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ABSTRACT: To evaluate management and outcome of the treatment of uterine leiomyosarcoma.
Retrospective study of a series of 9 patients treated for uterine leiomyosarcoma in this hospital from 1982 to 1994.
The condition is rarely suspected preoperatively, diagnosis is usually made on histological examination of the operative specimen. The outcome is related to the mitotic activity of the tumour and to the infiltration of nearly structures. Surgery is the only effective treatment, chemotherapy is ineffective, adjuvant radiotherapy improves local control of the tumour but has no incidence on survival.
In the absence of an effective adjuvant treatment uterine leiomyosarcoma bears a poor prognosis with the only exception of small non infiltrating tumours with a low mitotic activity.
Journal de Gynécologie Obstétrique et Biologie de la Reproduction 02/1997; 26(3):256-62. · 0.42 Impact Factor
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ABSTRACT: Having treated a case which resulted in the delivery at term of an intrauterine twin when the other twin had been lost after the rupture of a uterine cornu which itself followed a salpingectomy without removal of the interstitial portion of the tube brings the authors to discuss the physiopathology and the symptomatology of such cases. They also discuss the value of resecting the interstitial portion of the tube and what management should be when there is a live intrauterine pregnancy.
Journal de Gynécologie Obstétrique et Biologie de la Reproduction 02/1993; 22(4):411-6. · 0.42 Impact Factor
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ABSTRACT: Hydranencephaly is the total or virtually total absence of the cerebral hemispheres, which are reduced to a membranous sac of glial tissue, with no ependymal coating, in an intact skull. This is rare disorder (0.5 per thousand births). It is classified as a circulatory encephalopathy. Two opposing theories are generally advanced: the encephaloclastic or destructive theory and the theory of dysontogensis or malformation, due to early disruption of organogenesis. It has many causes (vascular, viral, parasitic, genetic, toxic, estrogenic...). It appears to be readily diagnosed by ultrasound, the neurological findings may be normal at birth, but transillumination of the skull remains a simple and reliable diagnostic test. Transfontanellar ultrasound, CT scanning and anatomical confirmation alone can establish the diagnosis. The prognosis is hopeless and there is no treatment.
Revue française de gynécologie et d'obstétrique 06/1991; 86(5):401-5.
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ABSTRACT: A case is reported of an infection with Streptococcus pyogenes, occurring 24 hours after an elective Caesarean section in a 30 year old woman. She worsened during the first 48 h, with shock (Pasys less than 70 mmHg, pH 7.28) as well as abdominal tenderness and guarding. Laparotomy revealed peritonitis, and subtotal hysterectomy was carried out. Gram positive cocci were found in the peritoneal exudate, with bacterial cultures yielding Streptococcus pyogenes. Histopathological examination of the specimen revealed necrosing endomyometritis with septic thrombophlebitis. During the immediate post-operative period, there were several prolonged episodes of circulatory arrest treated with dobutamine, adrenaline, and noradrenaline. Multiple organ failure occurred during the next five days, despite antibiotic therapy (vancomycin, tienamycin, amikacin) and intensive care. It included jaundice, thrombocytopaenia (10 G.l(-1] adult respiratory distress syndrome (ARDS). A further laparotomy was carried out because of abdominal and thigh cellulitis, with completion of the hysterectomy and bilateral salpingo-oophorectomy. Streptococcus pyogenes was still present in the peritoneal cavity. There followed an improvement, with a return to normal of the platelet count, haemodynamic stability such that vasoactive drugs were no longer needed, and a decrease in the degree of jaundice. However, the ARDS worsened, and the patient died 15 days after the Caesarean section. There have been recent reports of similar cases, suggesting an increase in the virulence of group A streptococci linked to a re-emergence of exotoxin A.
Annales Françaises d Anesthésie et de Réanimation 02/1990; 9(5):447-9. · 0.84 Impact Factor
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ABSTRACT: In France, 7,000 women die yearly of cancer of the breast, and 25,000 new cases are registered. The seriousness of the illness and its frequency show how important it is to diagnose it early at a stage before invasion or in situ (where 95 to 100% can be cured). In 4 years, at the University Hospital of Rennes, 90 out of 446 patients who were operated on for breast lesions had invasive cancer of the breast, i.e. 20%. 12 had a carcinoma in situ of the breast (C.I.S.E.), constituting 2.6%, of which 9 were in situ duct carcinomas and 3 in situ lobular carcinomas. In situ carcinoma of the breast can take almost any clinical form (a nodule, pain in the breast, mastitis, blood stained discharge from the nipple or Paget's disease). This means that lobular carcinoma in situ is always a surprise when diagnosed histologically in a lesion that is clinically benign. Since the anatomo-pathological diagnosis is difficult, a simple examination of the breast is not to be relied on in cases of carcinoma in situ of the breast. Mammography is the only truly valuable investigation in early diagnosis of C.I.S.E.
Journal de Gynécologie Obstétrique et Biologie de la Reproduction 02/1988; 17(4):491-4. · 0.42 Impact Factor
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ABSTRACT: The authors explain the particular nature of these multifocal tumors: absence of node involvement, difficulties of diagnosis, relatively favorable prognosis and a therapeutic dilemma: limited procedure with strict surveillance, subcutaneous bilateral mastectomy.
Revue française de gynécologie et d'obstétrique 01/1987; 81(12):667-9.
