BackgroundEwing sarcoma/primitive neuroectodermal tumor is a family of highly malignant proliferation of neuroectodermal origin, most often skeletal, adrenal localization is extremely rare. Only few cases have been reported in the literature. Classical management includes radical surgery with adjuvant chemotherapy or radiotherapy or both. This case report is the only one where recurrence was surgically removed, and it confirms the importance of adjuvant treatment, and the efficacy of neoadjuvant chemotherapy.Case presentationWe report the case of a 23-year-old Moroccan woman presenting with flank pain. An abdominal computed tomography scan showed a large and enhancing left suprarenal mass. After radical nephrectomy, histologic examination revealed a small round cell proliferation. The diagnosis of Ewing sarcoma was confirmed by molecular analysis; time to final diagnosis was 5 months due to financial and coordination issues. Computed tomography (on an asymptomatic patient) revealed a locoregional recurrence, our patient received 12 cycles of the vincristine, doxorubicin and cyclophosphamide/ifosfamide and etoposide protocol used in an alternating schedule, with partial radiologic response (62%) and pathologic complete response, then underwent adjuvant radiotherapy of 45 Gy. The young women is still in remission after 36 months of follow-up.ConclusionsOur patient had an early recurrence due to absence of adjuvant treatment, but did respond well to neoadjuvant chemotherapy with a pathologic complete response. Management of adrenal Ewing sarcoma could be extrapolated from skeletal one with good outcomes even in locoregional recurrence.

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Background: To evaluate the epidemiological aspect of lung cancer in women in Marrakech city in Morocco. Methods: This is a retrospective study conducted between 2003 and 2009 in the Department of Oncology-Radiotherapy, University Hospital Mohamed VI Marrakech. Results: Twenty nine women with lung cancer were unrolled (9% of all lung cancer). The average age was 55.7 ± 12 years. Only twenty percent of our patients were smokers while 38% reported a greater or lesser exposure to passive smoking. Ninety percent of patients were housewives and 62% were from rural areas and all reported massive exposure to smoke from cooking fuels which was mainly charcoal. Squamous cell carcinoma represents 67% of cases. Tumors were diagnosed at advanced stages II/IV in 81% of cases. Eight patients received neo-adjuvant chemotherapy followed by radio-chemotherapy combination and palliative chemotherapy has been indicated in twelve patients. Nine patients received best supportive care. Average follow-up was of twelve months. Fourteen patients were lost to follow-up. Among fifteen evaluable patients, response was noted in seven patients, stabilization in four patients and progression in four patients. Conclusion: Female lung cancer is a relatively rare condition in Marrakech, Morocco. Although the role of smoking in the pathogenesis of lung cancer is clearly established; there are other risk factors including hormones that make women more susceptible to carcinogens of tobacco. Other geographical and environmental factors could be incriminated including domestic smoke exposure especially in our context.

BackgroundPrimary breast angiosarcoma is defined as malignant proliferation showing endothelial differentiation. It is a very rare tumour (0.05% of primary mammary cancers), whose diagnosis can be difficult.Case presentationWe report the observation of a patient with no previous history, aged 27 years. The clinical examination finds a right breast discreetly increased in volume. The trucut biopsy was in favour of a lactating tubular adenoma. However, an immunohistochemical complement was requested. An absence of pancytokeratin labelling contrasted with strong expression of CD31, CD34 (endothelial markers) are described. The proliferation index (Ki67) was estimated at 30%. This led to the conclusion that the phenotypic aspect is related to a vascular proliferation that evokes an angiosarcoma. After a multidisciplinary assessment, the patient benefited from an enlarged excision of the tumour. The histopathological examination of the surgical specimen found an infiltrating mesenchymal proliferation made of vessels of variable sizes anastomosed to vascular slits with lesional limits. The immunohistochemical examination on the surgical specimen showed to the same phenotypic profile on biopsy. The final diagnosis was a high-grade mammary angiosarcoma of incomplete excision. The patient refused any additional surgical management; external radiotherapy and close supervision were prescribed. After eight months of evolution, no local or remote recurrence was reported.ConclusionPrimary breast angiosarcoma is a mesenchymal malignant tumour of rare vascular origin. Our observation is peculiar by the absence of any prior radiotherapy, its clinical presentation, its morpho-phenotypic characteristics, its management and its evolutive aspects.