[Dermal sinus and dermoid cyst complicated by abscess formation].
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Adolescent↗
Biomedical subjects
A Naja
Publications and source records attributed to A Naja.
[Intramedullary schwannoma. A case report].
The intramedullary localization of schwannoma is rare, corresponding to 0.3% of all intraspinal tumors. We report a case of intramedullary schwannoma without symptoms suggestive of neurofibromatosis. This patient presented with symptoms of spinal compression. Total removal of the tumor was achieved. The literature is reviewed about of this rare localization of schwannoma.
Adult↗
[Gliosarcomas. A case report].
Gliosarcomas account for 2% of glioblastomas. We report a case of gliosarcoma in a 65-year-old man, which presented as meningioma, and discuss diagnostic, therapeutic and prognostic aspects of this particular entity.
Aged↗
[Cerebellar schistomiasis. A case report].
Schistomiasis or bilharziosis remains an endemic parasitic disease in many countries world wide. Urogenital, intestinal and hepatic symptoms are common. The brain is exceptionally involved and very few cases have been described in the literature. We report the case of a 35-Year-old male with a history of hematuria and bladder disorders, who developed signs of intracranial hypertension and a cerebellar syndrome over a period of one Month. Brain MRI disclosed a cerebellar lesion and a pelvic CT scan revealed a bladder tumor. Treatment consisted in a ventriculo-peritoneal shunt and corticosteroid therapy. Cystoscopy was performed for total resection of the bladder lesion. Histopathology confirmed the diagnosis of schistomiasis. Surgery was also performed to approach the cerebellar lesion. Histopathology showed the inflammatory nature of the lesion. The patient was given an antiparasitic treatment. Clinical and radiological radiological manifestations regressed.
Adult↗
[Intramedullary tuberculomas. Five cases].
Tuberculosis of the central nervous system is uncommon. The intramedullary localization is exceptional. We report five cases of intramedullary tuberculosis observed in four women and one man with a mean age of 43 years. Two patients had a prior history of tuberculosis. Spinal cord compression was found clinically in all cases. The spinal MRI visualized the tuberculoma in all patients; two had a double tumor. Complete removal of the tuberculoma was possible in only one patient. Outcome was stationary for four patients.
Adult↗
[Epidermoid cyst of the cerebellopontine angle. A surgical series of 10 cases and review of the literature].
Epidermoid cyst or cholesteastoma is a congenital slow growing lesion. It usually arises in the paramedian cisterns of the posterior fossa. Its incidence varies between 0.2 and 1% of all intracranial tumors. The cerebello-pontine angle (CPA) is the most common localization. Our study reports 10 observations of CPA epidermoid cysts, treated in our department between 1989 and 1999. The age of our patients ranged from 20 to 45 years, with male predominance. The patients were admitted with symptoms of cerebello-pontine angle syndrome or signs of posterior fossa tumor. CT-scan was performed in all cases and MRI was performed in 5 patients. The audiometric explorations only provided an orienting contribution. Treatment was exclusively surgical. The retro-sigmoid approach was used in 6 cases, the sub-occipital in 30% and a subtemporal approach in one case. Total resection of the epidermoid cysts was accomplished in 4 cases, and subtotal resection in 4 cases. Two patients underwent partial resection and underwent a revision procedure. The histological examination showed an epidermoid cyst in all cases. The clinical course was controlled in 6 patients: 4 patients recovered and became symptom free. A persisting neurologic deficit was observed in two cases (hearing loss, dysphonia); 4 patients were lost to follow-up. Epidermoid cyst is a benign tumor. Total resection is the ideal treatment, but we have to be aware, taking into consideration the adherence of the tumor to neurovascular structures, of the risks at attempting total resection.
Adult↗
[Subperiosteal hematoma of the orbit associated with subfrontal extradural hematoma].
Subperosteal hematoma is rarely associated with extradural hematoma and orbital roof fracture. We report a case observed in a 16-year-old boy who developed exophthalmos, diplopia and visual loss after blunt head trauma. Computed tomography demonstrated the subperiosteal hematoma associated with a thin extradural hematoma and an orbital roof fracture. The hematomas were removed during the same procedure via fronto-orbito craniotomy. Surgery led to complete recovery without functional sequelae. We stress the importance of early diagnosis and treatment of post-traumatic exophthalmos.
Adolescent↗
[Sphenotemporal aneurysmal bone cyst. A new case and review of the literature].
Aneurysmal bone cysts (ABC) are benign tumors of the bones, formed by multiple cysts filled with blood and eroding the bone. They are rarely located at the skull. We report a case of a right temporal ABC in a 5-year-old girl. On admission, the physical examination showed a tough and fixed tumor, with no inflammatory signs nor vascular characteristics. The neurological examination was normal. Imaging studies showed an heterogeneous extracerebral mass, eroding the temporal bone and the greater wing of the sphenoid bone. The treatment consisted in an extensive tumor resection, associated with reconstructive surgery. The outcome was uneventful (follow-up 27 months). We underline the pathogenetic, diagnostic and therapeutic features of this condition.
Bone Cysts, Aneurysmal↗
[Tamoxifen adjuvant delays early breast cancer. Results of a cooperative randomized trial].
Adjuvant tamoxifen (TAM) has been proved to reduce recurrence and mortality in early breast cancer, nevertheless many patients did not receive TAM as adjuvant therapy after local treatment. In order to study the efficacy of delayed TAM therapy in patients who were not given immediate adjuvant hormonal treatment, a multicenter randomized trial has been conducted by the French National Cancer Centers (FNCLCC). According to eligibility criterias all women with breast cancer who received curative local treatment at least 2 years before (surgery +/- radiotherapy) with or without adjuvant chemotherapy but no hormonal treatment could have been included. Between September 1986 and October 1989, 494 women were randomized to receive either TAM 30 mg/day for 5 years or no treatment. Patients' characteristics such as age, tumoral stage, number of positive nodes, receptors status and time from local treatment were equally distributed in the 2 groups. An improvement in the disease free survival in the TAM treated patients can be observed with a significative difference (p = 0.05), nevertheless the overall survival is not improved in the TAM group. In the same way, in nodes positive patients although no significative improvement in the overall survival can be observed, a significative improvement in the disease free survival (p = 0.05) can be noted. In estradiol receptors positive patients tamoxifen gives a significative reduction in the odds of death (p = 0.04) and recurrence (p = 0.03). The disease free improvement seems to be limited to 50 and more years old patients. The first results of this trial lead to prescribe tamoxifen to all postmenopausal women previously treated for an early breast cancer without adjuvant tamoxifen treatment.
Adult↗
[Anterior approach of cervical spine in Pott's disease. Apropos of 7 cases].
This study reports 7 cases of cervical Pott's disease, gathered during 6 years in the department of neuro-surgery of Ibn Rochd U.H.C. 4 females and 3 males, aged between 9 and 52 years were included. All the patients complained of cervicobrachial pain and weakness of the limbs. Clinical features were: deterioration of general status, rachidian syndrome and neurological impairement with motor and sensitive deficit. Radiological analysis found a destructive and extensive lesion, cervical kyphosis from 10 degrees to 60 degrees, retropharyngeal abscess and intraspinal canal extension of infection. Diagnosis was confirmed by histological study in all cases. In addition to antituberculous therapy and preoperative cervical traction in 4 cases, all the patients had spinal fusion using an anterior approach. Post operative immobilization in a cervical collar varied from 9 to 12 months. All 7 patients had full neurological recovery, 6 patients had an excellent bony fusion and cervical kyphosis was corrected. For the remaining patient, the bone graft was mobilized without neurological disorders. This study confirms anterior arthrodesis efficiency. This procedure in conjunction with preoperative traction, allowed stabilization of the spine and healing of vertebral lesions with excellent kyphosis correction.
Adolescent↗
[Thoracic medullary epidermoid cyst. Apropos of a case with MRI and review of the literature].
We report the case of a 14 year-old patient presenting with a thoracic spinal cord compressing syndrome (T5-T6). The myelography and magnetic resonance imaging showed an intramedullary cystic mass. One year after the surgical excision of the capsule and an easy aspiration of the tumoral content, this patient had a good neurological recovery.
Adolescent↗
[Multiple and bilateral cerebral hydatid cysts. A case].
The authors report one case of multiple and bilateral cerebral hydatic cysts in a eight years old child. The disease was revealed by cranial hypertension signs, with homonymous hemianopsia. The diagnosis was based on the cerebral CT scan, and confirmed by surgical operation which was performed in two stages. The evolution was uneventful.
Brain Diseases↗
[Anal migration of ventriculo-peritoneal shunt catheter. Apropos of 3 cases].
Three cases of abdominal catheter migration through the anus following ventriculo-peritoneal shunt are described. Two cases involved hydrocephalus secondary to tuberculous meningitis and the third myelomeningocele. Among the reasons for migration, the length of the abdominal catheter, trauma during the operation and infection must be taken into consideration. One patient was suffering from meningitis at the time of admission, while the two others were asymptomatic. Treatment involved removing the peritoneal catheter in 2 cases and the entire shunt system in the patient with meningitis. The shunt was replaced one to two weeks later. The outcome was favourable in all three cases.
Anal Canal↗
Isolated clustered microcalcifications: diagnostic value of mammography--series of 400 cases with surgical verification.
PURPOSE: To determine the diagnostic value of mammographic criteria in cases of isolated clustered microcalcifications. MATERIALS AND METHODS: Four hundred mammographic studies of isolated clustered microcalcifications for which surgical verification was available were reviewed. A descriptive statistical study was performed to evaluate the distribution of each criterion relative to histopathologic results, followed by a multivariate study to determine statistically significant criteria. Seven breast specialists gave a consensus opinion on the need for surgery. RESULTS: There were 302 benign lesions and 98 cancers. The most useful criteria were vermicular form, linear/branching shape, and irregular size of microcalcification. The number of biopsies recommended with use of these three criteria was 177 instead of the 172 recommended by the experts. CONCLUSION: Use of these three preoperative criteria permits correct diagnosis of most such malignancies (90% in our series vs 67% diagnosed by the experts).
Breast Diseases↗
[Pure dysgerminomas of the ovary. Retrospective analysis of 17 cases treated at the Claudius Regaud Center from 1974 to 1989].
From 1974 to 1989, 17 dysgerminomas of the ovary were treated at the Centre Claudius Regaud. The mean age of the patients was 21 years: 53% were FIGO stage IA, 17% were stage IB, 6% were stage IIB and 24% were stage IIIC. Conservative surgery was performed in 13 patients (unilateral salpingo-oophorectomy) and non-conservative surgery was performed in the others patients. 70% of the patients underwent complete resection. Post-operative treatment was administered in every case but one (radiotherapy: 15 patients; combined chemo-radiotherapy: 1 patient). All patients achieved complete remission after the first-line treatment, but 2 of them recurred (1 IA, 1 IIB). A second remission was achieved in both cases. The overall survival rates were 100% at 2 years, 94% at 5 years and 89% at 10 years. The dual objective of curing the patient of her malignant disease while preserving her reproductive function was achieved in 53% of the patients.
Actuarial Analysis↗
[Node negative breast cancers: the good and the bad cases].
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Adult↗
[Cancer of the rectum: preoperative radiotherapy (344 cases)].
Radiation therapy prescribed as an adjuvant to surgery is an effective treatment of many cancers but has not been universally accepted for treatment of rectal cancer. Since 1969, preoperative radiation therapy of rectal carcinoma has been proposed in a curative intent, both at Centre Paul Lamarque in Montpellier and at Centre Claudius Regaud in Toulouse, France. Megavoltage radiotherapy was used in all patients and doses ranges from 35 to 40 Gy during 2.5 to 3 weeks. Among the 344 patients treated between 1969 and 1981, the ratio of abdominoperineal excision to anterior resection was 239/105, the percentage of pelvic recurrence was 7,8 per cent, and the 5-year survival rate, including postoperative mortality (5.2%) was 78 per cent in the Centre Claudius Regaud series and 64 per cent in the Centre Paul Lamarque series. The 10-year survival rate was 50 per cent. There was no evidence of an increased morbidity following irradiation. Pathologic staging showed no residual tumour in the excised specimen in 5.2 per cent of the cases. The number of Dukes'C cases was smaller than according to the clinical pre-treatment assessment of the tumours (16%). Ultrasonography of the liver and plasmatic CEA determination avoid irradiation of metastatic patients. Further development of this curative approach should include a postoperative boost of 25 Gy for patients who are at high risk for local failure in the pelvis, and an adjuvant chemotherapy for Dukes'C patients.
Aged↗
[Dysgerminoma of the ovary: a study of 13 cases (author's transl)].
Thirteen cases of primary ovarian seminoma have been referred to the Claudius Regaud Cancer Center during the last 2 decades, patients' ages ranging form 10 to 41 years with a peak in the 20's. Two patients were treated by surgery as definitive therapy, the others underwent combined radiation therapy (dose range 25 to 45 Gy) following surgical excision. The 2 patients treated by surgery alone had pelvic recurrences, whereas only 2 local failures appeared in the group treated by surgery and radiotherapy. Ten patients are asymptomatic and clinically free of disease after a mean follow-up of 3.5 years, the mean survival time of the series being 6 years. Because of the generally improved prognosis, surgical oophoropexy is recommended before radiotherapy.
Adolescent↗