[Soft tissue metastasis revealing an asymptomatic bronchial adenocarcinoma]. / Métastase musculaire squelettique révélatrice d'un adénocarcinome bronchique.

Skeletal muscle metastases from non-small-cell lung cancer are uncommon. We report a case of lung adenocarcinoma disclosed by metastatic dissemination to a forearm muscle. A 46-year-old man consulted for a painful mass of the right forearm. Ultrasonography and computed tomography revealed a heterogeneous collection in the forearm invading the cortex of the humerus. An excisional biopsy of the right forearm showed an infiltration of the muscle with metastatic adenocarcinoma. Immunohistochemical patterns suggested the pulmonary origin. Chest x-ray was normal. Bronchoscopy revealed an endobronchial mass that was confirmed by biopsy to be an adenocarcinoma. The lung tumor was staged T2N0M1. The patient has received local radiation therapy and chemotherapy. After eighteen months, the disease progressed but without local muscular recurrence. Skeletal muscle metastases from lung cancer are rare and although their prognosis is poor, local treatment may be worthwhile.

[Vermian epidermoid cyst revealed by head injury]. / Kyste epidermoide vermien revele par un traumatisme cranien.

Vermian epidermoid cyst developing in the fourth ventricle is very rare. We report a case observed in a 24-year-old man, who presented severe headache, dizziness and a blurred vision following head injury. Examination revealed a discrete gait disturbance. Cerebral CT-scan showed a large hypodense lesion of the posterior fossa without contrast enhancement. MRI demonstrated the vermian location of this lesion which displaced the roof of the fourth ventricle upward and the brainstem forward. A suboccipital approach allowed total removal of a well-encapsulated epidermoid cyst, non adherent to the floor of the fourth ventricle. The postoperative course was uneventful.

[Isolated synovial chondromatosis of the subacromial bursa: report of a new case and review of the literature]. / La chondromatose synoviale isolée de la bourse sous acromiodeltoïdienne: un nouveau cas et revue de la littérature.

Synovial chondromatosis is a rare metaplasia of the synovium of unknown etiology that may involve occasionally the subacromial bursa. We report a new case diagnosed by ultrasound in a 30-year-old man and we present pathogenetic, diagnostic and therapeutic features of this disease with a literature review.

[Calcification following intradiscal injection, a continuing problem?]. / Calcifications post-nucléorthèse, un problème toujours d'actualité?

INTRODUCTION: Intradiscal injection of triamcinolone hexacetonide, used to treat sciatica caused by herniated discs was discontinued after discovery that it was followed in some cases by epidural calcification. OBSERVATION: Ten years after an intradiscal injection at L4-L5, a 40 year-old man developed voluminous perivertebral, bilateral foraminal and intraductal calcifications that compressed the dural sheath. After preliminary excision, these calcifications recurred and required further excision, followed by posterior lateral grafting and osteosynthesis. DISCUSSION: Calcifications following intradiscal injections are symptomatic in 14 to 68% of cases. They require radical surgical treatment to avoid recurrence.

[Primary pulmonary angiosarcoma]. / Angiosarcome pulmonaire primitif.

Pulmonary angiosarcoma is an uncommon vascular and usually secondary tumor. Only a few primary cases of pulmonary angiosarcoma have been described. We report a case of primary pulmonary angiosarcoma in an adult man who presented with hemoptysis. Chest x-ray film and chest CT showed a right para-cardiac opacity associated with diffuse alveolar consolidation of the right basal lobe. Right inferior lobectomy has been performed. Pulmonary angiosarcoma was diagnosed on histological and immuno-histochemical studies of the operative specimen. The primitive character was retained after ruling out all other tumor localizations. The clinical outcome was rapidly fatal. This observation is added to the other rare cases published of primitive pulmonary angiosarcoma. It confirms the poor prognosis and the extremely hemorrhagic nature of this tumor. Isolated necrotic parenchymatous mass was an original radiological pattern observed in this patient.

[Carpal scaphoid chondroma complicated by fracture: a case report]. / Chondrome du scaphoïde carpien compliqué d'une fracture: à propos d'un cas.

The carpal scaphoid is an uncommon localization for chondroma. Ten cases have been reported in the literature. We report a new case of right carpal scaphoid chondroma complicated by fracture in a 30 year-old man. The diagnosis was strongly suggested by the computed tomography scan and confirmed at pathology examination of the operative specimen. Treatment consisted in tumor enucleation and a cortico-cancellous graft to fill the gap followed by plaster case immobilization. Clinical and radiological outcome was favorable.

[Gastro-epiploic lymphangioma. A case report]. / Lymphangiome gastro-épiploïque. A propos d'un cas.

The authors report a case of a gastro-epiploic lymphangioma in a 29-year-old male patient presenting with epigastric cramps. Physical examination was normal. Ultrasound and abdominal CT-scan showed a cystic mass under the left lobe of the liver containing fine septations and extending to the lesser sac. At surgery, a large cystic mass was found, situated around the celiac trunk. It was adherent to the lesser curvature of the stomach and posterior surface of the antrum and extended to the lesser sac. Excision of the mass and antrectomy were performed. Histologic examination was consistent with a diagnosis of cystic lymphangioma.

[A symptomatic choroid plexus cyst in the lateral ventricle]. / Kyste symptomatique du plexus choroïde du ventricule latéral.

Choroid plexus cyst is generally small and a relatively common finding at autopsy. Huge and symptomatic cysts are rare. Few cases are reported in the literature. We report one case of symptomatic choroid plexus cyst of the right lateral ventricle in a six month baby who presented with epilepsy. Cerebral CT scan and MRI showed a large cyst in the right lateral ventricle compressing the adjacent structures. Total removal of the cyst has been performed by a parieto-temporal approach. The course was uneventful.

[Giant lobar emphysema. The cause of a compressive hemithoracic opacity in a newborn infant]. / Emphysème lobaire géant. Cause d'une opacité hémithoracique compressive chez le nouveau-né.

The authors describe a case of congenital lobar emphysema of the upper right pulmonary lobe discovered at birth with an opaque hemithorax and a shift of mediastinum. The diagnosis was confirmed by a CT-scan. A lobectomy was performed at 6 weeks of age. The different diagnosis and physiopathological mechanisms are discussed.

[Amebic brain abscess. Apropos of a case]. / Abcès cérébral amibien. A propos d'un cas.

We report a case of double primary amoebic brain abscess in a 22 year old man, with signs of intracranial hypertension and deficit. Computed tomography found two hypodense lesions, not suggestive of pyogenic abscesses. Aspiration of one of the two abscesses, revealed the organism, and the two abscesses regressed in response to medical treatment. The authors insist on the rarity of these abscesses, their gravity, and the difficulty of the diagnosis.

Cerebral candidiasis. Computed tomography appearance.

A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodeficiency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature.