[Peritoneal splenosis simulating a right retroperitoneal mass]. / Splénose péritonéale simulant une masse rétropéritonéale droite.

We report a case of an incidentally diagnosed apparently isolated splenosis nodule located in the hepatorenal peritoneal recess. According to imaging features, this mass was a non-renal retroperitoneal tumor. In spite of the isolated location, the history of splenic rupture should have led to a heat-damaged red blood cell scintiscan and would thus have avoided percutaneous biopsy.

[Food preferences in anorectic girls at the beginning of therapy]. / Etude des préférences alimentaires chez la jeune fille anorexique au début de la prise en charge thérapeutique.

To determine the eating habits of patients with anorexia nervosa, we compared a group of 21 anorectic girls satisfying DSM-III-R criteria (A: 19 +/- 6.6 years; 14.2 +/- 2 kg/m2) with 30 control girls (C: 19.8 +/- 3.3 years; 20.9 +/- 4.4 kg/m2). A standardised form listing 226 food items was used to assess their food preferences. For each food category except vegetables and fish, the medium rate of positive appreciation was lower in group A than in group C. However, a positive correlation was found between the two groups (except for dairy and diet products), showing no major distortion of taste in group A. Anorectic girls generally discarded the sweetest fruit and the fattest meats, but sometimes chose to eat high-calorie food, possibly because of its supposed nutritional value. Their dislike for so-called "light" products was also apparent. Moreover, no regressive tendency to childish choices was found in their eating habits. It is concluded that group A displayed a narrowed food field, but without distortions of taste.

[Diabetes insipidus disclosing metastasis of breast adenocarcinoma]. / Diabète insipide révélant une métastase d'un adénocarcinome mammaire.

We are reporting on a case of diabetes insipidus (DI) and anterior pituitary failure revealing a breast cancer metastasis. Ten years after being diagnosed with a unilateral breast cancer, the patient presented with asthenia, thirst, polyuria and nocturia improved by subcutaneous DDAVP. MRI revealed a thickened pituitary stalk. DI is uncommon, late and usually asymptomatic in breast cancer. The association with an anterior pituitary failure is even more rare. In our patient the metastasis is in the pituitary stalk and seems to be due to meningeal deposits. MRI appears to be the best procedure to perform, showing a thickening stalk. Extension to the pituitary gland is related to direct tumor invasion from adjacent structures rather than haematogenous spread.

Nutritional status and growth in children with chronic hepatitis B.

As reported for other chronic liver diseases, hepatitis B virus (HBV) chronic infection might result in malnutrition. In order to establish whether this disease could be responsible of malnutrition and hence influence growth, 75 children, chronically infected with HBV, have been followed up for 4 years. Thirty-one of them had chronic active hepatitis (CAH), 25 chronic persistent hepatitis (CPH), 14 chronic lobular hepatitis (CLH), and five cirrhosis (three active, two inactive). The nutritional status was evaluated every 12 months, with careful physical and laboratory examinations. General nutritional status was estimated according to Waterlow criteria (13, 14). At our first observation, 50 children were following a balanced diet with a caloric intake adequate for age and weight, whereas 25 were on a low-fat diet, begun in the belief of its therapeutic value. For seven patients of this second group, the caloric intake was below the daily requirement. The latter group showed a growth failure in weight when they were first seen at our center and gained weight when the dietary intake was normalized. However, no biochemical feature of malnutrition was observed in all the 75 children. At the end of the follow-up period, the nutritional status was satisfactory for all of them.