First two autochthonous dengue virus infections in metropolitan France, September 2010.

In September 2010, two cases of autochthonous dengue fever were diagnosed in metropolitan France for the first time. The cases occurring in Nice, southeast France, where Aedes albopictus is established, are evidence of dengue virus circulation in this area. This local transmission of dengue calls for further enhanced surveillance, active case finding and vector control measures to reduce the spread of the virus and the risk of an epidemic.

[Focal nodular hyperplasia of the liver]. / Hiperplasia nodular focal del hígado.

Focal nodular hyperplasia (FNH) of the liver is an uncommon benign lesion that usually occurs in young or middle-aged women. Although it has been associated with oral contraceptive use, no evidence supports this hypothesis. Most patients with this lesion are asymptomatic. We report the case of a 10-year-old boy with a history of transient epigastric abdominal pain over several days. Physical examination revealed a tender mass in the upper left quadrant. Abdominal ultrasonography revealed an 85 3 45 mm mass located in the left lobe of the liver. Computed tomography-guided biopsy showed histological changes consistent with FNH. Left hepatectomy was performed and the diagnosis was confirmed by histological study. FNH of the liver is extremely rare in children, especially in boys. Unlike adenoma, malignant transformation of FNH has not been described and consequently patients can be periodically followed-up with imaging tests, without need of surgery. The differential diagnosis includes other benign hepatic lesions such as hemangioma and hepatocellular adenoma. Surgical resection is indicated in symptomatic patients, usually with abdominal pain, cholestasis or palpable abdominal mass, and when the differential diagnosis, especially with hepatic adenoma, is unclear.

Hiperplasia nodular focal del hígado / Focal nodular hyperplasia of the liver

La hiperplasia nodular focal es un tumor hepático benigno muy poco frecuente que afecta a mujeres jóvenes o de mediana edad. Se ha sugerido su asociación con el uso de anticonceptivos orales, pero este hecho no ha sido demostrado. En la mayoría de los casos la lesión es asintomática. Se presenta el caso de un niño de 10 años de edad, que consultó por un cuadro de dolor epigástrico intermitente de varios días de evolución. La palpación abdominal mostró una tumoración dolorosa y dura localizada en el hipocondrio izquierdo. La ecografía abdominal reveló la existencia de una masa de 85X45 mm situada en el lóbulo hepático izquierdo, de la cual se practicó una biopsia por punción dirigida mediante tomografía computarizada (TC). El estudio histopatológico mostró un tejido hepático con alteraciones indicativas de hiperplasia nodular focal. El paciente fue intervenido realizándose una hepatectomía izquierda. El estudio histológico definitivo confirmó el diagnóstico. La hiperplasia nodular focal del hígado en la edad pediátrica es rara y aún más en niños varones. A diferencia del adenoma, no se ha descrito la transformación maligna, por lo que los pacientes pueden ser seguidos de forma periódica mediante pruebas de imagen sin necesidad de tratamiento quirúrgico. El diagnóstico diferencial debe establecerse con otros tumores benignos como los hemangiomas y el adenoma hepatocelular. El tratamiento quirúrgico está indicado en pacientes con síntomas como dolor recurrente, colestasis por compresión o la presencia de una masa abdominal palpable, así como siempre que existan dudas en el diagnóstico diferencial, en particular con el adenoma hepático (AU)

[Intraabdominal metastasis of cerebellar medulloblastoma through ventriculoperitoneal shunt]. / Metástasis intraabdominales de meduloblastoma cerebeloso a través de un catéter de derivación ventriculoperitoneal.

We present a 6-year-old girl with cerebellar medulloblastoma causing obstructive hydrocephalus that was treated by ventriculoperitoneal shunting. The patient subsequently underwent surgical excision of the tumor followed by adjuvant craniospinal radiotherapy. Nine months after shunting, multiple intraabdominal metastatic lesions were found. Although the risk is low, ventriculoperitoneal shunting may facilitate the spread of malignant cells.

Metástasis intraabdominales de meduloblastoma cerebeloso a través de un catéter de derivación ventriculoperitoneal / Intraabdominal metastasis of cerebellar medulloblastoma through a ventriculoperitoneal shunt

Se presenta el caso de una paciente de 6 años de edad diagnosticada de meduloblastoma cerebeloso que provocaba una hidrocefalia obstructiva, por lo que se colocó una válvula de derivación ventriculoperitoneal. Posteriormente se practicó exéresis completa del tumor seguida de radioterapia craneospinal coadyuvante. Nueve meses después de la intervención se demostró la aparición de múltiples metástasis intraabdominales del meduloblastoma. La creación de una comunicación artificial entre el sistema nervioso central (SNC) y la cavidad abdominal puede facilitar la extensión de células tumorales, aunque el riesgo de que esto ocurra es bajo (AU)

[Nasal congenital cysts and fistulas: clinical and surgical aspects]. / Quistes y fístulas congénitas nasales: aspectos clínicos y quirúrgicos.

Eight patients affected with cysts or fistulae on the midline at the nose bridge (back of the nose) have been treated at the Pediatric Surgery Service of the Hospital Sant Joan de Dèu in Barcelona from march 1995 to october 1996. Six patients had a cystic mass (four of them having an intranasal prolongation) and two had a fistulous orifice (one of them also having intranasal prolongation). The test with the highest diagnostic sensibility was the CT-scan, which showed a bifid crista galli and intranasal prolongation in 5 of the patients. Pathologic exam confirmed the diagnosis of dermoid cyst. At follow-up, all patients were doing well. Congenital cysts and fistulae at the nose bridge (back of the nose) may appear as a trivial condition; the possibility of them being the only clinical feature of an intranasal or intracranial prolongation is the reason for a deeper study in order to determine the extension of the lesion. The treatment is always surgical removal of the cyst and the fistulous pathway at the time of diagnosis, regardless of the patient's age, thus avoiding possible infectious complications.

[Development of utero-chorionic vascular resistance in early pregnancy]. / Evolución de las resistencias vasculares uterocoriales en la gestación precoz.

The physiologic evolution of the utero-chorionic vascular resistances during the first trimester of pregnancy is described. With the use of pulsed Doppler, 25 normal pregnancies were followed weekly, performing 288 scans between the 6th and the 12th weeks of pregnancy. The detection of the FVW was done at the level of the uterine and retro-chorionic vessels. There is a progressive decrease of the vascular resistances to flow, with significant differences (p less than 0.001) between the values before and after the 9th week. The physiologic implications and its possible application to the study of the gestational pathology are commented.