Biomedical subjects
Publications and source records attributed to M Benameur.
Bone metastases in the hand and foot bone (acrometastases) are rarely observed. The authors report a case of a 57-years-old man diagnosed as hand tumour, revealing a bronchic adenocarcinoma. Radiography showed destruction of the phalanx, and histology study confirmed a metastasis of the lung cancer.
Tuberous sclerosis is a phakomatosis with central nervous system manifestations characterized by 4 lesions detectable on neuro-imaging: tubers, white matter abnormalities, subependymal nodules and subependymal astrocytomas. The first three are benign lesions composed of by identical cytological lesions varying only in size and location. At CT, enhancement of subependymal nodules is usually considered as evidence of transformation to subependymal giant cell astrocytoma. This latter poses the problem of its relative benignity: hydrocephalus source of morbidity or even mortality. From a series of 22 cases, the authors review the characteristics of these abnormalities.
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The authors report the case of a 40 year old patient with history of cauda equina syndrome and pyramidal signs due to intramedullary rupture of a congenital dermoid cyst of the conus without associated spinal dysraphism. Diagnosis was suggested at magnetic resonance imaging (MRI) and confirmed by histological examination and percutaneous aspiration of the intramedullary cavity.
INTRODUCTION: Among the extra-pulmonary localizations, isolated tuberculosis of the sternum is rare and difficult to diagnose. OBSERVATIONS: A 30 year-old man presented with tumefaction of the sternum that had developed over the past two months and a 52 year-old woman had developed a painful tumefaction of the sternum over the past 4 months. In both cases, the histopathological examination of a biopsy confirmed the diagnosis of tuberculosis. Anti-bacterial therapy permitted the favourable progression of the disease. DISCUSSION: Such diagnosis is rare. Contamination can occur through contiguity, which was not manifest in either of the two cases. Confrontation between the histological and/or bacteriological samples is required.
Rhino-orbito-cerebral mucormycosis is a rare fungal infection, invading rapidly the nasal cavity, paranasal sinuses, orbits and intracranial structures. It most often occurs in predisposing conditions (diabetics, immunosuppressed patients). The authors report the case of a diabetic patient who presented with extensive necrotic lesions of the face in spite of appropriate antistaphylococcic therapy. Diagnosis was confirmed by histologic and mycologic tests. The outcome was favorable after Amphotericin B therapy, daily debridement, and optimal control of the diabetes.
Isolated tuberculosis of the spleen is rare and difficult to diagnose. The features and management of this disease are discussed based on one case. A 52-year-old woman, presented with fever of unknown origin and splenomegaly. Ultrasonography and computed tomography demonstrated heterogeneous areas within the spleen. The diagnosis was made by a pathologic study of a splenic fragment obtained during laparotomy. When the spleen is the only organ involved by tuberculosis, the diagnosis is usually made by a pathologic study of splenic tissue obtained during laparotomy or percutaneous needle biopsy.
Hemangioma is an uncommon bone neoplasm that usually affects the craniofacial bones and spine, accounting for less than 1% of all primary bone tumors. The authors report a case of isolated hemangioma involving the proximal humerus in a 22-year-old man. Radiographically, the lesion was a well-defined osteolytic process with marginal sclerosis. The CT images demonstrated an osteolytic lesion with coarse trabecular pattern and partial cortical breakthrough. Magnetic resonance imaging showed a multilocular and hemorrhagic lesion with fluid-fluid level, that was suggestive of aneurysmal bone cyst.
Renal sinus hematoma is a rare complication of anticoagulant therapy. Prognosis is usually excellent with spontaneous regression. The authors report a case of spontaneous bilateral renal sinus hematoma in a 59-year-old woman, treated by anticoagulants for a cardiac disease. Diagnosis and follow-up are made using computed tomography.
Radiological, computed tomography and magnetic resonance imaging findings in a case of spinal hydatidosis are reported.
To evaluate the ventilatory consequences of high chest wall compliance during anesthesia in infants, we assessed the effects of halothane at different fractions of minimal alveolar concentration (0.75, 1.0, and 1.5 MAC) on ventilation and movements of the rib cage and abdomen in infants < or = 12 mo of age (group I) and children (group II) > or = 12 mo of age. Minute ventilation decreased in group I, (20.6%, 0.75 to 1.5 MAC), but the change in group II did not reach the level of statistical significance. Tidal volume decreased with halothane level between 0.75 and 1.5 MAC, and its fall was greater in group I (32.7 +/- 11.2 vs. 22.6 +/- 9.3% in group II, P < 0.05). Duty cycle, or ratio of inspiratory to total time (TI/TT), increased in group II with halothane level but did not change in group I, resulting in a decreased TI in group I at higher halothane levels. Thoracic paradox increased with halothane level in group I but not group II. The increase in thoracic paradox in association with the fall in tidal volume between 0.75 and 1.5 MAC was greater in group I than group II (P < 0.05). We conclude that smaller infants depend more on inspiratory intercostal muscle activity to stabilize the thorax, leading to a greater degree of depression of ventilation during halothane depression of inspiratory intercostal activity.
A case is reported of acute acalculous cholecystitis in a patient who suffered a digestive burn treated by total parenteral nutrition. Pain in the right upper abdominal quadrant and fever occurred 26 days after the start of parenteral nutrition and 24 h after abruptly resuming oral feeding. Ultrasonography showed a distended gall-bladder with a thickened wall and the formation of sludge. Cholecystectomy was followed by a complete recovery. The part played by each of the corrosive burn, the total parenteral nutrition and the abrupt resumption of oral feeding in the pathogenesis of this complication is reviewed.
Cowden's disease is a phacomatosis (multiple hamartomas), which is a familial, hereditary, dominant autosomal affection presenting as typical buccolabial mucocutaneous lesions associated with digestive tract polyps. Differential diagnosis of the predominantly digestive form of the disease is polyposis. A new case of this rare disorder is reported, only 62 cases being documented in literature.
The authors report a case of ruptured renal artery aneurysm in a 78 year old patient presenting with macroscopic hematuria. The rare occurrence of this entity and the value of imaging for diagnosis are discussed.
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The authors report a case of abdominal pregnancy that reached term. This type of pregnancy is now rare except in developing countries due to lack of early diagnosis. Ultrasonography is useful to confirm a clinically suspected diagnosis. MRI is helpful to further characterize the relation between placental tissue and intra-abdominal organs. Prognosis for the fetus is usually poor, and risks to the mother are non-negligible. Management is typically surgical and placental resection is the main concern. In this case, surgical delivery of an otherwise normal appearing infant was performed.
The authors report a new observation of Köhler's disease. Since Köhler's description in 1975, 40 observations have been noted. It concerns a particular entity characterized by a hyperostosis usually bilateral sternocosto clavicular able to associate other osseous lesions and cutaneous eruptions. Its etiology remains unknown.