[Ectopic intraspinal extradural anaplastic ependymoma in an infant]. / Ependymome anaplasique ectopique intrarachidien extradural chez un nourrisson.

BACKGROUND: Ependymomas represent about 10% of the spinal tumors in children. Some of them may be unusually located. CASE REPORT: A 10-month-old boy was admitted for an abdominal mass syndrome with dehydration asthenia and acute bladder dysfunction. A few hours later, he developed a flaccid paraplegia. Ultrasonic and magnetic resonance spinal imaging showed a giant intraspinal tumor extending from T9 to IA level, posteriorly located to the dural compartment, widening the spinal cord. Ultrasonography also showed right ureterohydronephrosis due to the neurological bladder dysfunction. A conservative laminotomy-laminoplasty was performed in emergency. Total removal of the tumor that was attached to the right dorsal root was achieved extradurally, requiring resection of the proximal part of the root. Histological features were typical of malignant ependymoma. Chemotherapy was initiated 2 weeks later. The severe renal destruction and the persistent bladder dysfunction led to a heminephrectomy and a cystostomy, 3 weeks later. The neurological recovery was only partial with a follow-up of 18 months. CONCLUSION: Ectopic intraspinal extradural localization of ependymomas is rare and their development from a nerve root is exceptional.

[Is Stewart's malignant midline granuloma a peripheral T-cell lymphoma? Apropos of 5 cases]. / Le granulome malin centro-facial de Stewart est-il un lymphome T périphérique? A propos de 5 observations.

Midline granuloma includes diverse clinicopathological entities, such as Wegener granulomatosis, polymorphic reticulosis, lethal midline granuloma and conventional malignant lymphoma of the nose usually of B-cell origin. The authors describe five patients with LMG clinically and pathologically typical. Using an extensive panel of monoclonal antibodies, they demonstrate an "activate" T-cell phenotype observed on the initial lesion of the face in one patient, similar to that found in two patients with LMG but studied after dissemination in peripheral T-cell lymphoma. Furthermore, many atypical cells were found in LMG, and stained with the Ki-67 monoclonal antibody, a marker of proliferating cells. These findings support the view that LMG is closely related to T-cell malignancies. Two of them were treated with recombinant Interferon alpha 2a followed by a response rapidly objective. Immunohistologic studies are very important for confirming the T-cell origin of such a disease and for selecting patients to be treated with Interferon alpha.

[Anatomo-clinical study in severe head injury (author's transl)]. / Etude anatomo-clinique du syndrome de traumatisme cranien grave.

Fourty-one cases have been studied, using the research of 10 brain stem reflexes, leading to define 6 levels of axial disturbances. The anatomical post-mortem findings allowed the authors to assume that primary brain stem damages are scarcely found (4 p. 100), as compared with diffuse brain damage (93 p. 100). The amount of supratentorial diffuse lesions seems to be the most important factor to determine the level of axial disturbance: the larger supra-tentorial lesion the lower brain stem dysfunction level. The authors emphasize the special value of corneo-pterygoidal reflex as a borderline in the rostro-caudal deterioration process of theCNS, following severe head injury.