[Epidermoid carcinoma developing in a chronic anal fistula]. / Carcinome épidermoïde développé sur fistule anale chronique.

BACKGROUND: Malignant degeneration of anal fistula is a rare occurrence in the course of a common disease. Abdominoperineal resection offers the only hope of cure. CASE REPORT: A 41-year-old patient who was operated 14 years earlier for anal fistula presented recurrence treated by fistulectomy. Histology revealed a well-differentiated squamous-cell carcinoma. Radiotherapy (45 Gy) was added postoperatively. Five months later, local recurrence was treated by chemotherapy and abdominoperineal resection. Two months later the patient died from cachexia with local recurrence. DISCUSSION: Biopsies of anal fistula tract and histology of all fistulectomies are required for early diagnosis of possible carcinoma. Abdominoperineal resection offers the only hope of cure.

Recurrent squamous-cell carcinoma arising in sacrococcygeal pilonidal sinus tract: report of a case and review of the literature.

PURPOSE: Carcinoma arising in a pilonidal sinus is a rare complication. This study reports the case of a patient with recurrent squamous-cell carcinoma arising in a sacrococcygeal pilonidal sinus tract. METHODS: This patient was treated with a wide local excision and mesh grafts. Three months later the patient was treated with adjuvant radiation therapy. RESULTS: The patient died two years later from recurrence in inguinal lymph nodes, liver, and lungs. CONCLUSION: Some authors propose consideration of treatment with adjuvant chemotherapy and radiation therapy in addition to complete local excision as a possible means to decrease the local recurrence rate.

[Aberrant origin of the splenic artery]. / Orgine aberrante de l'artére splénique.

We report an incidental finding of an aberrant origin of the splenic artery described here for the first time.

[Metastatic implants after laparoscopic cholecystectomy in unsuspected gallbladder cancer. A case report and review of the literature]. / Implants métastatiques apres cholécystectomie laparoscopique d'un cancer non suspecté de la vésicule biliaire. Rapport d'un cas et revue de la littérature.

A gallbladder carcinoma, diagnosed preoperatively, is a counter-indication for laparoscopic cholecystectomy. When this cancer is not diagnosed and laparoscopic surgery is undertaken, neoplastic dissemination may occur along the trocars pathways which renders the prognosis even worse. The most probable explanation of the dissemination is a seeding of sloughed cancerous cells onto abdominal wall during exsuflation. The authors report the case of a 36-year-old woman with an adenocarcinoma of the gallbladder discovered after laparoscopic cholecystectomy and who has had rapid intra-abdominal and parietal metastases.

[Unusual metastases of breast cancer]. / Métastases inhabituelles du cancer du sein.

The breast cancer is the common cancer in female. The metastasis may occur any where in the body. The common sites are in the lymph nodes, the bones, the chest, the liver and the brain. Other sites of metastasis have little importance, rarely researched and constitute the objective of this article.

[Spontaneous splenic rupture due to heparin. Report of a case and review of the literature]. / Rupture spontanée de la rate sous héparine. Rapport d'un cas et revue de la littérature.

We describe in this report a case of spontaneous rupture of the spleen in a 68-year-old man on heparin therapy for cerebrovascular disease. This spontaneous splenic rupture is a rare complication of anticoagulant or thrombolytic therapy. Twenty cases were reported in the world medical literature. Only one case was due to heparin. The clinical presentation, which includes mainly abdominal and left shoulder pain with shock, could mimic cardiac diseases and delay or even mask the diagnosis. The mechanism of the rupture is still unknown. It is possible that altered hemostatic mechanisms may aggravate unrecognized micro trauma to provoke a rupture of the spleen. Once the rupture is suspected, the diagnosis can be confirmed with CT scan, or ultrasound. The treatment will be mainly reversal of anticoagulation and splenectomy.

[The place of enucleation in the surgical management of hepatic hemangioma. Report of a case and review of the literature]. / Place de l'énucleation dans le traitement chirurgical de l'hémangiome hépatique. Rapport d'un cas et revue de la littérature.

Hepatic hemangioma is the most frequent benign tumor of the liver. It is often asymptomatic. If surgery is needed the best method will be enucleation of the hemangioma. We report a case of enucleation of a cavernous hepatic hemangioma with review of the literature.

[Gastric metastases of breast cancer]. / Métastases gastriques du cancer du sein.

Breast cancer is the most frequently encountered cancer in women and the first cause of death in the female population. Metastasis may occur ubiquitously depending on the histological type and the presence or absence of oestroprogesterone receptors. We report three cases with gastric metastasis. Signs of gastric involvement are often non-specific and should not be mistaken for simple side reactions to treatment. Hormone chemotherapy is indicated in most situations but surgery may be needed. It should be noted that gastrointestinal metastasis predominates in lobular breast cancers positive for progesterone receptors.

[Digestive manifestations of juvenile dermatomyositis. A case report and review of the literature]. / Les manifestations digestives de la dermatomyosite juvénile. A propos d'un cas avec revue de la littérature.

Childhood dermatomyositis should be separated from the adult polymyositis and is characterized by the frequency of vasculitis and ulcerations of the gastrointestinal tract. The authors present a case of colonic perforation with a review of the different disorders of the gastrointestinal system secondary to this disease.