[Spontaneous remission of cutaneous myeloid sarcoma]. / Régression spontanée d'un sarcome myéloïde cutané.

INTRODUCTION: Cutaneous myeloid sarcoma is a rare extramedullary tumour of immature myeloid cells. It is most often associated with acute myeloid leukaemia, and more rarely with myelodysplastic/myeloproliferative disease. PATIENTS AND METHODS: Herein we report a case of cutaneous myeloid sarcoma associated with myelodysplastic/myeloproliferative disease in an 84-year-old man with a diffuse purple papular and nodular rash. The disease course was marked by a spontaneous and total regression for two months. Given the patient's age and general condition, chemotherapy could not be given. DISCUSSION: Cutaneous myeloid sarcoma is rare. It is often associated with acute myeloid leukaemia, and more rarely with myelodysplastic/myeloproliferative disease, but it can occur in isolation. Diagnosis is particularly difficult and is based a consistent body of clinical and histological evidence. Spontaneous regression is very rare and involves immunological mechanisms that are still incompletely understood. Recurrence occurs within a variable time frame and is often associated with transformation to acute myeloid leukaemia if this was not already present at the time of diagnosis. CONCLUSION: Herein we report an extremely rare case of spontaneous regression of cutaneous myeloid sarcoma associated with myelodysplastic/myeloproliferative disease.

[Traumatic double rupture of the isthmic aorta. Apropos of an unrecognised case successfully treated by two-stage surgery]. / Rupture traumatique à double étage de l'aorte isthmique. A propos d'un cas méconnu traité chirurgicalement en deux temps avec succès.

The authors report the case of a 33 year old patient, who underwent an emergency repair of a traumatic tear of the thoracic aorta, after a car accident. This operation was carried out with femoro-femoral cardiopulmonary bypass support. Associated lesions were traumatic tear of the left diaphragm repaired through left thoracotomy during repair of the aorta, rupture of the liver and multiple fractures of the left superior limb. Postoperative course was marked by liver hemorrhage and septicemia. Orthopedic treatment of the various fractures was performed. The course of thoracic lesions was uneventful. An aneurysm of the aortic isthmus was revealed during venous digital subtraction angiography routinely performed 60 days after surgery. The patient was reoperated with femoro-femoral bypass support. A second incomplete tear of the aorta, missed during the first operation was discovered 3 cm above the suture of the first one. This lesion was easily repaired and the post-operative course was uneventful. The value of systematic control angiography after aortic traumatic repair is emphasised.

[Endocarditis after Bentall's operation. Apropos of 3 reoperated cases]. / Endocardite après intervention de Bentall. A propos de trois réopérés.

The authors report three cases of endocarditis after replacement of the aortic valve and the ascending aorta by Bentall's method. This complication, rare in published series, is a serious possible complication during medium and long term follow-up. Its treatment consist of early complete removal of prosthetic material under suitable antibiotic therapy.

[Aneurysm of the membranous ventricular septum. Apropos of 4 cases surgically treated]. / Anévrysme du septum membraneux. A propos de 4 cas opérés.

Four patients with aneurysms of the membranous ventricular septum were operated either because of complications or for associated malformations. The authors describe the anatomical, radiological and, above all, the echocardiographic and angiographic features of this malformation. Surgical management is necessary in complicated cases or when there are associated congenital malformations. The information provided by echocardiography in the diagnosis and follow-up of ventricular septal defects indicates that this malformation is not as rare as was previously thought.

[Hypoglycemic pleural mesothelioma. A case report]. / Mésothéliome pleural hypoglycémiant. A propos d'une observation.

Organic hypoglycemia occurs in pancreatic and mesenchymal tumors. Thirty percent of extrapancreatic tumors are intrathoracic. A patient with hypoglycemic pleural mesothelioma was treated by surgical excision without recurrence five years after surgery. The mechanisms of hypoglycemia are not clearly established. The recurrence of hypoglycemia is a good sign of tumor recurrence.

A case of spontaneous incomplete non-traumatic rupture of the ascending aorta with acute aortic insufficiency (successful emergency surgical repair).

Spontaneous incomplete non traumatic rupture of the ascending aorta is rare but life-threatening; it may well remain unnoticed until emergency surgery becomes necessary. Its possibility should be considered in all patients presenting signs of tamponade, chest pain or aortic regurgitation, and it must be diagnosed by appropriate procedures.

[Spontaneous incomplete rupture of the supra-sigmoidal aorta presenting as aortic insufficiency. Apropos of an emergency surgical case]. / Rupture spontanée incomplète de l'aorte sus-sigmoïdienne révélée par une insuffisance aortique. A propos d'un cas opéré en urgence.

We report a case of spontaneous incomplete rupture of the first segment of the ascending aorta presenting as aortic incompetence and acute tamponade confirmed by preoperative angiography in a 57 year old hypertensive woman. This patient underwent emergency conservative surgery with good results at 8 months' follow-up. This rare pathology occurs in the same terrain as dissection of the aorta. The diagnosis should be suspected not only when chest pain and/or aortic incompetence are associated or not with acute tamponade, contrasting with a normal electrocardiogram, but also in atypical presentations which necessitate angiography in multiple incidences in order not to miss the diagnostic signs which are often invisible in the standard projections. When there are no complications, this condition may pass undiagnosed. However, in most cases, it leads to acute tamponade due to intrapericardial rupture or to an aortic aneurysm or aortic incompetence. The latter complications are usually associated with severe regurgitation requiring surgical correction, which in some cases may be conservative.