Syndrome de Demons-Meigs. À propos de deux cas et revue de la littérature

The authors report a case of Demons-Meigs syndrome associated in two women. This syndrome associates ascitic effusion, pleural effusion and benign ovarian fibrothecoma. The evolution is favourable after total excision of the tumor. The authors underline the clinical, therapeutic and pronosis features of the syndrome.     

Lymphome malin non hodgkinien primitif de l’ovaire: à propos d’un cas

The malign, primitive and non-Hodgkin’s lymphoma of the ovary in young child is a rare entity. Therefore, we report the observation of a 13-years-old girl who consulted for an abdominopelvic tumour. The radiological exploration suggested an ovarian tumor. The differential diagnosis was put with the germinal tumors but the biological markers were normal. The laparotomy was indicated and highlighted an unilateral ovarian tumor, and the patient benefited of an annexectomy. The histological study revealed a primary malignant and non-Hodgkin’s lymphoma of the ovary. The assessment of extension was normal and the patient received adjuvant chemotherapy. In this case report, we are underlining the difficulty of the preoperative diagnosis, the therapeutic and the prognosis of this rare entity.     

Les tumeurs de la granulosa juvénile de l’ovaire. À propos d’un cas et revue de la littérature

The authors describe a juvenile granulosa cell tumour occurring in a 30-year-old woman. Clinically, the presence of ascites was associated with a pelvic mass. The tumour was localized strictly to the ovary, so conservative surgery was performed, proving sufficient to remove all the tumour tissue. Erroneous histological results revealed microscopic signs of an ovarian fibrothecoma. The patient, who presented with ascites, underwent laparotomy and excision was found to be impossible. A second histological examination showed microscopic signs of an ovarian juvenile granulosa cell tumour. Adjuvant chemotherapy was administered. After four months of treatment, however, the patient died. The purpose of this study is to assess the difficulty in using histological examinations to evaluate these tumours.     

Vulval tuberculosis: a rare case report

The authors report an observation of a rare case of vulvar tuberculosis in its hypertrophic form it is observed in a 16-years-old girl. The diagnosis was retained on a beam of arguments anamnestic, clinical, histological and evolutionary. A medical treatment based on antibacillar was founded supplemented of a surgical reduction for aesthetic concern.     

Neratinib overcomes trastuzumab resistance in HER2 amplified breast cancer

Trastuzumab has been shown to improve the survival outcomes of HER2 positive breast cancer patients. However, a significant proportion of HER2-positive patients are either inherently resistant or develop resistance to trastuzumab. We assessed the effects of neratinib, an irreversible panHER inhibitor, in a panel of 36 breast cancer cell lines. We further assessed its effects with or without trastuzumab in several sensitive and resistant breast cancer cells as well as a BT474 xenograft model. We confirmed that neratinib was significantly more active in HER2-amplified than HER2 non-amplified cell lines. Neratinib decreased the activation of the 4 HER receptors and inhibited downstream pathways. However, HER3 and Akt were reactivated at 24 hours, which was prevented by the combination of trastuzumab and neratinib. Neratinib also decreased pHER2 and pHER3 in acquired trastuzumab resistant cells. Neratinib in combination with trastuzumab had a greater growth inhibitory effect than either drug alone in 4 HER2 positive cell lines. Furthermore, trastuzumab in combination with neratinib was growth inhibitory in SKBR3 and BT474 cells which had acquired resistance to trastuzumab as well as in a BT474 xenograft model. Innately trastuzumab resistant cell lines showed sensitivity to neratinib, but the combination did not enhance response compared to neratinib alone. Levels of HER2 and phospho-HER2 showed a direct correlation with sensitivity to neratinib. Our data indicate that neratinib is an effective anti-HER2 therapy and counteracted both innate and acquired trastuzumab resistance in HER2 positive breast cancer. Our results suggest that combined treatment with trastuzumab and neratinib is likely to be more effective than either treatment alone for both trastuzumab-sensitive breast cancer as well as HER2-positive tumors with acquired resistance to trastuzumab.