[Maxillary cementoblastoma. A case report]. / Cémentoblastome maxillaire. A propos d'un cas.

Cementoblastoma is a rare benign odontogenic neoplasm. Its cause is unknown. It represents less 6 % of all odontogenic tumors. The aim of our work is to present a rare case of maxillary cementoblastoma involving an included central incisor. A 32-year old man consulted for a left maxillary swelling to projection under nostril. A panoramic radiographic examination revealed an included tooth 21 with a radiopaque lesion around its root. The computed tomography revealed the included tooth 21 with a process around its root. This process is well-defined, high-dense and is surrounded by a radiolucent halo. The treatment should consist of complete removal of the lesion with the tooth 21. Histological examination concluded to the diagnosis of a cementoblastoma. The cementoblastoma occurs most frequently in young persons and predominantly among men. The mandibular premolar and molar are the more frequently reached. The maxillary localization remains rare. This tumor occurs around the roots of the posterior and lower teeth. Radiographically, the lesion is well-defined and attached to the root of the tooth, radiopaque dense and surrounded by a radiolucent halo. The cementoblastoma evolves slowly and has the tendency to blow the cortical. The prognosis is good.

[Comparison of scanners and porto-scanners, both in helical mode, for the study of hepatic metastases. Prospective study in 12 patients]. / Comparaison du scanner et du porto-scanner, tous deux en mode hélicoïdal, pour l'étude des métastases hépatiques. Etude prospective chez 12 malades.

PURPOSE: The aim of this study was to compare helical CTAP and helical CT-scan in the preoperative assessment of liver metastases. METHODS: A prospective unicentric study in 12 patients was performed with helical CTAP and helical CT-scan. All patients underwent partial hepatectomy with intraoperative palpation and sonography within 19 days (mean: 9 days). RESULTS: Examination of resected liver specimens found 38 metastases, from colorectal cancer in 36 cases. The sensitivity was 92.1% for helical CTAP and 79% for helical CT-scan. This sensitivity was 85% for helical CTAP and 60% for helical CT-scan for nodules 1 cm or less in diameter (P = 0.08). CONCLUSION: In the preoperative screening of liver metastases, helical CT-scan should be performed as the first choice examination. When hepatic lesions seem to be curable by resection based on helical dynamic CT-scan results, helical CTAP should be performed to increase the sensitivity of detection of lesions 1 cm or less in diameter.

[Centrosomatic spinal tuberculosis: radiographic features in 10 cases]. / Tuberculose rachidienne centrosomatique: aspects radiologiques. A propos de 10 cas.

We report a series of 10 cases of centrosomatic tuberculosis of the spine. The mean age of the patients was 36 years. Plain x-rays of the spine showed isolated defects in 3 cases, a defect with wedge fracture in 3 and a wedge fracture alone in 2. A sequestrum was found in 2 cases and bony condensation around the defect in 6. A CT scan performed in 3 cases showed, in addition to the bone lesions, a perilesional bony condensation in all cases. Soft tissue abscess formation was noted in 1 case and epidural involvement in the 2 others. MRI performed in 2 cases evidenced an alteration of the vertebral body signal with localized anterior epiduritis at the site of a small epidural abscess. CT scan and MRI contribute usefully to the radiographic diagnosis of centrosomatic tuberculosis, evidencing sequestra, bony condensation at the periphery of defects, and the presence of soft tissue abscesses and or epidural involvement. When these signs are absent, the differential diagnosis may be difficult with other causes of tumor formation, requiring vertebral biopsy.

[Intracranial hydatid cyst: contribution of scanography]. / Kyste hydatique cérébral. Apport de la scanographie.

We reviewed 14 cases of intracranial hydatid cysts, describing the clinical features and radiographic findings. The clinical presentation was dominated by signs of increased intracranial pressure and neurological manifestations. Diagnosis was established on the basis of CT findings, most valuable as a diagnostic tool.

[Cavernous sinus dermoid cyst with unusual parapharyngeal development]. / Kyste dermoïde de la loge caverneuse à développement inhabituel parapharyngé.

We report a case of dermoid cyst arising in the cavernous sinus and parapharyngium areas through the foramen lacerum. A 12-year-old girl was hospitalized in October 1966 for progressive intracranial hypertension. CT before a prior surgical intervention in 1994 showed an intracranial process suggesting a dermoid cyst. CT performed in October 1996 showed a temporal process at the left side measuring 8 cm x 5 cm and well circumscribed with a thin wall. This process extended towards the parapharyngium area through the foramen lacerum. The exocranial part measured 4 cm in diameter. The density of the process strongly suggested a mature dermoid cyst with fatty and calcium components. The histology study confirmed the diagnosis of dermoid cyst. The frequency of intracranial dermoid cysts is 2 to 3 times less than that of epidermoid cysts. This is an uncommon process accounting for 1% of intracranial tumors occurring in children. In the sustentorial spaces, the process occurs more frequently in the parasellar area. To our knowledge, exocranial extension has not been reported to date.

[Thrombosis of the superior vena cava in Behçet's disease. Apropos of 13 cases]. / Thrombose de la veine cave supérieure au cours de la maladie de Behçet. A propos de 13 cas.

The author reports 13 cases of Behçet's disease with thrombosis of superior vena cava. The thrombosis of superior vena cava achieve to superior cava syndrome. In all cases, the X ray of the chest showed a discreet widening of the superior mediastinum related to collateral circulation confirmed by angiography. The thrombosis interest the brachial veins in 9 cases. The analysis of the results point out to the importance of the chest X ray in orientating the diagnosis. The etiological diagnosis is always clinical.

[Ultrasonography in the diagnosis and treatment of psoas abscess. Apropos of a study with 30 patients]. / Apport de l'échographie dans le diagnostic et le traitement des abcès du psoas. A propos d'une étude portant sur 30 patients.

The abscess of psoas are more often secondary to a loco-regional cause. The authors report a series of 42 abscess of psoas in 30 patients during 3 years. It concerns 16 men and 14 women witch a mean age of 35 years. The abscess was secondary to a spondylodiscis in 25 patients and primary in 5 patients. The size of the abscess was upper 5 cm with a variable ultrasound structure: liquid in 33 cases, hypoechogenic in 9 cases. All patients underwent a percutaneous treatment guided by ultrasonography. A single or multiple evacuation puncture with 16 Gauge needle were performed for 40 abscess. Complementary percutaneous drainage with 14 french drain was used in 3 cases. In 2 other cases, the percutaneous drainage was used firstly. The bacteriological study of puncture liquid isolated the germ in 8 cases. Evaluation has been assessed in only 29 cases. The recovery was reached in 12 abscess on 15 which were treated by a single puncture. In 10 abscess on 13 treated by multiple puncture; and in 4 abscess an 5 managed by drainage. The results demonstrate the accuracy of single or multiple drainage puncture associated with adapted antibiotherapy in the management of abscess.

[Ultrasound-guided transparietal thoracic puncture biopsy]. / Les ponctions biopsies thoraciques transpariétales échoguidées.

UNLABELLED: Transthoracic needle biopsy is a reliable method for the diagnosis of thoracic lesions, specially when they are peripleral. AIM: The main objective was to evaluate the results of US guidance for thoracic needle biopsy in 159 cases. RESULT: Overall sensitivity was 83% as tissue was obtained in 132/159 cases. In 24 cases, 2 or 3 biopsies were necessary. In 17 cases, analysis was made on cytology only with a 70.6% sensitivity. One pneumothorax and two cases of hemoptisies were encountered. COMMENTARY: US guidance is a useful method for the diagnosis of peripheral thoracic masses, yielding a high sensitivity and a very low complication rate.

[Percutaneous treatment of liver abscess. Apropos of 34 cases]. / Apport du traitement percutané dans les abcès du foie. A propos de 34 cas.

The authors report on a retrospective series of 37 liver abscesses treated via the percutaneous route in 34 patients, in order to assess the efficacy of this method. One or more aspiration punctures were undertaken in 24 patients (70.6%), while percutaneous drainage was performed in 10 patients (29.4%). In 27 cases (79.5%), this percutaneous treatment resulted in a cure. Further surgical drainage, carried out in 7 patients (20.5%) was only required in 3 cases, twice due to the inefficacy of percutaneous drainage and once in the presence of three liver abscesses containing particularly thick pus. Ultrasonographic monitoring demonstrated a return to normal in 66.6% of cases, the persistence of a slight residual collection in 26.6% patients and one relapse, two months after percutaneous drainage. Two complications inherent to the percutaneous treatment were noted: a pneumothorax and a case of septicemia, both of which had a favourable outcome.

[Radiological aspects of ileocecal tuberculosis. Apropos of 31 cases]. / Aspects radiologiques de la tuberculose iléo-caecale. A propos de 31 cas.

The radiological diagnosis of ileo-cecal tuberculosis is based on the analysis of various and polymorph semiological signs. The authors report a series of 31 cases of ileo-cecal tuberculosis. The concomitant involvement of the ileum and the cecum il up to 61.2% of all cases. The associated peritoneal involvement is observed in 35.4% of the cases. The hypertrophic form is the most common (57%) and the ulcero-hypertrophic form in 43% cases. The observation of ileum short stenosis, valve attempt, cecum retraction, and associated peritoneal involvement is in favour of the ileo-cecal tuberculosis origin.

[Percutaneous treatment of abdominal collections. Apropos of 135 cases]. / Traitement percutané des collections abdominales. A propos de 135 cas.

The authors reviewed 135 abdominal collections, collected at the Radiologic Central Service over four years. The average age of the patients was 40 years. The abscesses sit especially in the liver (54 cases) and the psoas muscle (43 cases). The percutaneous management was guided by ultrasonography in all the cases. The results were successful in 74%. Only 15 cases needed surgical therapy. The literature results are similar. The authors underline the percutaneous treatment interests, its efficacy, its complications and their therapy.

[Malignant stromal tumors of the small intestine: report of 9 cases]. / Les tumeurs stromales malignes du grêle: à propos de 9 cas.

PURPOSE: Analysis of imaging features of malignant stromal tumors of the small bowel and review of literature. MATERIAL AND METHODS: 9 cases of malignant stromal tumor of the small bowel with histological proof were imaged at US (8 cases), small bowel series (9 cases) and CT scan (3 cases). RESULTS: There were 6 cases of leiomyosarcoma and 3 cases of malignant schwannoma. Tumors involved the jejunum in 3 patients, the ileum in 4 patients, and the duodenum in 2 patients. The main clinical presentation was an abdominal mass (8 cases), which appeared heterogeneous and hypoechoic with eccentric lumen at US confirming its GI origin (7 cases). Small bowel series showed a bulky cavitary mass opacified via a thin fistula (7 cases), an ileo-ileal intussusception (1 case) and enlarged duodenal lumen (1 case). CT performed in 3 cases showed an intraperitoneal mass with soft-tissue density. A communication with the GI tract was noted in 1 case, and in another case, it showed an intestinal intussusception. US guided biopsy performed in 3 cases provided diagnosis in 2 cases (malignant schwannoma, leiomyosarcoma). Tumor growth was exophytic in 8 cases and dumbbell-shaped in 1 case. CONCLUSION: The imaging features of malignant stromal tumors of the small bowel are similar. It varies with the type of tumor growth and its size. The diagnosis may be suggested based on imaging features.

[Mesenteric infarction secondary to antithrombin III deficiency]. / Infarctus mésentérique secondaire à un déficit en anti-thrombine III.

AT III is a physiologic inhibitor of blood clot formation: its deficiency is manifested by venous thrombosis. The authors reported case of mesenteric venous infarction in a 42-years-old woman. AT III deficiency was transient and caused by an oral contraceptive. In patients with AT III acquired deficiency it is necessary to suppress any risk factors of venous thrombosis.

[Diffuse infiltrative lung disease in scleroderma. Analysis of radio-clinical and functional semiology]. / Pneumopathie infiltrante diffuse (PID) de la sclérodermie. Analyse de la sémiologie radioclinique et fonctionnelle.

Scleroderma (SD) is a systemic disease that predominantly affects the skin. Diffuse infiltrative lung disease (DILD) is rare and occurs most often in the course of the disease. We analyzed seven cases of DILO of SD recorded between 2003 and 2010 among 196 PID (3.6%). Functional signs were limited to respiratory dyspnea, it was associated to dysphagia in six cases, dry syndrome in five cases and Raynaud's phenomenon in four cases. Clinical examination found crackles in the bases of the thorax in all cases and specific cutaneous signs in six cases. The chest radiograph showed that interstitial disease predominates at the lung bases in all cases with a large aspect of the pulmonary arteries in two cases. The chest CT scan confirmed the predominance of basal and peripheral damage with signs of fibrosis in six cases. The pulmonary function objectified a severe restrictive ventilatory defect in all cases. Bronchoscopy showed a normal macroscopic appearance in all cases, the broncho-alveolar lavage was predominated by neutrophilic formula in four cases. SCL 70 antibodies were positive in four cases. All patients were treated by steroids with improvement of dyspnea and stabilization of radiographs. A patient had died in an array of acute respiratory failure and one patient was lost to follow-up. DILD in scleroderma is rare and seldom reveals the disease, it affects the patient's prognosis especially when associated with arterial pulmonary hypertension.

[An uncommon cause of dyspnea in children. Plexiform neurofibroma of the larynx]. / Une cause rare de dyspnée: neurofibrome plexiforme du larynx.

Plexiform neurofibroma is a rare benign tumor developed from cells of the sheath of Schwann peripheral nervous system often associated with neurofibromatosis type 1 or Von Recklinghausen disease. Laryngeal involvement in neurofibromatosis is rare and usually presents with obstructive respiratory symptoms. Imaging including CT and MRI provides the diagnosis as well as the staging of this lesion, whose treatment is primarily surgical. We report the case of a plexiform neurofibroma of the larynx found in a 4-year-old child revealing a mass completely obstructing the laryngeal vestibule.

[Pott's disease (about 16 cases)]. / Mal de Pott (à propos de 16 cas).

INTRODUCTION: Pott's disease or spinal tuberculosis is rare, but represents the most common form of osteo-articular tuberculosis in endemic countries. MATERIAL AND METHODS: [corrected] From January 2000 to December 2010, we collected 16 cases of Pott's disease. We analyzed clinical and radiological profile, means of confirmation and treatment. RESULTS: Spinal and chest pain were the most frequent signs. Four patients had neurological signs. The diagnosis was made by the detection of bacillus in the pus of paravertebral abscess in six cases, by histological study of vertebral biopsy in five cases, biopsy of another associated lesion in one case and in front of radio-clinical arguments with good clinical evolution under antibacillary treatment in four cases. The antibacillary treatment associating four drugs was indicated and correctly followed by all patients. Surgical drainage was associated in five cases. The evolution was good in all cases. DISCUSSION: Diagnosis of Pott's disease is late when there is no neurological sign. Imaging allows to make early diagnosis with MRI. Prognosis is good when treatment is started early.

[Malignant pilomatrixoma of head and neck. A case report]. / Le pilomatricome malin cervical métastatique : à propos d'un cas.

We report the case of a 66-year-old patient with a pilomatrix carcinoma from the right submandibular region with pulmonary and cerebral metastases. The histological confirmation of the diagnosis has been based on the biopsy of the submandibular tumefaction which was rapidly growing. We tried at first a doxorubicine and cisplatine chemotherapy because of the considerable locoregional extension and the existence of pulmonary metastases. The patient response to three cures of chemotherapy was spectacular with a partial clinical response (75%) and a partially cleaned-up chest observed in the radiological evaluation. In the 5th cycle of chemotherapy following the same protocol, the patient presented a relapse with cerebral metastases. The patient received hypofractionated radiotherapy on the brain followed by etoposide and cisplatine chemotherapy, then oral vinorelbine. The patient died of progressive disease after 32 weeks.