[Myopathy in the uremic patient: apropos of a case]. / Myopathie chez l'urémique: à propos d'une observation.

Uremic myopathy is relatively unknown, despite the fact that it can be quite a severe handicap. It is a non-specific proximal myopathy which must be distinguished from uremic polyneuropathy. Several disorders linked to renal insufficiency have been implicated, but these only play an adjuvant role with regard to renal osteodystrophy. Indeed the presence of myopathy in cases of severe osteodystrophy, its similarity to the myopathies associated with different types of osteomalacia and hyperparathyroidism without renal failure, suggest that the most important pathogenic factor is related to disorders of the calcium phosphate metabolism: excessive parathyroid hormone, vitamin D deficiency and/or impaired calcium transport. Treatment will depend on the predominant bone lesions: secondary hyperparathyroidism or osteomalacia. However prevention remains the best course.

[Liposarcoma of the spermatic cord. Review of the literature. Apropos of a case of myxoid liposarcoma]. / Liposarcomes du cordon spermatique. Revue de la littérature. A propos d'un cas de liposarcome myxoïde.

Based on one case of spermatic cord liposarcoma, the authors mention the different histological types of this lesion. A review of the literature confirms this rare tumor typically occurs in the adult population; the majority of spermatic cord liposarcomas are of low grade malignancy. The treatment of choice remains radical orchidectomy with wide excision of the tumor. Because of the predilection of this lesion for local recurrence, the patients must be followed periodically.

[Renal adenocarcinoma in a dialysis patient with acquired multicystic disease]. / Adénocarcinome rénal chez un dialysé présentant une maladie multikystique acquise (MMA).

ACKD is frequent in chronic dialysis patients: its incidence is proportional to the length of time on dialysis. It occurs also in uremic patients before dialysis and persists, despite a tendency towards involution, in transplanted patients. ACKD is frequently associated with adenoma which can evolve into adenocarcinoma. Screening studies by sonography, eventually completed by CT, are essential to discover patients with ACKD, to follow them up and propose bilateral nephrectomy if ACKD evolves towards malignancy. ACKD should be considered as a pre-malignancy state.

[Colonic necrosis, an unusual extrarenal involvement in hemolytic and uremic syndrome]. / La nécrose colique, atteinte extra-rénale inhabituelle du syndrome hémolytique et urémique (SHU).

A seventeen years old girl presented a HUS. The usual gastrointestinal symptoms of the prodromal phase involved secondary complications leading to emergency surgical treatment. Laparotomy exploration revealed segmental necrosis of the colon which was treated by colectomy: histological studies revealed its ischemic nature with specific lesions of thrombotic microangiopathy. Later course was uneventful with the exception of renal failure requiring maintenance hemodialysis. Review of literature confirms the rare and severe nature of gastrointestinal lesions requiring surgery. Great care should be taken on one hand, not to undertake a useless operation and on the other hand to operate in time colonic necrosis involving or not intestinal perforation or intussusception.