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1.
Rare Tumors ; 11: 2036361318820171, 2019.
Article En | MEDLINE | ID: mdl-30719261

BACKGROUND: Soft tissue leiomyosarcomas are rare, accounting for almost 5%-10% of all soft tissue sarcomas; they account for almost 1% of all sarcomas. They are aggressive tumors where location, size, and management require a multidisciplinary approach. Since there are few series published, we here analyze epidemiological pattern, clinical and pathologic features of soft tissue leiomyosarcomas. METHODS: We conducted a retrospective study of 29 consecutive cases of histologically proven soft tissue leiomyosarcoma extracted from the database of the Cancer Registry of the Center of Tunisia and the Department of Pathology of Farhat Hached University Hospital of Sousse of Tunisia, during a 10-year period (from January 1996 to December 2005). Epidemiologic details, clinico-pathological features, and treatment modalities were assessed with focus on patients' 5-year overall survival, tumor relapse, and metastases. RESULTS: Soft tissue leiomyosarcoma accounted for 17.5% of all soft tissue sarcomas diagnosed at our pathology department. Most of patients were of advanced age (median: 52 years), with extremes ranging from 12 and 87 years. There was a slight male predominance (sex-ratio = 1.07). Tumors were located mostly in the lower limbs (45%). Deep sites as retroperitoneum was found only in two cases. Tumor size was more than 5 cm in 83% of cases (average size = 9.4 cm). Five cases had metastasis on initial staging. For 24 patients, the disease was locally limited at the moment of diagnosis. Palliative chemotherapy was indicated for four patients and surgery was performed for 20 patients. Local recurrence occurred in 11 patients (55% of operated patients) and metastasis in 6 patients. Overall, 5-year survival was about 24%. CONCLUSION: Our study results highlight the scarcity of soft tissue leiomyosarcoma. Unfortunately, unusual tumor sites, disease's advanced stages, and intralesional resection made the prognosis poorer than in other series. Clinical course of soft tissue leiomyosarcoma was highly marked by local recurrence and metastasis.

3.
Tunis Med ; 85(7): 586-90, 2007 Jul.
Article Fr | MEDLINE | ID: mdl-18064992

BACKGROUND: Unicondylar femoral fractures are rare. They form a particular entity of the femoral lower extremity fractures. THE PURPOSE of this work was to evaluate the anatomical and functional results of unicondylar femoral fractures on pain, mobility, walking and stability of the knee. METHODS: We reviewed, retrospectively, 28 patients presenting unicondylar femoral fracture. There were 19 men and 9 women, with average age of 54 years (22 - 87 years), victims essentially of domestic accident. The fracture was alone in 65 % of cases. According to Nordin's classification, the fracture was of type I in 3% of cases, type II in 35 % of cases, type III in 20 % of cases and type IV in 42 % of cases. Twenty five patients had a surgical treatment after a median period of 7 days post-accident, 3 patients were treated orthopedically. RESULTS: After 3 years follow up, results were noted according to MEGY's score which takes into account walking, mobility, pain and the stability. Clinically, we noted 26 good and very good results and 2 moderate results. Anatomically, we obtained 75 % of satisfactory reductions. CONCLUSION: Unicondylar femoral fractures remain rare. It is important to recognize them and to make the exact diagnosis of their type. Surgical treatment exposes old subjects to risk of dismantling anatomical osteosynthesis because of osteoporoses.


Femoral Fractures/therapy , Adult , Aged , Aged, 80 and over , Female , Femoral Fractures/classification , Humans , Male , Middle Aged , Retrospective Studies , Treatment Outcome
4.
Tunis Med ; 85(12): 1065-7, 2007 Dec.
Article En | MEDLINE | ID: mdl-19170389

UNLABELLED: UNKNO WLOGEMENT: Ganglion cysts have been reported in all joints, with varying frequency in location. A few cases have been described concerning ganglia of the anterior cruciate ligament (ACL) particularly intraligamentous cysts. AIM: The aim of the study is to report specific particularities of intraligamentous ganglion cyst of the ACL. CASE: We report a new case of intraligamentous ganglion cyst of the anterior cruciate ligament treated successfully with arthroscopic aspiration followed by partial excision of the cyst wall after MRI examination. The MR findings, clinical features and arthroscopic findings were evaluated comparatively. Diagnosis was confirmed by means of histological study after arthroscopic excision. The cyst was fluid-filled, with low T1-weighted signal intensity and high T2-weighted signal intensity. Pain was the most frequent clinical sign without any history of trauma. Postarthroscopy outcome was painless. Histologic diagnosis corresponded to ganglion cyst. CONCLUSION: An intraligamentous ganglion cyst of the ACL is extremely rare and suggests some diagnostic and therapeutic particularities.


Anterior Cruciate Ligament , Ganglion Cysts , Anterior Cruciate Ligament/surgery , Arthroscopy , Ganglion Cysts/diagnosis , Ganglion Cysts/surgery , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Treatment Outcome
5.
Tunis Med ; 85(10): 857-61, 2007 Oct.
Article Fr | MEDLINE | ID: mdl-18236808

BACKGROUND: Brodie's abscess is a bone abscess described as a localized primary purulent collection with sclerotic wall. Since the first report of Sir Benjamin Brodie in 1832, many papers described different clinical and treatment aspects. Pathogeny and therapy still remain not clearly elucidated. AIM: The aim of our study is to describe clinical aspect and to study the result of treatment including surgery and antibiotics. METHODS: Our study is retrospective including 20 patients admitted to the author's institution for isolated bone abscess. The mean age of these patients is 30 years old (14 up to 46 years) with male predominance. Symptoms were chronic including localized pain with no systemic illness. The erythrocyte sedimentation rate was elevated in 2/3 of the cases. Roentegenogram was typical in 18 cases showing metaphysic cyst with sclerotic wall. Tibia was the most involved bone, 14 among 20 cases. Bacteriological study of the abscess pus isolated staphylococcus in 12 cases and pseudomonas in two cases. No organism was identified in the six remaining cases. Histopathological study showed chronic osteomyelitis with granulation including lymphocytes and plasma cells in all cases. Surgery and antibiotics were adequate for treatment in all cases. Our approach consisted in curettage without primary skin closure, cast immobilisation and antibiotics. RESULTS: Our patients were followed up over a median period of six years (8 months to 10 years). Overall, the results of treatment were good and in the long-term the abscess disappeared in all cases without recurrence. The erythrocyte sedimentation rate was normalized in 10 weeks and roentegenologically, the abscess disappeared progressively without osteomyelitis complication. CONCLUSION: According to our study, we believe that surgical treatment based on total excision of the bone collection and the sclerotic wall is the best method of therapy. As a matter of fact, healing was obtained without grafting in all cases and in the long-term follow up, abscess disappeared without recurrence and fistulisation.


Abscess/diagnosis , Osteomyelitis/diagnosis , Abscess/microbiology , Abscess/therapy , Adolescent , Adult , Anti-Bacterial Agents/therapeutic use , Bone Cysts/diagnosis , Casts, Surgical , Curettage , Drainage , Female , Follow-Up Studies , Humans , Lymphocytes/pathology , Male , Middle Aged , Osteomyelitis/microbiology , Osteomyelitis/therapy , Osteosclerosis/diagnosis , Plasma Cells/pathology , Pseudomonas Infections/diagnosis , Pseudomonas Infections/therapy , Retrospective Studies , Staphylococcal Infections/diagnosis , Staphylococcal Infections/therapy , Tibia/microbiology , Tibia/pathology
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