Post-surgical surveillance of non-functioning pituitary adenoma (NFPA) is based on magnetic resonance imaging (MRI) at 3 or 6 months then 1 year. When there is no adenomatous residue, annual surveillance is recommended for 5 years and then at 7, 10 and 15 years. In case of residue or doubtful MRI, prolonged annual surveillance monitors any progression. Reintervention is indicated if complete residue resection is feasible, or for symptomatic optic pathway compression, to create a safety margin between the tumor and the optic pathways ahead of complementary radiation therapy (RT), or in case of post-RT progression. In case of residue, unless the tumor displays elevated growth potential, it is usually recommended to postpone RT until progression is manifest, as efficacy is comparable whether treatment is immediate or postponed. The efficacy of the various RT techniques in terms of tumor volume control is likewise comparable. RT-induced hypopituitarism is frequent, whatever the technique. The choice thus depends basically on residue characteristics: size, delineation, and proximity to neighboring radiation-sensitive structures. Reduced rates of vascular complications and secondary brain tumor can be hoped for with one-dose or hypofractionated stereotactic RT, but there has been insufficient follow-up to provide evidence. Somatostatin analogs and dopaminergic agonists have yet to demonstrate sufficient efficacy. Temozolomide is an option in aggressive NFPA resistant to surgery and RT.

A 7-year-old, 34-kg, neutered male Labrador retriever was presented with a 1-year history of intermittent sneezing with occasional left-sided epistaxis. CT revealed a mass in the left nasal cavity. Histopathological analysis of rhinoscopy-guided tissue biopsies was consistent with chronic necrotic and ulcerative rhinitis. Surgical debridement by ventral rhinotomy was subsequently performed and histopathological diagnosis was leiomyoma. Complete resolution of the nasal discharge and reduced sneezing frequency were observed after surgery. Fourteen months postoperatively, CT detected no regrowth of the mass.

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La radio-chimiothérapie concomitante est devenue le traitement de référence des carcinomes épidermoïdes localement évolués inopérables de la tête et du cou. L'association d'une chimiothérapie à une radiothérapie hyperfractionnée est également supérieure à une radiothérapie hyperfractionnée exclusive. Par ailleurs la radiochimiothérapie concomitante est actuellement le traitement postopératoire standard des patients à haut risque de récidive locorégio-nale. Le schéma optimal reste à déterminer. Le cisplatine est la molécule ayant fait la preuve d'une plus grande efficacité et la place de la polychimiothérapie n'est pas encore définie. La toxicité aiguë de ces protocoles nécessite des soins de support adaptés mais la toxicité tardive ne semble pas majorée. Des essais avec un long suivi et une évaluation de la qualité de vie sont nécessaires. Mots clés : Carcinomes localement évolués -Radio-chimiothérapie Treatment of locally advanced head and neck cancer: the place of chemoradiotherapyAbstract: Concurrent chemoradiotherapy (CRT) has been shown to be superior to radiotherapy (RT) alone in several clinical trials for unresectable head and neck cancer. Additionally, chemotherapy given with hyperfractionated RT leads to improved outcome versus hyperfractionated RT alone. In the postoperative setting, clinical trials suggest that CRT is superior to RT alone in high risk patients. The optimal CRT regimen is still an ongoing study and a matter of debate. In the literature, cisplatin is the most effective drug and the superiority of poly-chemotherapy has not been demonstrated. CRT acute toxicity requires significant supporting care; late toxicity is not increased, but large trials with long follow-up and evaluation of quality of life are needed.