[Acute pyelonephritis and subcapsular hematoma revealing nephroblastoma at the age of 15 years]. / Pyélonéphrite aiguë et hématome sous-capsulaire révélant un néphroblastome à l'âge de 15 ans.

BACKGROUND: Nephroblastoma' the most common renal tumor in children between 1 and 5 years, occurs rarely in the oldest child. CASE REPORT: A 16-year-old teenager suffered from acute pyelonephritis caused by Klebsiella pneumoniae. Renal ultrasonography showed a left subcapsular hematoma; the CT scan confirmed the finding and also showed renal scarring. However, a second CT scan showed pulmonary nodules suggestive of metastasis, a diagnosis that was confirmed by needle biopsy of pulmonary lesions. Recovery was obtained after chemotherapy and nephrectomy with a 3-year-follow-up. CONCLUSION: This nephroblastoma was particular because its development in an adolescent, its association with acute pyelonephritis and subcapsular hemorrhage.

[Abdominoscrotal hydrocele]. / L'hydrocèle abdominoscrotale.

The abdominoscrotal hydrocele (ASH) is a rare variant of hydrocele of the tunica vaginalis with fluid accumulation into the abdominal cavity passing through the inguinal canal. The etiology of ASH is not clear. The positive diagnosis depends on the clinical data (hydrocele + abdominal mass). It is confirmed by means of echography and or by TDM. The treatment is surgical complete resection of the vaginalis with ligation of the peritoneal cavity. This report concerns the observation of a huge ASH, so far described in a literature review. We try to distinguish the diagnostic and therapeutic elements of this exceptional pathology.

[Cystic renal cancers. Review of 6 cases]. / Les cancers du rein d'aspect kystique. A propos de 6 observations.

The authors present six cases of cystic renal cancers which raised preoperative and intraoperative diagnostic difficulties. Computed tomography is currently the most reliable diagnostic examination. The diagnosis of complicated benign cyst must be made cautiously and persistence of doubtful images must lead to surgical exploration. The authors try to up-date the diagnostic strategy for atypical cysts based on recent progress in medical imaging and propose a practical approach to treatment.

[Testicular microlithiasis]. / La microlithiase testiculaire.

Testicular microlithiasis is an uncommon condition in which calcified concretions fill the lamina of seminiferous tubules. It has a specific appearance on sonography with diffuse intra testicular echogenic foci without acoustic shadows. Testicular microlithiasis can be associated with various entities and frequently with primary testicular neoplasm. The authors report a new case of testicular microlithiasis diagnosed by sonography in a 14-year-old boy with epididymo-orchitis. Based on a review and discussion of the literature, the authors emphasize the importance of regular and protracted ultrasound follow-up and monitoring of serum tumour markers to allow early detection of primary testicular neoplasm.

[Isolated kidney lymphoma. Case report]. / Le lymphome isolé du rein. A propos d'une observation.

Renal lymphomas, essentially secondary, are the commonest site of lymphoma in the urinary tract: 68% of cases. Apparently primary renal lymphoma is very rare and difficult to diagnose. The authors report the case of a 55-year-old patient admitted with solid tumour of the right kidney. Radical nephrectomy was performed. Histological examination revealed renal lymphoma. Postoperative assessment looking for other sites was negative. Based on a review of the literature, the authors analyse the epidemiological and diagnostic aspects of isolated lymphomas of the kidney.

[Extra-adrenal pheochromocytoma. Report of two cases]. / Le Phéochromocytome extra-surrénalien. A propos de deux cas.

Paraganglioma is rare neoplasm. The authors report two new cases. The first case was a 36 year-old woman who presented with post-micturitional episodes of hypertension. Radiologic and endoscopic investigations showed a left submucosal bladder neck tumor. A partial cystectomy was performed under neuroleptanalgesia. The postoperative course was uneventful is simple. The second case was a 61 year-old woman who presented with a non secreting para-aortic paraganglioma.

[Gangrenous conditions of the perineum and the genital area. Apropos of 15 cases]. / Les états gangréneux du périnée et de la sphère génitale. A propos de 15 observations.

The authors report 15 cases of gangrene of the perineum and genital organs: 10 patients with urological lesions (urethral stricture: 6 cases, benign prostatic hypertrophy: 3 cases, bladder stones: 1 case) and 5 patients with Fournier's disease. The unexpected recrudescence of this disease, its persistent severity, the limits of our understanding of the pathogenesis and the therapeutic problems involved, led the authors to analyse this series of cases which, despite an apparent diversity of aetiologies, retained common anatomical, bacteriological and therapeutic features. They stress the importance of emergency surgery, appropriate antibiotics and postoperative intensive care. The mortality remains high (5 patients in this series died).

[Urachal cyst. Report of 3 cases]. / Le kyste de l'ouraque. A propos de trois observations.

The authors report three cases of cyst of the urachus, one of which was complicated by infection. This diagnosis is only rarely established clinically. The current performance of ultrasonography allows very precise analysis of the anterosuperior surface of the bladder, which may reveal the diagnosis. The authors discuss the problems raised by cysts of the urachus and emphasize the importance of clinical history, physical examination and complementary investigations, particularly CT which should allow the diagnosis of this disease, which needs to be treated surgically.

[A case of bladder pheochromocytoma]. / A propos d'une observation de phéochromocytome vésical.

Phaeochromocytoma is an endocrine neuroectodermal tumour usually located in the adrenal gland, but occasionally arising in other organs. The authors report a case of a vesical phaeochromocytoma presenting with haematuria. Radiological and endoscopic investigations revealed a right laterovesical submucosal tumour. Partial cystectomy was performed. The normality of the postoperative endocrine survey suggested disappearance of the tumour and absence of any other sites.

[Disease of the pyelo-ureteral junction in adults. 215 cases in 194 patients]. / La maladie de la jonction pyélo-urétérale chez l'adulte. 215 cas chez 194 malades.

215 uretero-pelvic obstruction syndrome among 194 adult patients are analysed. 56.8% of them are of stage III or IV. Lithiasis is a frequent complication (41.8% of cases). The other congenital anomalies are very rare. The diagnosis is based on intravenous pyelography with use of furosemide test when the obstruction is moderate. 178 uretero-pelvic plasties are performed, the resection-anastomosis has retrained our choice. It was done in 119 cases with good results in 85.6 cases. Failure are due to error of indication or technical defect. The high level of nephrectomies (25%) is explained by the very important number of advanced and complicated cases. Among the less symptomatic patients, 37 haven't been operated on and were controlled. All except one remained stable.

[Attempted classification of scrotal contusions]. / Essai de classification des contusions scrotales.

We present a review of the literature and results of a survey involving 50 closed scrotal traumas. Based on this analysis, we propose an anatomoclinical classification of scrotal contusions based on what we consider to be the most appropriate therapeutic management.