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M Fourati

Publications and source records attributed to M Fourati.

At least 19 recordsLinked to original sources
PubMed2006

[Panhypopituitarism revealing metastasis of small-cell lung carcinoma associated with sarcoidosis].

Pituitary metastasis and sarcoidosis are two causes of pituitary stalk thickening. Their association has been described ago three decades. In this setting, we report a case of panhypopituitarism revealing pituitary metastasis from a small-cell lung carcinoma associated with sarcoidosis. A 49 year-old smoking patient with type 2 diabetes was admitted for acute adrenal failure with polyuria polydipsia syndrome and a pituitary tumor syndrome. Hormone explorations confirmed anterior pituitary insufficiency. Water restriction revealed central diabetes insipidus. The hypothalamic-pituitary MRI revealed a 1-cm sellar mass with nodular thickening of the stalk. The chest radiograph showed a heterogeneous opacity in the left lung. The thoraco-abdominal scan demonstrated a mass in the left lung highly suggestive of malignancy and many enlarged mediastinal nodes, hepatic nodules, and hypertrophy of the left adrenal. Bronchoscopy was performed three times and showed infiltration of the left bronchial tree but histological examination of the bronchial biopsies was negative for all samples. Ultrasound-guided biopsy of the liver was achieved and histology demonstrated sarcoidosis. The diagnosis of sarcoidosis was incompatible with the deterioration of the patient's general status. Subsequent radiographic explorations showed an increase in the size of the tumor mass and histological evaluation of a scan-guided trans-thoracic biopsy demonstrated small-cell carcinoma. Small-cell lung carcinoma is the most common cancer with pituitary metastasis. The proposed link between sarcoidosis and malignancy has remained controversial but has not been proven false.

Adrenal Gland Diseases↗
PubMed2004

[Adenocarcinoma of the umbilicus].

INTRODUCTION: Most of the umbilical neoplastic processes are metastatic whereas primary adenocarcinoma is scarce and hard to distinguish from a secondary process. Our observation illustrates this difficulty. OBSERVATION: A fifty year-old woman had developed chronic omphalitis over several years. She consulted for a multinodular, erythemato-violine, oozing and deep infiltrating tumor of the umbilicus which had been developing for two months. The anatomopathological exploration of a biopsy of the lesion suggested a clearly differentiated adenocarcinoma whose digestive origin was the most likely. Investigations for a primary neoplasm were negative. Polychemotherapy was efficient with eight months recline. DISCUSSION: Umbilical metastases are referred to as Sister Marie Joseph nodule. They essentially correspond to a metastatic localization of an intra abdominal adenocarcinoma. The major problem consists in distinguishing a Sister Marie Joseph nodule where the neoplasm remains indefinite from an adenocarcinoma developed from an embryonic remainder. The existence in our patient's case history of a chronic omphalitis developing for Years and the negative tests for a primary neoplasm suggest a primary adenocarcinoma of the umbilicus.

Abdominal Neoplasms↗
PubMed2004

[Pemphigoid gestationis: a study of 20 cases].

INTRODUCTION: Pemphigoid gestationis is a bullous autoimmune sub-epidermal dermatosis, occurring during pregnancy and/or postpartum. The objective of our study was to define the epidemio-clinical profile, the histopathological and immunopathological features, the treatment and the course of pemphigoid gestationis in Tunisian patients. PATIENTS AND METHODS: This was a retrospective study concerning the cases of pemphigoid gestationis recorded between 1989 and 2003 in the dermatology department in La Rabta Hospital in Tunis. The patients were included according to clinical, histopathological and immunopathological criteria. RESULTS: We retained 20 patients: 15 multiparae and 5 primiparae. The average age at onset was 29. The first clinical signs appeared in the 3rd trimester in 60 p. 100 of all cases. Clinically, the urticarial patches were noticed in 90 p. 100 of all cases and blisters in 65 p. 100 of the cases. The eruption was located mainly on the trunk and the limbs. The face was affected in 7 cases, the mucous membranes in 3 cases, the palms in 2 cases and the soles in 1 case. Cutaneous histologic examination revealed a sub-epidermal blister in 11 cases and a lymphohistiocyte infiltrate in all cases. Direct immunofluorescence showed a linear deposition of the third component of the complement along the basement membrane zone in all cases. Fetal prognosis was assessed in 13 cases: 1 fetal death, 1 still-born, 3 miscarriages, 1 anencephaly and 2 cases of transit bullous affection in the new-born. DISCUSSION: Our results are similar to those in the literature, but with some particular aspects: the late onset of the pemphigoid gestationis in the course of the 3rd trimester of pregnancy, the frequent involvement of the face and the mucous membranes and the absence of the two main fetal risks: prematurity and hypotrophy. Moreover, we underline the efficiency of topical class I corticosteroids in the treatment of pemphigoid gestationis.

Administration, Topical↗
PubMed2002

[Penetrating keratoplasty in ocular cicatricial pemphigoid].

PURPOSE: Ocular cicatricial pemphigoid (OCP) is a chronic progressive disease characterised by exacerbations of immunologically driven conjunctival inflammation. In the advanced stages of the disease, severe xerosis with mechanical factors may contribute to the development of blinding keratopathy. The authors report two cases of penetrating keratoplasty (PK) in patients with OCP and discuss the modalities of the surgical procedure for this particular disease. METHODS: Two patients with stage III OCP according to Foster's classification, underwent PK. Initial and final visual acuity, indications of PK, surgical procedure, postoperative therapy, and complications were recorded. RESULTS: For the first patient, after 3 months of follow-up, the graft is still clear, with a remarkable improvement in vision (3/10). For the second patient, however, graft rejection developed 15 days after the operation, complicated later by endophthalmitis, which was controlled with an antibiotic. DISCUSSION: The progression of ocular pemphigoid involves the filling of the conjunctival fornices, formation of symblepharon with lagophthalmos, and dry eye, from which blinding keratopathy can originate. A corticosteroid-based or immunosuppressant treatment blocks the progression of the fibrosis but does not get rid of palpebrale or corneal anomalies, making surgery necessary. This surgery generally gives disappointing results and should be planned when the disease is perfectly under control, during a lull in the disease so as to avoid reactivation of the fibrosis process. Reconstruction of the conjunctival fornices should also precede any corneal transplantation. CONCLUSION: These results indicate that PK may be performed to restore of sight in patients with advanced OCP after controlling the primary immunological process and aggressive treatment of the mechanical factors damaging the ocular surface.

Adult↗
PubMed2001

[Effectiveness of conjunctival autograft transplantation in pterygium surgery].

INTRODUCTION: Pterygium is a fibrovascular overgrowth of bulbar cunjonctiva over the cornea and may produce visual impairment. Many surgical techniques and adjunctive therapies have been proposed but recurrence remains frequent. MATERIALS AND METHODS: We report a prospective study of 52 eyes treated by limbal conjunctival autograft for primary and recurrent pterygium. We compare our results with the technique of simple excision performed in 111 cases of pterygium (3 being a recurrent pterygium). RESULTS: The mean age of the patients was 45 years. 30 cases of pterygium were primary (57.7%) and 22 were recurrent (42.3%). After an average follow-up of 14 months, the incidence of recurrence was 10%. Only 2 of these recurrent cases of pterygium were primary. DISCUSSION: Conjunctival autograft is a simple, safe, and highly effective procedure for the treatment of pterygium. It reduces the rate of recurrence more than simple excision (55.9% after a follow-up of 1 year). CONCLUSION: The introduction of limbal conjunctival autograft for the treatment of pterygium meets three main goals: safety, good optical outcome and a lower rate of recurrence. This procedure could be accepted as a successful technique for cases with recurrent pterygium specially in younger patients and when the environment al factors lower the development of recurrent pterygium.

Adult↗
PubMed2001

[Pterygium: surgical treatment].

PURPOSE: The surgical management of pterygium is often complicated by recurrence of disease. The goal of this study was to compare three different surgical techniques used for the treatment of pterygium. METHOD: We propose a prospective and partly retrospective study on 167 cases of pterygium 151 were primary and 16 were recurrent, treated between 1 January, 1995 and 30 June, 1998. The surgical treatment used of 3 different techniques: pterygium excision for 111 eyes, pterygium excision with conjunctival autograft for 29 eyes, pterygium excision with application of mitomycin C for 27 eyes. RESULTS: Immediate results for the three kinds of treatment were good. No serious complications were noted. Long-term results show a recurrence rate of 10.3% for conjunctival autograft, 11.1% for mitomycin C application, while the pterygium excision alone had a recurrence rate of 55.9%. CONCLUSION: This study demonstrated that conjunctival autografting and the application of mitomycin C are safe surgical techniques that reduce the probability of recurrence after surgery for pterygium. They can be recommended for young people and patients exposed to sun. Mitomycin therapy is the most appropriate treatment for these cases, because of its simplicity, lower lost and the relative lack of complication.

Adult↗
PubMed2000

[Effect of scleral indentation on the corneal topography and the axial length after retinal detachment surgery. A prospective study in 30 cases].

INTRODUCTION: Scleral indentation is an essential time in conventional retinal detachment surgery. It enables re-establishing retinal contact and to counterbalance vitreal tractions. It can be circular, segmental or radial. Silicone materials are often used. MATERIALS: In a prospective study, we followed up 30 eyes of patients who underwent retinal detachment surgery. We analyzed changes in corneal surface using differential map of the corneal (induced astigmatism, meridian axial deviation) and change in the axial length of the globe. RESULTS AND DISCUSSION: Follow-up examination showed corneal astigmatism: 2.62 diopter (D) at one week, 2.37D at one month and 1.80D at 3 months. Corneal axis meridians changed: 25 degrees at one week and 18.6 degrees at 2 months. Axial length was also modified. We observed a lengthening: 1.7mm during the first week which remained unchanged at 1.63 after 2 and 3 months. These changes were studied according to the different techniques used in our study and were compared with results reported in the literature. CONCLUSION: We think that conventional retinal detachment surgery causes modifications in refractis (induced astigmatism and axial lengthening).

Adolescent↗
PubMed2000

[Primary malignant paratesticular tumors: report of six cases].

The authors report six cases of primary malignant paratesticular tumors. They reexamine the literature and emphasize the influence of the histopathological type of these tumors on the prognosis. Survival of the patients is better when tumors are differentiated and detected early.

Adolescent↗
PubMed1999

[Blepharitis due to Demodex: myth or reality?].

PURPOSE: Demodex folliculorum has been incriminated in the development of blepharitis although much controversy persists. Certain authors suggest that Demodex is a direct pathogen in chronic palpebral conditions while others consider the saprophyte to be innocuous to skin. METHODS: We conducted a prospective study of eyelashes in 100 persons, searching for Demodex folliculorum and chronic blepharitis. Microscopy in immersion oil after storage in a moist chamber was performed. RESULTS: The incidence of Demodex folliculorum was very high in patients with blepharitis compared with normal controls. Incidence increased with age. Harmless cuffs around the base of the eyelashes was found in 4% with Demodex irradior. CONCLUSION: Demodex should be considered as the cause of chronic blepharitis. Anti-Demodex treatment is indicated when the parasite is found.

Adult↗
PubMed1998

[Childhood plaque milia of the inner canthus].

BACKGROUND: Milia en plaque is an uncommon skin condition usually seen in adult women, typically in the retroauricular region. We report a new localization in a young child. CASE REPORT: A 6-year-old girl with an uneventful history had developed over the last 7 months an erythematous plaque with numerous whitish-yellow microcysts on the left internal canthus. No local or general favoring factor was found. Skin biopsy showed numerous cystic cavities with an epidermal lining containing layers of keratin within a moderately inflammatory infiltration. The lesion resolved after enucleation of the cysts and no recurrence has been observed after 9 months follow-up. DISCUSSION: Milia en plaque is a charateristic erythematous lesion covered with cysts. The usual localization is the retroauricular region, but other localizations have been reported, mainly on the head. This is the first report involving the internal canthus and also in such a young child. One case of a 15-year-old boy has been discribed. Milia en plaque is often a primary condition as in our case although local or general factors may rarely be inductive. Our case illustrates the different localizations possible for milia en plaque, with predominance on the head, and the possibility of childhood cases. We prefer the term milia en plaque rather than retroauricular milia en plaque.

Child↗
PubMed1989

[Thymoma. Anatomo-clinical results apropos of 16 cases].

We report a clinicopathologic study in sixteen patients (11 male and five female) with thymomas. The fairly large proportion of children (3 cases: 12.5%) and significant number of advanced forms may at least partly explain the low survival rate (27% at five years) in our series. Advances in histologic studies of tumors have made possible the accurate diagnosis of thymomas, but the value of a histologic classification is still under debate. Conversely, pathologic and surgical classification is at present the best predictor of outcome.

Adolescent↗
PubMed1988

[Arterial involvement in Behçet's disease].

Ten cases of Behçet's disease with arterial lesions were observed in a series of 500 patients over a period of 12 years. The majority of patients were male (9/10) aged between 24 and 36 years with a mean of 30 +/- 5 years. The first group (3 cases) presented with thrombosis of the radial and superficial femoral arteries, the second group (4 cases) presented with aneurysm of the subclavian artery, common and external iliac arteries, brachiocephalic trunk and abdominal aorta and the third group (3 cases) had a combination of thrombosis and aneurysm of the pulmonary, external iliac and renal arteries.

Adult↗
PubMed1987

[Bronchial carcinoid: anatomico-clinical study. Anatomico-clinical study apropos of 16 cases].

The authors report a clinicopathologic study of 16 cases of bronchial carcinoid in 11 women and 5 men. Histologically, there were 15 cases of typical carcinoid and one case of atypical carcinoid. Typical carcinoids displayed endocrinoid pattern with regular cells. Atypical carcinoid had still recognizable endocrinoid pattern, but with increased cellular pleomorphism and mitotic activity. The argyrophilic stain and the immunohistochemical stain with a monoclonal antibody against cytokeratin were positive in all cases. Typical carcinoid were treated only by surgical resection. One case was treated by conservative bronchial resection and an other by tumoral enucleation. Thirteen were alive disease-free. The remaining patients have been lost to follow up. However atypical carcinoid received an adjuvant chemotherapy, but he died 4 months after pneumonectomy.

Adolescent↗