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PurposeGastrosplenic fistula (GSF) is a rare and potentially fatal complication of various diseases, of which lymphoma is the most common cause. We aim through our work to relate two cases of GSF and to review literature. Methods We reviewed two cases treated in our department of GSF and made a research in Pubmed using the keywords “Gastrosplenic fistula” and “Splenic lymphoma”.Results GSF is a rare condition that can occur spontaneously or after initiation of chemotherapy. It arises from the rapid growth of tumour and invasion of surrounding organs. Diagnosis may be difficult to make and confused with splenic abscess. Treatment modalities include surgical resection, chemotherapy or a combination of both. Here we report two cases of GSF due to diffuse large B cell lymphoma patients. The first case is of a 54-year-old woman with a spontaneous fistula in the stomach. The second one is of a 48 year-old- male patient presenting a fistula after chemotherapy. Both patients died after surgery. ConclusionGSF is a rare but dangerous condition in which surgery is currently the preferred treatment.

Pancreatic metastasis (PM) of renal cancer is a rare condition. It is characterized by a long period after initial nephrectomy and a favorable prognosis compared to other pancreatic malignancies. Its diagnosis may confuse clinicians if the medical history is not known. In the era of targeted therapies for metastatic renal carcinoma, surgery stands as the best treatment option for PM of renal cancer. We report the case of a woman who underwent successfully left splenopancreatectomy for corporeal PM of renal cancer treated seven years ago. This case underlines the necessity of long-term follow-up of patients treated for kidney cancer.

Background: Osteosarcoma is the most frequent bone cancer occurring in children and adolescents aged 10–20 years. Several prognostic factors have been identified by studies done at western centers. The aim of our study was to identify the prognostic factors in Tunisian patients in order to improve their management. Methods: We reviewed the data of localized limb osteosarcoma patients treated in Salah Azaïz Institute from January 1980 to December 2018. Patient’s treatment and survival variables were assessed. Patients received a neoadjuvant chemotherapy and underwent surgery in an expert center. They received afterward an adjuvant chemotherapy depending on the tumor necrosis assessed by Huvos. Results: Eighty-five patients were enrolled. Mean duration of follow-up was 30 months (range 1–297 months). Males were 1.6 times more frequent, median age was 17 (from 1 to 62 years). Conventional osteoblastic osteosarcoma was the most frequent histological subtype (77%). Median tumor size was 10 cm. Femoral location was the most frequent (60%). The overall average history of symptoms was 103 days (4 to 423 days). The 5-year overall-survival was 38% and the event free survival 32%. Tumor site, lactate dehydrogenase levels, high methotrexate levels at 24 h, clinical evaluation of the tumor perimeter, surgery type and delay of relapse were found to affect overall survival. Tumor site, Lactate dehydrogenase levels and clinical evaluation of the tumor perimeter affected the progression free survival. Conclusion: Demographic characteristics of Tunisian patients are mainly the same than worldwide. Femoral site, normal level of lactate dehydrogenase, a clinical response during neoadjuvant treatment, an R0 surgery, a delay of relapse over 2 years and Median H24 Methotrexate level superior to 4.4 µmol/l were associated with a better prognosis in our study.