[Peritonitis due to a suppurating urachal cyst in a young woman. Review of the literature]. / Péritonite due à un kyste suppuré de l'ouraque chez une jeune femme. Revue de la littérature.

Peritonitis caused by a suppurating urachal cyst in a young woman. A review of the literature. Urachal cysts are not rare but occur much more often in children. In adults they may become infected and cause clinical symptoms including sub-umbilical mid-abdominal pain, fever, guarding and leukocytosis. Intraperitoneal rupture is rare (21 published cases) and only 7 cases have involved an adult female patient. The authors report the case of a 27 year old woman with peritonitis caused by rupture of a suppurating urachal cyst. 6 cm in diameter, for which the diagnosis had been established by pre-operative ultrasound. The surgical procedure carried out was total excision of the urachus, of the fascia between the umbilicus and the bladder, and partial excision of the dome of the bladder. Indeed total excision should have been carried out because of the risk of malignant degeneration of this mass to an adenocarcinoma.

[Survey in 2000: 3 cases]. / Scorbut en l'an 2000: 3 cas.

BACKGROUND: We report three new cases of patients presenting scurvy. In the year 2000 this rare disease still occurs in France. CASE REPORTS: The three patients, 2 men and a woman respectively 51, 50, and 73 years-old were alcoholics, and lived alone in difficult social conditions. Dietary survey indicated in the 3 cases inadequate vitamin C intake, and a regimen including solely bread, rice, pasta, and packet soup devoid of fresh vegetables and fruit. The cutaneous findings attributed to scurvy were: in the first patient, a woody inflammatory and painful oedema of the left leg associated with perifollicular petechial haemorrhages over the lower limbs, and hyperpigmentation of the facial skin with slate-gray spotty pigmentation of the tongue (pseudo-addisonian hyperpigmentation); in the second patient, an accentuation of a pre-existing acne becoming more inflammatory and extensive; and in the third patient, a diffuse petechial eruption on the abdomen and lower extremities. The diagnosis of scurvy was confirmed by low plasma ascorbic acid levels (< 6 mumol/l). All patients were treated with 1 to 2 g of oral ascorbic acid daily for 2 weeks resulting in rapid and dramatic response. DISCUSSION: Scurvy is a rare disease in industrialized nations. Its incidence is unknown because of absence of total census. Dietary vitamin C deficiency represents the main risk factor exposing for scurvy among adults, often alcoholics and living in social isolation. Cutaneous features supporting the diagnosis of scurvy are described in our observations. The recognition of these cutaneous abnormalities is important because their association can be misleading, and erroneously interpreted as a sign of systemic vasculitis, or connective tissue disease. The diagnosis of scurvy is confirmed by the measurement of plasma ascorbic acid levels. Treatment is simple and based on the administration of vitamin C, which results in dramatic improvement.

[Extended pleiomorphic adenoma of the hard palate. Apropos of a case]. / Important adénome pléomorphe de la voûte palatine. A propos d'un cas.

A patient presented with a large pleomorphic adenoma of roof of mouth measuring 6.5 cm in diameter and weighing 90 grams. Surgical exeresis was by simple enucleation with immediate covering of the roof of mouth by an extemporaneous palatine plate fixed with transcortical screws, this allowing rapid institution of normal feeding and reduction of postoperative management.

Peritoneal sarcoidosis. An unrecognized cause of sclerosing peritonitis.

In a Caucasian woman with a history of ocular and pulmonary sarcoidosis, the occurrence of sclerosing peritonitis with exudative ascites but without any of the well-known causes of this syndrome prompts us to consider that sclerosing peritonitis is a manifestation of sarcoidosis. The dramatic improvement that occurred on corticosteroid therapy adds credibility to this previously unreported association.

[Intravascular malignant B-cell lymphomatosis with renal glomerular involvement: a case]. / Lymphomatose maligne intravasculaire de type B avec atteinte rénale glomérulaire: une observation.

We report a case of intravascular malignant lymphomatosis observed in a 71 year-old male and characterised by the presence of a proteinuria in relation to the specific intraglomerular localisation. This malignant lymphoma, usually of the B phenotype, is rare and affects predominantly the central nervous system and the skin. Neoplastic cells home selectively to endothelium. Histological renal infiltration is frequent but a glomerular localisation, with proteinuria, is rare. The mechanism whereby lymphocytes home to endothelium cells is unclear but it could be related to the expression of lymphocyte-endothelium adhesion molecules. When present the nephrotic syndrome is associated with minimal change disease.