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Biomedical subjects

M Auriol

Publications and source records attributed to M Auriol.

At least 19 recordsLinked to original sources

Mesenchymal chondrosarcoma of the jaws. Report of four cases.

Mesenchymal chondrosarcoma (MCS), described in 1959 by Lichtenstein & Bernstein, is a very rare malignant tumour. Only 46 cases have been previously reported in the jaws. Over a period of 30 years, four chondrosarcomas of mesenchymal type (of which one has already been published in 1987 with a three-month follow up) were treated in our department. Two patients have been followed for more than 17 years, of whom one has died of an intracranial extension and the other is still alive after surgical treatment of numerous recurrences and metastases. The two others are tumour-free with a follow up of 18 months and 11 years respectively. Histological, epidemiological and clinical features and treatment of MCS are discussed relevant to the data published in the literature.

Adolescent↗

[Intra-mandibular adenoid cystic carcinoma].

A case of mandibular cystic adenoid carcinoma was observed in a 49-year-old man. After slow progression, the diagnosis was directed to mandibular pseudocystic tumor. The treatment was enucleoresection. Histological findings in this exceptionnal lesion led to a discussion of the radioclinical diagnosis and etiopathogenic features of adenoide cystic carcinoma. The origin of this tumor is hypothesized to be heterotopic salivary inclusion although no histologicaly proof can be provided.

Carcinoma, Adenoid Cystic↗

[Paradental cyst].

The paradental cyst is an odontogenic inflammatory cyst (WHO classification, 1992). It has been rarely described in the french literature and includes: The inflammatory paradental cyst which occurs on the buccal or distal aspects of an erupted third mandibular molar or of a canine (first description by Main in 1970); the mandibular infected buccal cyst which occurs on the buccal surface of the mandibular second or first molar in children around 6-8 years of age with an associated history of inflammatory signs (Stoneman and North, 1993). The histological features are the same as those of the radicular cyst. Prognosis is excellent after enucleation. This paper present an additional case report of a paradental cyst located on a second mandibular molar.

Adolescent↗

[Orbital paraganglioma. Apropos of a case and review of the literature].

Paragangliomas are exceptional in the orbit. Among the 47 cases reported in the world literature more than 1/3 has been classified as alveolar soft part sarcoma. Diagnosis of paraganglioma was confirmed on the basis of pathology reports in only 10. We observed a case in a 46-year-old woman who presented with a tumour of the orbit. The histology examination and the ultrastructure determined by electron microscopy confirmed the diagnosis of paraganglioma. Characteristic histologic features are discussed together with a review of the literature.

Chromogranins↗

[Malignant xanthogranuloma of the mandible. Presentation of a case and review of the literature].

A malignant xanthogranuloma located in the mandible presented as a tumefaction of the alveolar crest with labiomental hypoaesthesia in a 52-years-old woman. The patient was treated with combined chemoradiotherapy and remained in complete remission for 14 years. Epidemiologic features (age, sex, race) of this tumour are discussed in light of the 24 cases reported in the literature. Histology features and possible treatment protocols as well as observed results are discussed. Five-year survival rate in malignant cervicofacial xanthogranulomas is estimated at 48%.

Combined Modality Therapy↗

[False Merkel cell tumor of the gingival mucosa disclosed by small cell bronchial carcinoma].

Merkel cell tumours are exceptional and usually occur in exposed areas of the face or limbs. These tumours are related to small-cell bronchogenic cancer. The case reported here demonstrates the relationship between these two cancers since the diagnosis of Merkel cell tumour of the gingival mucosa, initially made in a patient with no other presenting signs other than the stomatological lesions, was corrected six weeks later when the buccal lesion was found to be a metastasis of small-cell bronchogenic cancer. This observation is in agreement with the retrospective study reported by the Institute of Stomatology of the Salpêtrière hospital published in 1992 and presented at the XXIVth congress of the French Society of Cervicofacial Cancerology.

Carcinoma, Bronchogenic↗

Clear cell sarcoma of the pre-parotid region: an initial case report.

An unusual case of clear cell sarcoma (CCS) found in the parotid region of a 75-year-old man with a long history of chronic lymphoid leukemia is reported. Treatment of the patient included a total parotidectomy with preservation of the facial nerve. The tumor was pathologically consistent with a clear cell sarcoma. Since CCS originates from the neural crest and is melanin producing, we suggest that this particular tumor originated from the superficial musculo-aponeurotic system (SMAS). To our knowledge, this is the first case of CCS that has been reported in the parotid region.

Aged↗

[A comparative study of rhabdomyosarcoma with cervicofacial involvement in children and adults. A therapeutic protocol].

Rhabdomyosarcoma is a malignant tumour of striated muscles. It is usually encountered in children and rarely in adults. In this study we compared sex ratios, aetiologic factors, different localizations, development stages, modes of extension and treatment as well as prognosis in children and adults with cervicofacial localizations. The differences observed led to the conclusion that cervicofacial rhabdomyosarcomas in children and adults are two very different pathological entities.

Adult↗

[What can be expected of the microscopic study of a biopsy of the accessory salivary glands? An argument for a new approach: "D.D." (diagnosis, destruction)].

Histological study is made on labial salivary gland biopsies in three usual circumstances: presence of a sicca syndrome; suspicion of a Gougerot-Sjogren's disease or of another systemic disease (sarcoïdosis; amyloïdosis). Its aim is: to appreciate the accuracy of the biopsy; to analyse elementary lesions and to suggest an etiologic diagnosis. The authors put emphasis on the interest: 1) to use new techniques of immunocytochemistry or molecular biology to appreciate the degree of evolutivity of lesions; 2) to quantify lymphoïd infiltrates, fibrosis and epithelial alterations; 3) to formulate results with regard not only to the etiological Diagnosis but also to the glandular Destruction by means of a double descriptive score: the "D.D." score.

Amyloidosis↗

[Histopathologic lesions of the accessory salivary glands in Gougerot-Sjögren syndrome: re-evaluation of the diagnostic criteria of Chisholm and Mason and of Chometter et al].

In a retrospective study, we used a series of 29 patients with Sjögren's Syndrome diagnosed according to the new European criteria (Cl. Vitali, S. Bombardieri, H. M. Moutsopoulos et al.) (8). (Arthritis Rheum 1993; 36:340-7). A labial biopsy technique allowed to classify these patients into the anatomical "scores" formerly related by Chisholm and Mason and Chomette et al. Referring to these criteria, only 45% of patients presented a characteristic histopathological pattern. If another complementary criterium, i.e. ductal tropism of lymphoid infiltrates, was added, that percentage remained low (50% only). Thus, these results would suggest the following considerations: the classical histopathological criteria do not seem sufficiently specific; other histological criteria such as ductal lesions previously noted by Leroy et al. must in addition be looked for; thus it would seem to be of considerable value to use in the future complementary quantitative studies by means of morphometric methods.

Diagnosis, Differential↗

[Sarcoid granuloma of the accessory salivary glands. An anatomic study and anatomo-clinical correlations: apropos of 17 cases].

From 228 clinical files of cases with suspected sarcoidosis who had had a biopsy of the accessory salivary glands, 17 cases with both a final diagnosis of sarcoidosis and one or more tuberculoid granulomas. There were 12 women (mean age: 30 years) and 5 men (mean age: 28.5 years) including 3 of Caribbean or African descent. The histopathological examination was performed to determine: 1) the number of granulomas per biopsy, divided into 3 groups: group I, 1 granuloma (n = 1); group II, 2 to 5 granulomas, mean 3.5 (n = 6); group III more than 5 granulomas, mean 12.5 (n = 5); 2) the diffusion of the granulomas within the lobules: 17% of the lobules were involved in groups I and II vs 47% in group III; 3) the size of the granulomas "minimal" (barely identifiable in 3 of 6 patients in group I; rather easily identifiable in all the other patients; 4) the presence of "non-specific" lesions including lymphoid infiltration, epithelial changes. In addition correlations with other clinical parameters of severity and/or duration were evaluated including: involvement of the main salivary glands and/or non-secretory syndrome. The following conclusions were drawn: 1) lesions of the accessory salivary glands is a sign of sarcoid lesions outside the thorax since 16 of the 17 patients had extra-thoracic clinical, biological or anatomic manifestations; 2) there is not however any significant difference in clinical severity between the 3 anatomic "intensity" groups (number of follicules in the accessory salivary glands); 3) both cases of sarcoidosis of recent onset (< 3 months) with Loefgren's syndrome were in group I; 4) the intensity of the specific lesions in the accessory salivary glands was similar to that of the non-specific lesions and can be correlated with the intensity of the main salivary gland involvement, with or without a non-secretory syndrome.

Adult↗

[Undifferentiated carcinomas of the thyroid corpus. Apropos of 10 cases].

Ten undifferentiated thyroid carcinomas detected between 1976 and 1991, were reviewed by means of immunohistochemical techniques. These tumors were highly aggressive with a mean survival rate of three months after the histological diagnosis. They were predominant in women and always occurred in old people (mean age 63.1 years). Four tumours were composed of differentiated trabecular areas. Another one was included in a microvesicular adenoma and a sixth one occurred as a recurrence of a papillary carcinoma surgically treated four months previously. Six tumours were cytokeratin-positive and two of them showed a cytokeratin-vimentin coexpression. These results, like those of an electron microscopic analysis of 1 case, confirm the epithelial origin of these tumours. Undifferentiated carcinomas must be distinguished from poorly differentiated carcinomas and from malignant non Hodgkin lymphomas which have a better prognosis and a different therapeutic approach. The immunohistochemistry and the electron microscopy are useful to identify undifferentiated thyroid carcinomas.

Adult↗

[The value of biopsy of the accessory labial salivary glands for the diagnosis of amylosis].

Diagnosis of amyloidosis depends on the demonstration of amyloid deposits in biopsies using specific stains. Recently, in addition to classical biopsies (kidney, liver, gum, skin, rectal mucosa), labial salivary gland biopsy has been recommended as safe diagnostic method. In our recruitment, it allowed the fortuitous discovery of amyloidosis in three patients suffering from rheumatoid polyarthritis or spondylarthritis. In five other patients (2 cases of familial amyloidosis, 1 dysglobulinemia, 2 primary cardiac amyloidosis), biopsy was performed for systematic search of amyloidosis. In five of these eight cases, a sicca syndrome was associated with the salivary deposits. These deposits were stained with congo red viewed in polarized light and with T thioflavine. Besides, Wright's method allowed to know the AL or AA type of amyloidosis and thus to guide the treatment. On the whole, labial salivary gland biopsy is a highly sensitive method for diagnosis of primary and secondary amyloidosis.

Adult↗

[Heart-lung transplantation. A necropsy study of thirty-seven patients].

Between 1987 and 1992, thirty-seven heart-lung transplant recipients had a postmortem examination at the Pitié-Salpêtrière Teaching Hospital in Paris, France. Except for three patients who survived 2 months, 4 months and 16 months after transplantation, respectively, most patients died in the early postoperative period (mean survival time = 34.6 days). Autopsy disclosed minor acute heart rejection in four patients and minor acute lung rejection in three patients. Five patients had obliterating bronchiolitis that was the cause of death in two cases. Main causes of death included perioperative pleural bleeding, respiratory infection with or without septicemia, diffuse alveolar lesions (adult respiratory distress syndrome and/or pulmonary edema undergoing organization) and multiple organ failure. Hemodynamic and respiratory complications responsible for multiple organ failure in the perioperative period, as well as pre-existing morbid conditions such as cirrhosis of the liver induced by heart failure, may have a major bearing on the outcome of heart-lung transplantations.

Adolescent↗