[Anatomical and clinical effects of neoadjuvant hormonal treatment before radical prostatectomy]. / Effets anatomo-cliniques du traitement hormonal néo-adjuvant avant prostatectomie radicale.

Neoadjuvant endocrine treatment before radical prostatectomy is designed to reduce the positive margin rate and therefore the risk of recurrence. It usually consists of complete androgen blockade for 3 months, but no consensus has been reached concerning the type of blockade and the optimal duration. The main histological changes consist of glandular atrophy with pycnosis and vacuolization of tumour cells. These changes could reflect increased apoptosis. The residual tumour is usually small. PIN become rare, raising the problem of possible chemoprevention. The overall result is a markedly increased frequency of intracapsular tumours and a reduction of at least 50% of positive margins. However, some authors consider that this is simply due to a more detailed histological examination. The frequency of seminal vesicle and lymph node involvement does not appear to be modified. Endocrine therapy could act on the apoptosis-proliferation balance and also decrease the number of circulating cells. However, the intermediate results of randomized studies are contradictory. As improvement in overall survival remains the main objective, only a longer follow-up will be able to clearly determine the value or uselessness of neoadjuvant endocrine treatment before radical prostatectomy.

Pemphigus foliaceus.

Pemphigus foliaceus is a skin disease in which antibodies against the cell surface of keratinocytes destroy the adhesion between epidermal cells, thereby producing blisters. It is a rare disease in childhood, and treatment guidelines for juvenile pemphigus foliaceus are lacking. An 8 year old boy with pemphigus foliaceus is described. He did not respond to topical steroids, and the condition flared up when high dose oral steroids were tapered. The lesions resolved completely in four weeks on dapsone, which was maintained for nine months with no major adverse effects, except for a moderate increase of the methaemoglobin concentration at the outset of treatment. There has been no evidence of disease reactivation in more than nine months of follow up since dapsone withdrawal.

[Renal oncocytoma. Report of 13 cases]. / L'oncocytome rénal. A propos de 13 observations.

We report 13 cases of renal oncocytoma. Urinary symptoms occurred in only 3 cases. The patient's age ranged from 41 to 74 years with an average of 62.3 years. The mean tumor diameter was 5.6 cm (range: 1.5-14). Diagnostic features of ultrasonography, CT scan and, in some instances, angiography were suggestive of renal oncocytoma in 2 patients, but never affirmative, 4 patients were treated by partial nephrectomy. No local or metastatic recurrence was observed with a mean follow-up of 30.8 months, ranging from 6 to 96 months. We assume that the term renal oncocytoma should be restricted to tumors exclusively composed of regular oncocytic cells with an eosinophilic granular mitochondria-rich cytoplasm and an absence of malignant potential. Diagnostic imaging characteristics may sometimes suggest the diagnosis of renal oncocytoma, but cannot eliminate the main differential diagnosis, i.e. granular renal cell adenocarcinoma. When the tumor is small and unifocal, nephron sparing surgery may be considered. Whether or not the diagnosis has been confirmed by fine needle aspiration, conservative surgery must be controlled by intraoperative frozen sections of the tumor and surgical margins.

[Is surgery useful in kidney cancer with lymph node invasion?]. / La chirurgie est-elle utile dans le cancer du rein avec envahissement ganglionnaire?

SUMMARY: lymph node involvement in renal cell carcinoma is factor of very poor prognosis. In a series of 55 node-positive patients, 33 (60%) had simultaneous renal vein or vena cava invasion and 32 (58.2%) had metastases. Gross lymph node involvement was found in 39 patients (70.9%). Patients without venous invasion or metastasis may have a prolonged survival. In this group, those with microscopic nodal involvement can be cured, as the 10 and 15-year the actuarial survival rate is 54.5% Formal lymphadenectomy might have played a role in these results. Surgery can be performed when vein invasion is present without metastasis, but the prognosis is generally poor. Survival does not seem to be influenced by surgery when metastasis is present, regardless of the vein status.

[Scrotal panniculitis due to cold: a pseudo-tumoral lesion in the prepubertal child. Report of a case]. / Panniculite scrotale au froid: une lésion pseudo-tumorale chez l'enfant prépubère. A propos d'une observation.

We reported a case of scrotal panniculitis in a 7 year-old boy after exposure to cold by swimming in cold sea water. Scrotal cold panniculitis is an unusual, confined to prepuberal patients. This entity must be known to avoid surgical exploration because injuries subside spontaneously within few weeks.

[Colonic pseudo-obstruction caused by digestive amyloidosis in a chronic hemodialyzed patient. Apropos of a case]. / Pseudo-obstruction colique par amylose digestive chez l'hémodialysé chronique. A propos d'un cas.

A case of intestinal pseudo-obstruction by amyloidosis, occurring after 20 years of dialysis in a 72-year-old woman is reported. Although acute intestinal complications of intestinal amyloidosis, such as ischemia, colonic obstruction or haemorrhage are well known, colonic pseudo-obstruction is more unusual. It gradually results in, it carries out an intestinal obstruction with colonic and gastric distension. The diffuse topography of amyloid deposits throughout the gastrointestinal tract carries a poor prognosis and surgery cannot be curative.