Testicular metastasis of colorectal carcinoma: A new observation.

Testicular metastases in colorectal cancer are rare, and pathogenesis still remains unclear. It tends to occur in late stage of disease and has a poor prognosis. We present a 37-year-old patient complained from abdominal pain with deterioration of performance status and weight loss. Body scan showed a recto sigmoid tumor associated with metastasis in the left liver with pelvic lymphadenopathy and hetero nodular testis. Colonoscopy showed a stenosing upper rectum tumor. Histology concluded to an adenocarcinoma. The patient had a transverse colon resection and a right orchiectomy. Histology concluded to an invasive adenocarcinoma with carcinosis, secondary testicular and hepatic metastasis.

[Giant retroperitoneal liposarcoma: report of a case]. / Le liposarcome rétropéritonéal géant: à propos d'un cas.

Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. We report the case of a 32-year-old woman who had a complete exeresis of a 15 cm retroperitoneal myxoid liposarcoma. Three months later, a 9 cm local recurrence was excised and radiotherapy was performed. In 2000, a local recurrence and an intestinal localisation of the liposarcoma were observed. The retroperitoneal tumor could not be removed and she had an intestinal resection followed by chemotherapy. With the literature data, we review the pathological, therapeutic and prognostic aspects of this tumor.

[Isolated, spontaneous hematoma of the kidney. Report of 2 cases]. / L'hematome spontane et isole du rein. A propos de 2 cas.

Spontaneous hematoma under the renal capsula is a rare pathology. The authors report two cases with one male and one female aged respectively of 50 and 63 years. The symptomatology is presented by right renal aches associated with repetitive and total hematuria in male and atypical abdominal aches in female. The radiological explorations (IVP, renal sonography and Computered Tomography) had conclude in a renal cancer in the two cases. The diagnosis is made by the pathologic study. Some etiology may be searched such as malignant tumor, an angiomyolipoma, vascular abnormalities and disturbance to the hemostasis. If no etiology is find, a nephrectomy or a simple supervision can be discussed.

[Aspects of evolving urogenital tuberculosis. 60 cases]. / Les aspects évolutifs de la tuberculose urogénitale. A propos de 60 cas.

Based on the results of a retrospective study of 60 patients treated between January 1984 and December 1994, the authors review the current clinical features of urogenital tuberculosis. The sex-ratio shows a male predominance of 65%. The mean age is 48 years. Cystitis and low back pain are the main symptoms of the disease. IVU, performed in all patients, showed pathological images in 98.3% of cases. Urine culture was positive in 23 out of the 50 cases in which it was performed. Serious forms were relatively frequent, with bilateral lesions in 12 cases, associated with renal failure in 4 of them, or unilateral renal destruction in 43 cases. All patients were treated with triple- or quadruple-agent tuberculostatic therapy. 54 patients required one or several surgical procedures: 43 nephrectomies, 7 ureterovesical reimplantations, 11 augmentation enterocystoplasties, 1 Bricker ureteroileostomy, 3 ureterostomies, 1 ureteric resection and 4 epididymectomies. Two patients admitted in a context of deterioration of the general state died during the days following admission. 56 patients were reviewed with a minimum follow-up of 6 months. Two were cured by medical treatment alone. Among the 54 operated patients, clinical improvement was obtained in 43 patients (91%) and radiological improvement was obtained in 33 of the 36 cases in which IVU was performed (91%). In conclusion, despite the various anti-tuberculosis campaigns, urogenital tuberculosis remains a serious disease, essentially because of the delayed diagnosis.

[ST52 treatment of cancer of the prostate during the hormonal resistance phase]. / Traitement par ST52 du cancer de la prostate au stade d'échappement hormonal.

OBJECTIVE: Stilboestrol phosphate (ST 52) was evaluated on pain, general status, life expectancy and PSA, in a retrospective study of patients with prostatic carcinoma and relapse to hormonal treatment. MATERIAL AND METHODS: 32 patients were treated by infusion of Stilboestrol phosphate at a daily escalating dose from 1.2 to 3 g over a period of 10 days, then subsequently oral administration. RESULTS: Minor complications, especially nausea were observed in 12 cases but no major complication or interruption of treatment. Improvement for pain alone or with general status was obtained in 50% (16 cases) at 3 months, but at one year only 10% were still improved. Median survival was 8 months, with 19.4 months for responders at the end of infusions and 4.2 months for non-responders-respectively. CONCLUSION: Stilboestrol phosphate can obtain a clinical response with low morbidity when relapse to hormonal treatment occurs. Infusion responders have a better life expectancy.

[Ultrasonography of the urethra: prognostic value of the ultrasonographic structure of corpus spongiosum peristenotic fibrosis: prospective study of 33 patients]. / Echographie de l'urètre: valeur pronostique de l'échostructure de la fibrose spongieuse péristénotique. Etude prospective sur 33 patients.

OBJECTIVES: The contribution of ultrasonography to pretreatment morphological assessment of strictures of the anterior urethra and assessment of the risk of recurrence after internal urethrotomy. MATERIAL AND METHODS: 33 patients (16-89 years) operated by internal urethrotomy for stricture of the anterior urethra and followed for at least 6 months. Preoperative urethral ultrasonography, recording the number, length and degree of strictures and echostructure of the peristenotic fibrosis of the corpus spongiosium. RESULTS: Ultrasound visualization of all urethral strictures, with no false-positives and no false-negatives. 11 patients relapsed after a mean interval of 5.7 months (1-16 months), 22 patients did not present recurrence: mean interval: 15.5 months (6-36 months). Corpus spongiosum fibrosis associated with urethral stricture is isoechoic to the corpus spongiosum (19 cases) or hyperechoic to the corpus spongiosum (14 cases). No statistical correlation was observed between the echostructure of the fibrous tissue and the risk of recurrence after internal urethrotomy. CONCLUSION: Ultrasonography allows excellent analysis of the morphological characteristics of a stricture of the male anterior urethra. In our experience, and in contrast with the limited data of the literature, no correlation was observed between the echostructure of the peristenotic fibrosis and the risk of recurrence after internal urethrotomy.

[Emphysematous cystitis: apropos of 2 cases]. / Cystite emphysémateuse: à propos de 2 cas.

Emphysematous cystitis is a rare infectious disease of the lower urinary tract. Its reputedly serious prognosis is related to treatment failures revealing ignorance concerning its pathophysiological mechanisms. Two cases of this disease were seen in our department, both in diabetic men over the age of 70 years with a history of prostatism. They presented to the emergency department with complete urinary retention and alteration of the general state and fever. Urine culture isolated Klebsiella pneumoniae in both cases. Treatment consisted of bladder drainage associated with adapted antibiotic therapy and control of diabetes. A suprapubic prostatectomy was subsequently performed in one case and transurethral prostatic resection was performed in the other case. The prognosis of this disease depends on early diagnosis and rapid introduction of effective treatment.

[Trans-symphyseal approach in the treatment of cervico-urethro-vaginal fistulas. Apropos of 2 cases]. / La voie trans-symphysaire dans le traitement des fistules cervico-urétro-vaginales. A propos de 2 cas.

We opted for a symphysiotomy approach in the management of cervico-urethro-vaginal fistulae in two patients. This approach offers an excellent exposure of the region of the bladder neck. After section of the symphysis pubis with a Gigli's wire saw, the anterior wall of the bladder was taken down to the fistulae and we excised the fistulous tract. Longitudinal closure of the fistulae and the bladder followed. Results were satisfactory and there were no urinary incontinence.