sein chez l'homme présente des similitudes avec le cancer mammaire chez la femme. Mais il présente aussi beaucoup de particularités, d'où l'intérêt de mener des études prospectives randomisés à plus large échelle afin d'améliorer la prise en charge et le pronostic de cette affection dont l'impact psychosociale est considérable.
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