Levaluation prenatale du pronostic postnatal des nouveau-nes porteurs de hernie de coupole diaphragmatique (HCD) sest amelioree au cours des cinq dernieres annees. Bien que les facteurs pronostiques utilises ne fassent pas lunanimite, il semble important que toutes les equipes utilisent les memes mesures afin de pouvoir comparer et ameliorer nos pratiques. Levaluation du pronostic se fera souvent a laide du Lung over Head Ratio (LHR) entre 22 et 28 SA ou du LHR observe/attendu (LHR o/a) quels que soient le terme, la position du foie et la mesure du volume pulmonaire a lIRM. Ces facteurs permettent de definir un groupe de fœtus porteurs de HCD de mauvais pronostic. Lorsque le LHR est inferieur a 1 ou le LHR o/a est inferieur a 25 % et le foie est dans le thorax, les chances de survie en periode neonatale sont de moins de 20 %. pour ce groupe, un traitement in utero peut etre propose. Un ballonnet peut etre place, entre 28 et 30 SA, par voie endoscopique dans la trachee fœtale et Il est retire vers 34 SA. Les premiers resultats montrent que le taux de survie de ces enfants passe de moins de 20 % a environ 50 %. Cette technique ne semble pas entraîner une majoration de la morbidite, mais cela est en cours devaluation.
Breast sarcoma is a rare and aggressive form of cancer that is often difficult to diagnose and treat due to its rarity and lack of consensus on management. This case series presents two cases of breast sarcoma in women with no notable medical history, highlighting the importance of early detection and proper management in improving patient outcomes. The first case involves a 45-year-old woman who presented with a rapidly growing mass in her right breast, which was later diagnosed as a malignant phyllodes tumor. The second case involves a 26-year-old woman who underwent multiple surgeries for a recurrence of a high-grade phyllodes tumor in her right breast. The rarity of breast sarcoma makes it challenging to establish standardized treatment protocols, and further research is needed to determine the most effective treatment options. In this context, multidisciplinary collaboration and specialized centers for sarcoma management play a critical role in providing optimal care to patients with breast sarcoma.
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