[Rhinocerebral mucormycosis in four diabetics]. / la mucormycose rhinocérébrale chez le diabétique. A propos de quatre observations.

UNLABELLED: Mucormycosis is caused by a zygomycetes fungus in a vascular location. This fungus is a saprophytic organism which can become pathogenic in specific conditions, particularly in patients with diabetes mellitus. A rhinocerebral localization is common, leading to often fatal devastating sinusitis. Positive diagnosis requires histological proof with characteristic hyphal tissue invasion. Frozen section is essential for diagnosis and management of rhinocerebral mucormycosis. MATERIAL AND METHODS: We report four cases of rhinocerebral mucormycosis in diabetic patients, two men and two women, mean age 51 years. RESULTS: Histological examination showed characteristic hyphae in a vascular localization. Treatment was systemic antifungal therapy with amphotericin B and debridement of necrotic tissue. Three patients recovered completely. One died. CONCLUSION: Rhinocerebral mucormycosis is a rare fungal infection with very poor prognosis. The aim of this study was to report the clinical and pathological features of rhinocerebral mucormycosis and to evaluate the contribution of frozen section for diagnosis and management.

[Polymorphous low-grade adenocarcinoma of the accessory salivary glands--a case report]. / Adénocarcinome polymorphe de faible malignité des glandes salivaires accessoires--une observation.

A case of polymorphous low-grade adenocarcinoma of minor salivary gland is reported. This tumor was first described in two clinical case series in 1983. Before that time most of these neoplasms were diagnosed as benign salivary gland neoplasms (pleomorphic adenomas) or salivary malignant conditions (malignant pleomorphic adenomas, adenoid cystic carcinomas, papillary adenocarcinomas and adenocarcinoma not otherwise stated). This neoplasm, with few exceptions, originates in minor salivary gland tissues of the palates or buccal mucosa. It is characteristically slow to enlarge. Clinical reports show the neoplasm present for many years before diagnosis. The tumor have a variety of morphological patterns, a cytological uniformity and an infiltration into adjacent structures. The treatment is a wide local excision. Recurrences and lymph node metastases are rare.

[Buschke-Loewenstein giant condyloma in the perianal region with inguinal invasion: a case report]. / Condylome géant de Buschke-Loewenstein de la région périanale avec envahissement inguinal: a propos d'un cas.

The giant condyloma acuminatum of the perianal region is a tumor characterised by its large size with the propensity to infiltrate into deeper tissues, contrasting with a microscopically benign pattern. The evolution after malignant transformation of condyloma and lymph node invasion is rare. However it is exceptionally observed a lymph node invasion of microscopically benign condyloma acuminatum. The authors report a case of microscopically benign giant condyloma acuminatum of the perianal region associated with inguinal invasion, discovered in a 47 year-old man. Treatment consists in extensive surgery of the tumor and inguinal nodes, followed by a radiation therapy.

Adenolipoma of the skin.

Adenolipoma of the skin (ALS) is an uncommon histological variant of lipoma, characterized by the presence of normal eccrine sweat glands inside the fat proliferation. A 32-year-old woman presented to our department with a slow-growing, painless subcutaneous soft tumour located on the upper part of the right thigh. Microscopically, there was lobulated adipose tissue proliferation with well-differentiated eccrine glands and ducts in the periphery and centre of the nodule. These features were suggestive of ALS. ALS is a rare microscopic variant of cutaneous lipoma having similar clinical features to lipoma. The most frequent locations of this tumour are thighs (as in our patient), shoulders, chest and arms. Histologically, the tumour is composed of lobulated adipose tissue with larger and more prominent lobules than those in normal subcutaneous adipose tissue. A well-developed capsule may also be identified. Eccrine glands and ducts, without proliferative changes, are well-differentiated within the adipose tissue. Differential diagnosis of adenolipoma includes the common lipoma and its variants, skin tag and other hamartomatous lesions, such as nevus lipomatosus superficialis, and the lipomatous variant of eccrine angiomatous hamartoma.

[The myofibroblastic inflammatory tumours: A fortuitous association or an unknown postpartum complication]. / Les tumeurs myofibroblastiques inflammatoires : association fortuite ou complication peu connue du post-partum ?

The inflammatory myofibroblastic tumour has clinical, biological or histological features sometimes misleading with a septic condition. Presenting symptoms are variable and arising circumstances remain obscure. We report three cases occurring in a postpartum context. The first patient, a 28-year-old female, had left psoitis with a sepsis the first day postpartum in relation with an inflammatory myofibroblastic tumour of the meso-ovary. The second patient, a 40-year-old woman, had a hepatic inflammatory myofibroblastic tumour revealed by a ruptured sub-capsular haematoma of the liver in the forth day postpartum. The third patient, a 32-year-old woman, had a pulmonary inflammatory myofibroblastic tumour, diagnosed 5 months after a delivery and which recurred 10 years after surgical treatment. These cases illustrate the difficulty to diagnose inflammatory myofibroblastic tumour, particularly in postpartum.

[Leiomyoma of the ovary. Apropos of 12 cases]. / Les léiomyomes de l'ovaire. A propos de douze cas.

Twelve ovarian leiomyomas were seen over a 12-year period, representing one quarter of all reported cases. Most of them were situated in the ovarian hilum (9/12 of our cases), some were situated in the medulla (2 of our cases) and one case was situated in the cortex. They were fairly small and, due to their site, they were generally asymptomatic and rarely diagnosed on ultrasonography.

[Endometrioid adenocarcinoma of the uterine isthmus associated with atypical endometrial hyperplasia and polycystic ovaries. Apropos of a case with bicornuate uterus in a 38 year old woman]. / Adénocarcinome endométrioïde de l'isthme utérin associé à une hyperplasie endométriale atypique et à des ovaires polykystiques. A propos d'un cas sur utérus didelphe chez une femme de 38 ans.

A 38 year old patient with multiple known risk factors for endometrial carcinoma (monophasic cycles, obesity, familial prediabetes, nulliparity, polycystic ovaries with diffuse thecal hyperplasia) presented with metrorrhagia caused by an endometrial lesion for which the diagnosis hesitated between atypical endometrial hyperplasia and carcinoma. Hysterectomy was performed because of the presence of a bicornuate uterus, obesity of 130 kg and the patient's lack of desire to have children. Examination of the uterus did not reveal any myometrial invasion in contact with the hyperplastic endometrium. The discovery of an endometrioid carcinomatous metastasis in the lower third of the vagina one year later allowed the retrospective detection of a 3 mm endometrioid carcinoma in the isthmus. No other metastases or recurrence were observed with a follow-up of 5 years.

[Acute phlegmonous gastritis. Apropos of a case]. / La gastrite aiguë phlegmoneuse. A propos d'un cas.

Phlegmonous gastritis is a rare bacterial infection of the stomach. Its diagnosis is difficult and has a poor prognosis. The authors report a case of phlegmonous gastritis occurring in a 50 year-old woman in whom the diagnosis was made by microscopic examination after surgery for intestinal occlusion. The patient died a few hours after the operation.

[Non-invasive lesions of the cervical glands. Apropos of a study of 431 conization specimens]. / Lésions non invasives des glandes cervicales. A propos de l'étude de 431 pièces de conisation.

431 cone biopsy specimens referred for CIN2 and CIN3 between 1984 and 1993 were reviewed with a peculiar attention paid to the possible associated endocervical glandular changes. The following features could be demonstrated: microglandular hyperplasia (17 cases), tubal metaplasia (15 cases), mesonephric hyperplasia (10 cases), in situ adenocarcinoma (7 cases), tunnel clusters (5 cases), and ectopic endometrium (4 cases). Cervical glandular atypia could not be found. A classification of the glandular lesions in uterine cervix has been proposed for an accurate diagnostic approach of lesions who could simulate carcinomatous changes.