Treatment of fibromas.

This study defines the current modes of treatment of patients with uterine fibromas with a review of the literature. Progesterone treatments appear to be principally used in cases of minor functional symptomatology and we discuss recent studies of mifepristone. GnRH agonists are particularly effective in preoperative treatment for conservative surgery. The indications and results of hysteroscopic resection and laparoscopic myomectomy are compared to those of classic myomectomy and hysterectomy. The indications for myolysis are discussed.

[Spontaneous umbilical cord hematoma, a rare cause of acute fetal distress]. / L'hématome spontané du cordon: une cause rare de souffrance foetale aiguë.

BACKGROUND: Spontaneous umbilical cord hematoma is a rare life-threatening gestational accident. CASE REPORT: A 26 year-old primipara was examined at 38 weeks of gestation for fetal monitoring. There were a number of fetal decelerations with loss of baseline variability. Cesarean section performed for acute fetal distress resulted in a male infant with an Apgar score of 3 at 1 minute and 7 at 5 minutes and neonatal anemia (Hb: 11.6 g/l). Four umbilical cord hematomas were observed. Microscopic examination revealed a ruptured umbilical vein without other abnormality. Post natal evolution was marked by hypoxic-ischemic encephalopathy and death. CONCLUSION: Spontaneous umbilical cord hematoma is rare (1/5,500 births) and often due to rupture of the umbilical vein. Risk factors are shortness or traction of the cord, post-maturity and infection. Umbilical cord hematomas are usually responsible for severe fetal distress or death.

[Angiosarcoma of the breast: 4 case reports and review of the literature]. / Les angiosarcomes du sein. Quatre observations et revue de la littérature.

Four cases of angiosarcoma of the breast, including three previously unpublished, form the starting point for a brief descriptive review of this extremely rare but fearsome tumour which accounts for only 0.04 per cent of breast malignancies. The contrast between the initially totally benign clinical appearance of this sarcoma and the dramatic prognosis of its advanced or metastatic forms against which adjuvant chemotherapy remains of only relative usefulness, leads the authors to chiefly discuss a diagnostic approach likely to speed recognition (histological diagnosis) and treatment (simple mastectomy) of a tumour with two troublesome features: its powerful metastatic potential being matched only by its extreme rarity which may cause clinicians, radiologists and histopathologists to use valuable time.