[Epidemiologic study of pediatric uveitis: a series of 49 cases]. / Étude épidémiologique des uvéites de l'enfant: à propos de 49 cas.

PURPOSE: To analyze the patterns of pediatric uveitis. PATIENTS AND METHODS: A retrospective study of 49 children with uveitis, examined from January 2000 to December 2009. All patients underwent a complete ophthalmic examination and an etiological search; follow-up varied from six months to seven years. RESULTS: The mean age at onset of uveitis was 11.6 years (range, 5-14 years). The sex ratio was 1.04. Uveitis was bilateral in 59.20% of the patients, anterior in 22 cases (44.9%), intermediate in seven cases (14.3%), posterior in four cases (8.1%), and panuveitis was found in 16 cases (32.7%). In 57.2% of the patients, uveitis was idiopathic. Infectious uveitis was responsible for 14.1% of the cases, the most common of which were toxoplasmosis and toxocarosis. Systemic associations were found in 22.5%, with juvenile idiopathic arthritis in 6.2%. A specific ocular entity was responsible for 6.2% of the cases. Ocular complications occurred in 65.3% of the affected eyes, the most common being cataract (24.5%) and cystoid macular edema (20.5%). The final visual acuity was less than 20/200 in 18%. CONCLUSIONS: Pediatric uveitis is rare but may cause visual loss. In our study, the cause of uveitis in childhood remains most often undiagnosed. Toxoplasmosis and toxocarosis are the most frequent infectious causes. Cataract was the most frequent complication. A strict ophthalmological follow-up is mandatory to improve the prognosis.

Immunodetection of SV40 T/t-antigens in human osteosrcoma in a series of Tunisian patients.

Osteosarcoma is a primary bone malignancy that typically occurs during adolescence but also has a second incidence peak in the elderly. The etiology of osteosarcoma is not well understood. Recent investigations have identified SV40 DNA sequences in osteosarcomas, suggesting that SV40 may contribute to tumor development. However, these studies also demonstrated geographical differences in SV40-positive osteosarcomas. The purpose of this study was to determine the prevalence and clinicopathological characteristics of SV40 positive osteosarcoma in Tunisian patients. Fifty-six formalin-fixed paraffin-embedded specimens of osteosarcomas were retrospectively investigated. Samples investigated were clinical cases examined between 1990 and 2004 in the Laboratory of Pathology at the University Hospital Farhat-Hached of Sousse (Tunisia). The search for SV40 was performed by immunohistochemistry using the Pab108 antibody for the detection of the viral oncoproteins: large T antigen and small t antigen (T/t-ag). SV40 status was correlated with clinico-pathological data. T/t-ag immunostaning was detected in the tumor cells in 31/56 (55.4%) osteosarcoma cases. SV40 positivity was more frequent (83%) in patients older than 40 years (5/6 cases) than in patients under 40 years (52%, 26/50), but the difference does not reach statistical significance (p = 0.33). Moreover, the time between the onset of clinical symptoms and diagnosis was shorter for SV40 positive than SV40 negative cases (p = 0.08). However, the viral status did not differ significantly according to gender, tumor size, histological subtype, tumor location, or metastases. This study documents the presence SV40 T/t-antigens in a proportion of osteosarcomas in Tunisian patients. The expression of these viral oncoproteins supports the hypothesis that SV40 may have a role in the pathogenesis of this tumor.

[Orbital metastasis from cutaneous melanoma]. / Métastase orbitaire d'un mélanome malin cutané.

PURPOSE: We report the case of a patient presenting with a one-sided orbital metastasis from a cutaneous melanoma, and analyze clinical features, diagnostic difficulties and prognosis of such metastasis. CASE REPORT: We report the case of a woman aged 70 years, who presented with a right one-sided proptosis associated to a decrease of the vision. The clinical features were: visual acuity at 2/10, an axile proptosis and a papillary sectorial temporal atrophy. The computed tomography (CT) disclosed an intraorbital mass with double tonality, rounded and well limited driving back the optic nerve and erasing the limits of the lateral rectus muscle. The orbital magnetic resonance imaging (MRI) showed an intra-conal fusiform mass with an heterogeneous signal in T1 and T2, heightening intensely and heterogeneously after the injection of Gadolinium. Otherwise, the patient presented with an associated respiratory failure, and thoracic CT has disclosed diffuse metastases. It was then noted that a cutaneous melanoma of the left foot had been operated ten years before. The patient died during the following month. DISCUSSION: The cutaneous melanoma is a rare cause of orbital metastasis. The diagnosis is often easy, when a primitive tumor is known, but it remains uncertain for a long time. CONCLUSION: Orbital metastases from cutaneous melanoma are rare, generally occurring at the late stage of the disease with a life expectancy not passing one year.