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A comparison between neoadjuvant endocrine therapy and surgery seems feasible to assess the concept of neoadjuvant hormonotherapy.

The association of interleukin-2 (IL-2), interferon alpha-2a (IFNa), 5-fluorouracil (5-FU) has been reported to induce response in metastatic renal cell carcinoma (MRCC). This study evaluated IL-2, IFNa and 5FU as second-line treatment after failure under immunotherapy. A total of 35 patients received IL-2, at 9 Â 10 6 IU m À2 , once or t.i.d, 5 days a week, every other week. Interferon alpha was administered at 6 MUI, TIW along with IL-2 every week. 5-Fluorouracil was given at 750 mg m À2 day À1 on days 1 -5 every 4 weeks. One cycle lasted 8 weeks. All patients were evaluable for response and toxicity. There were two objective responses (5.7%) and 14 stable diseases (40%). Survival was 14 months. In all, 17 patients experienced grade 3 toxicity. The predictive factor for progression to second-line immunotherapy was the results of first-line immunotherapy, and performance status, delay from primary tumour to metastases and response or stabilisation to chemo-immunotherapy for survival. IL-2, IFNa and 5-FU induce low objective response but stabilisation in patients with MRCC having failed with immunotherapy, and may be considered only in selected patients on performance status, stabilisation or response after first-line immunotherapy and interval from their primary tumour to metastases.

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Lymphoepithelioma-like carcinoma (LELC), which is commonly reported in the nasopharynx and occasionally in other organs, remains a rare condition in gynecology. It is morphologically defined as a poorly differentiated carcinoma with prominent lymphoplasmacytic infiltrate. We present a case of an 82-year-old woman with a 10 cm LELC of the ovary shown by inguinal lymph nodes. There was no peritoneal carcinomatosis. Cytoreductive surgery was performed to remove a left ovarian neoplasm and multiple involved lymph nodes. Cytoreduction was complete. The tumor was a mixed poorly undifferentiated ovarian carcinoma consisting of 95% LELC and 5% moderately differentiated serous adenocarcinoma. Immunohistochemistry showed a large infiltration of T lymphocytes and plasma cells. Epstein-Barr virus was not detected by immunolabeling and polymerase chain reaction. The patient was still alive at 24 months of follow-up. To our knowledge, this is the second case of ovarian LELC and the first description of the native tumor before chemotherapy. In conclusion, this rare tumor of the ovary is difficult to diagnose both preoperatively and perioperatively. However, clinicians and pathologists should be aware that ovarian tumors with massive involvement of lymph nodes and no peritoneal carcinomatosis are suggestive of such a diagnosis and that prognosis is relatively good.

Interleukin-2 has known efficacy in the treatment of metastatic renal cell carcinoma but it also has adverse effects mediated by an inflammatory mechanism and capillary leak syndrome. The authors report the case of a patient with a metastatic renal cell carcinoma who had an asymptomatic intra-epidural metastasis in the thoracic spine, which became symptomatic during IL-2 administration without any recurrence after specific treatment by surgery and radiotherapy.

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