[Desmoplastic small round cell tumour of the pancreas with breast metastasis]. / Tumeur desmoplastique à petites cellules rondes du pancréas avec métastase mammaire.

Desmoplastic small round cell tumour (DSRCT) is a very rare, highly aggressive neoplasm. Most cases have been reported in adolescent and young male patients. These tumours occur mainly in the peritoneal cavity, with peritoneal and lymphatic dissemination. Their histologic features are unspecific and immunohistochemistry and cytogenetic or biomolecular techniques are required for their diagnosis. Involvement of the pancreas is exceptional and is difficult to differentiate from other pancreatic primary tumours. We report here the case of a 49-year-old woman who had a DSRCT of the pancreas with metastasis to the breast. She died within one year after the diagnosis despite an aggressive surgical strategy.

[Sudden bilateral hearing loss disclosing meningeal carcinomatosis]. / Surdité brusque bilatérale révélatrice d'une carcinomatose méningée.

We report the case of a patient presenting a sudden bilateral hearing loss. Four years before, a bladder carcinoma was resected and a chemotherapy was started. Gadolinium-enhanced magnetic resonance images revealed enhancement of both acoustic nerves. Cerebrospinal fluid analysis showed malignant cells consistent with the initial bladder cancer. Meningeal metastases from bladder carcinoma are extremely rare. Systemic chemotherapy and its low meningeal diffusion may enhance the incidence of this complication. Bilateral hearing loss is a rare initial manifestation of meningeal carcinomatosis.

Hyperenteroglucagonaemia and small intestinal mucosal growth after colonic perfusion of glucose in rats.

Beside intraluminal factors, humoral agents play an important role in intestinal adaptation. Enteroglucagon, the mucosal concentration of which is maximal in the terminal ileum and colon, is the strongest candidate for the role of small intestinal mucosal growth factor. The present experiment was designed to study the role of colonic enteroglucagon in stimulating mucosal growth in rats with a normal small intestine. After eight days of glucose large bowel perfusion, enteroglucagon plasma concentrations were 120.7 +/- SEM 9.2 pmol/l, versus 60.1 +/- 6.8 in mannitol perfused control rats (p less than 0.001). Gastrin, cholecystokinin, neurotensin, pancreatic glucagon, and insulin plasma concentrations were unchanged. Crypt cell proliferation, measured by the vincristine metaphase arrest technique, increased significantly in the small intestine of glucose perfused animals (p less than 0.005-0.001) in comparison with the controls. This resulted in a greater mucosal mass in both proximal and distal small bowel: mucosal wet weight, DNA, protein and alpha D-glucosidase per unit length intestine were all significantly higher (p less than 0.05-0.001) than in mannitol perfused rats. Our data, therefore, support the hypothesis that enteroglucagon is an enterotrophic factor and stress the possible role of the colon in the regulation of small bowel trophicity.