G Escourrou

Centre Hospitalier Universitaire Rouen, Rouen, Upper Normandy, France

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Publications (54)82.78 Total impact

  • Annales de Pathologie 02/2013; 33(1):70–72. · 0.24 Impact Factor
  • Annales de Pathologie 02/2013; 33(1):70-2. · 0.24 Impact Factor
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    ABSTRACT: Context:McCune-Albright syndrome (MAS) is characterized by polyostotic fibrous dysplasia, café-au-lait skin pigmentations, and gonadotropin-independent sexual precocious puberty, resulting from a somatic postzygotic activating mutation of the GNAS1 gene.Setting:We report a virilizing sclerosing-stromal tumor of the ovary in a young female with MAS.Patient:She presented polyostotic fibrous dysplasia of the left upper and lower limbs and a café-au-lait skin spot in the posterior area of the neck. She had a history of precocious puberty, diagnosed at the age of 6 years and treated with cyproterone acetate until the age of 10 years; then she developed central puberty with severe oligomenorrhea. At the age of 23 years, she was hospitalized for a virilization syndrome including hirsutism, acne, deepening of the voice, amenorrhea, and clitoromegaly. Serum levels of T were dramatically increased (1293 ng/dl; normal range, 10-80). The abdominal computed tomography scan revealed a solid mass located on the left ovary.Intervention:An ovariectomy was performed, and histological examination revealed a sclerosing-stromal tumor with pseudolobular pattern.Results:Immunohistochemical studies revealed that the tumor cells expressed all steroidogenic enzymes involved in androgen synthesis. Molecular analysis revealed that ovarian tumor cells harbored the Arg 201 activating mutation in the GNAS1 gene. After surgery, T levels returned to normal, the patient retrieved a normal gonadal function, and she was able to become pregnant.Conclusion:This observation extends the clinical spectrum of ovarian pathology of women with MAS. However, the mechanisms causing this ovarian tumor remain unclear, even if the gsp oncogene has been implicated in the pathogenesis of some gonadal tumors.
    The Journal of clinical endocrinology and metabolism 01/2013; · 6.50 Impact Factor
  • Cytopathology 07/2012; · 1.71 Impact Factor
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    ABSTRACT: Nitric oxide synthases (NOSs) and estrogen receptors are expressed in the female urethra. We aimed to assess the impact of sildenafil on micturition behavior, urethral tone according to the hormonal status and to determine the implications of the neuronal isoform of NOS (nNOS). Four-week-old C57/BL6 female mice were sham-operated or ovariectomized. Six weeks later, they were injected intraperitoneally by any combination of sildenafil, 7-nitroindazole (7-NI)-a potent selective nNOS inhibitor-or the corresponding vehicles. The mice were then subjected to micturition behavior and leak point pressure studies. Urethral histomorphometry was performed. The main outcome measures were micturition behavior, leak point pressure, and histomorphometry. In sham-operated and ovariectomized animals, sildenafil did not impact micturition, although it decreased urethral resistance 10-fold. nNOS inhibition by 7-NI reduced the number of micturitions and increased residual volume and leak point pressure. It abrogated sildenafil-induced drop in urethral resistances. Hormonal status did not influence the structure of the urethral layers. Irrespective of the hormonal status, sildenafil decreased leak point pressure by a nNOS-mediated mechanism.
    Journal of Sexual Medicine 12/2011; 9(2):466-71. · 3.51 Impact Factor
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    ABSTRACT: Vulvar Paget's disease is sub-classified into three types based upon its origin. It might be a primary vulvar disease (type 1) or associated with a non-cutaneous adenocarcinoma-rectal, colonic, cervical (type 2) or linked with an urothelial neoplasia (type 3). Type 1lesions must be considered as potentially invasive. Their immunophenotype is CK7+/CK20-. Classically, in case of depth of invasion below 1mm, nodal metastases are exceptional. We report a case of type 1 Paget's disease in a postmenopausal woman with superficial invasion and multiple inguinal nodal metastases.
    Annales de Pathologie 10/2011; 31(5):341-4. · 0.24 Impact Factor
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    ABSTRACT: Ovarian Sertoli-Leydig cell tumours (SLCT), also termed arrhenoblastomas, are the most frequent virilising tumours in women of reproductive age. Very rare secretory Brenner tumours (BT) have been described, generally after the menopause. A 31-year-old woman sought medical advice for secondary amenorrhoea, progressive hirsutism and a 5-year history of virilisation syndrome with clitoromegaly. Testosterone was markedly high (285 ng/dl, N<85) with moderate elevation of delta 4-androstenedione (D4AD) (311 ng/dl, N <270), dehydroepiandrosterone sulfate (DHEAS) (366 μg/dl, N <340) and 17-hydroxyprogesterone (17OHP) (275 ng/dl). LH was 9 IU/l, FSH 4.3 IU/l, estradiol 60 pg/ml and progesterone 314 ng/100 ml. Cortisol was decreased (1.3 μg/dl) after the dexamethasone suppression test. Pelvic MRI showed a 5-cm right ovarian tumour with a 2.5 cm nodular component and cystic areas, and two nodules measuring 11 mm and 15 mm above the right and left ovaries. After right ovariectomy by laparoscopy, pathological examination concluded on a 3-cm SLCT and a 2-cm BT; the nodules above the ovaries were dysembryoplastic cysts. Postoperatively, testosterone level was normal after 24 h (26 ng/dl), estradiol and progesterone rapidly decreased, cyclic secretion then resumed and the patient menstruated at day 27. To our knowledge, this is the first report of an ovarian tumour associating a Sertoli-Leydig cell tumour and a Brenner tumour in a patient with virilisation syndrome which resolved after ovariectomy.
    Gynecological Endocrinology 05/2011; 27(5):345-50. · 1.30 Impact Factor
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    ABSTRACT: Solitary fibrous tumors of the genital tract female are extremely rare. We reported a case of solitary fibrous tumor originating in the vulva of a 37-year-old woman. The histological analysis revealed a conjunctiva tumourous proliferation, with variable cellularity, the morphology feature and the immunohistochemistry profile of which entailed us to infer on a solitary fibrous tumor. No recurrence was observed 16 months after surgery with flap reconstruction. Because of their possible pejorative evolution, it is very important to know these tumors. A long term follow-up must be advised.
    Gynecologie Obstetrique & Fertilite - GYNECOL OBSTET FERTIL. 01/2011; 39(2).
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    ABSTRACT: Vulvar Paget's disease is sub-classified into three types based upon its origin. It might be a primary vulvar disease (type 1) or associated with a non-cutaneous adenocarcinoma–rectal, colonic, cervical (type 2) or linked with an urothelial neoplasia (type 3). Type 1 lesions must be considered as potentially invasive. Their immunophenotype is CK7+ / CK20–. Classically, in case of depth of invasion below 1 mm, nodal metastases are exceptional. We report a case of type 1 Paget's disease in a postmenopausal woman with superficial invasion and multiple inguinal nodal metastases.
    Annales De Pathologie - ANN PATHOL. 01/2011; 31(5):341-344.
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    ABSTRACT: Solitary fibrous tumors of the genital tract female are extremely rare. We reported a case of solitary fibrous tumor originating in the vulva of a 37-year-old woman. The histological analysis revealed a conjunctiva tumourous proliferation, with variable cellularity, the morphology feature and the immunohistochemistry profile of which entailed us to infer on a solitary fibrous tumor. No recurrence was observed 16 months after surgery with flap reconstruction. Because of their possible pejorative evolution, it is very important to know these tumors. A long term follow-up must be advised.
    Gynécologie Obstétrique & Fertilité 01/2011; 39(2):e49-51. · 0.55 Impact Factor
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    ABSTRACT: PRÉCIS: Positive endocervical margins are an important predictor of recurrence in high-grade cervical lesions, and though they do not always warrant retreatment, closer surveillance is recommended. To identify predictors of recurrence and persistence of high-grade cervical dysplasia and to determine appropriate follow-up. Design: prospective pilot study. Setting: Gynaecological surgical center. Three hundred fifty-two patients were treated between 1999 and 2002 for high-grade lesions. According to the accessibility of the transformation zone and the degree of dysplasia, patients were treated either by conization or by loop electrosurgical excision procedure (LEEP). Follow-up comprised colposcopy and Pap-smear screening 4-6 months after treatment as well as high-risk human papillomavirus (HR-HPV) testing before and after treatment. underscore predictors of recurrence and propose a treatment flowchart for both management and follow-up. Of the 352 patients, 37 (10.5%) had true recurrence 6 months after initial surgical treatment and 6 patients (1.7%) had persistent lesions. Overall, 43 patients (12.2%) were considered as having recurrent disease. Patients were followed up for 5 years with a mean of 73 months. The most important predictor of recurrence was a positive HR-HPV test at 6 months postoperatively (odds ratio 38.8, 95% confidence interval 14.09, 107.05). The second significant predictor was positive endocervical margins and the third was positive pre-treatment HPV typing. A positive post-treatment HPV test had a more significant influence on risk than a positive test before treatment. In agreement with recent findings, our study supports the usefulness of the HR-HPV test in the follow-up of treated high-grade lesions, especially when excision margins were positive.
    European journal of surgical oncology: the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology 11/2010; 36(11):1073-9. · 2.56 Impact Factor
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    ABSTRACT: The CT and MR imaging features of the main cardiac tumors will be reviewed. Cross-sectional imaging features may help differentiate between cardiac tumors and pseudotumoral lesions and identify malignant features. Based on clinical features, imaging findings are helpful to further characterize the nature of the lesion. CT and MR imaging can demonstrate the relationship of the tumor with adjacent anatomical structures and are invaluable in the presurgical work-up and postsurgical follow-up.
    Journal de Radiologie 09/2010; 91(9 Pt 1):857-77. · 0.35 Impact Factor
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    ABSTRACT: The CT and MR imaging features of the main cardiac tumors will be reviewed. Cross-sectional imaging features may help differentiate between cardiac tumors and pseudotumoral lesions and identify malignant features. Based on clinical features, imaging findings are helpful to further characterize the nature of the lesion. CT and MR imaging can demonstrate the relationship of the tumor with adjacent anatomical structures and are invaluable in the presurgical work-up and postsurgical follow-up.
    Journal De Radiologie - J RADIOL. 01/2010; 91(9):857-877.
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    ABSTRACT: We report the histological evaluation of both endocardial and epicardial radiofrequency (RF) ablation lesions in the explanted heart of a patient presenting with nonischemic dilated cardiomyopathy complicated by recurrent electrical storms. In this case, chronic RF lesions were almost transmural at the endocardial side, while remaining only superficial at the epicardial aspect, possibly because of the insulating interposed epicardial fat layer.
    Pacing and Clinical Electrophysiology 10/2008; 31(9):1218-22. · 1.75 Impact Factor
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    ABSTRACT: Adenoid cystic carcinoma generally arises from the salivary glands and is rarely found in the female genital tract. Infection with HPV is implicated in this cervical lesion. Differential diagnosis includes adenoid basal carcinoma, polymorphous low-grade adenocarcinoma and basaloid squamous cell carcinoma. Only one case of vaginal localisation was previously described. We report a case of adenoid cystic carcinoma in a 48-year-old woman with previous cervical HPV infection. Histological examination revealed nests of cells with peripheral palisading organisation and glandular lumina containing material produced by the tumor cells.
    Annales de Pathologie 05/2008; 28(2):135-7. · 0.24 Impact Factor
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    ABSTRACT: Estrogens are known to modulate lower urinary tract (LUT) trophicity and neuronal nitric oxide synthase (nNOS) expression in several organs. The aim of this study was to explore the effects of endogenous and supraestrus levels of 17beta-estradiol (E2) on LUT and urethral nNOS expression and function. LUT function and histology and urethral nNOS expression were studied in adult female mice subjected either to sham surgery, surgical castration, or castration plus chronic E2 supplementation (80 microg.kg(-1).day(-1), i.e., pregnancy level). The micturition pattern was profoundly altered by long-term supraestrus levels of E2 with decreased frequency paralleled by increased residual volumes higher than those of ovariectomized mice. Urethral resistance was increased twofold in E2-treated mice, with no structural changes in urethra, supporting a pure tonic mechanism. Acute nNOS inhibition by 7-nitroindazole decreased frequency and increased residual volumes in ovariectomized mice but had no additive effect on the micturition pattern of long-term supraestrus mice, showing that long-term supraestrus E2 levels and acute inhibition of nNOS activity had similar functional effects. Finally, E2 decreased urethral nNOS expression in ovariectomized mice. Long-term supraestrus levels of E2 increased urethral tone through inhibition of nNOS expression, whereas physiological levels of E2 had no effect.
    AJP Regulatory Integrative and Comparative Physiology 04/2008; 294(3):R851-7. · 3.28 Impact Factor
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    ABSTRACT: La présence d’une maladie résiduelle infracentrimétrique après chirurgie de debulking des cancers ovariens avancés est le facteur pronostique le plus important. La chirurgie d’intervalle après trois à six cycles de chimiothérapie augmente-t-elle le taux de résection infracentimétrique ? Le but de cette étude est de comparer le taux de résection infracentimétrique et la survie sans récidive dans le groupe A (43 patientes: chirurgie d’intervalle) et le groupe B (43 patientes: cytoréduction optimale première) à la clôture du traitement. Les taux de résection considérés comme optimaux (< 1 cm) sont respectivement de 88,4 et de 65,1 % dans les groupes A et B. La différence dans la survie sans récidive à trois ans tend vers la significativité sans l’atteindre (p = 0,08). La chirurgie d’intervalle paraît être une bonne alternative pour sélectionner les patientes résistantes aux sels de platine, et pour diminuer la morbidité chirurgicale chez les patientes ne pouvant bénéficier d’une chirurgie première. The presence of residual tumour measuring less than 1 cm after debulking surgery for advanced ovarian cancer is the most significant prognostic factor. Does interval surgery after three to six cycles of chemotherapy increase the resection rate of lesions measuring less than 1 cm? The aim of this study was to compare the rate of these resections and disease-free survival (DFS) in an interval surgery group (A) and a cytoreductive surgery group (B) at the end of treatment. The rates of resection of tumours measuring less that 1 cm, considered the optimal treatment, are, respectively, 88.4 and 65.1% (P < 0.05) in groups A and B. The difference in DFS after 3 years is not significant but tends toward significance (P = 0.08). Interval surgery is a good alternative for platinum-resistant patients and decreases the morbidity of patients for whom debulking surgery is contraindicated.
    Oncologie 02/2008; 10(3):216-225. · 0.10 Impact Factor
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    ABSTRACT: Adenoid cystic carcinoma generally arises from the salivary glands and is rarely found in the female genital tract. Infection with HPV is implicated in this cervical lesion. Differential diagnosis includes adenoid basal carcinoma, polymorphous low-grade adenocarcinoma and basaloid squamous cell carcinoma. Only one case of vaginal localisation was previously described. We report a case of adenoid cystic carcinoma in a 48-year-old woman with previous cervical HPV infection. Histological examination revealed nests of cells with peripheral palisading organisation and glandular lumina containing material produced by the tumor cells.
    Annales De Pathologie - ANN PATHOL. 01/2008; 28(2):135-137.
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    ABSTRACT: To evaluate the role of PTH-related peptide (PTH-rP) and 1,25-dihyhydroxyvitamin D3 in a case of hypercalcemia related to an ovarian adenocarcinoma. We report a case of humoral hypercalcemia in a patient aged 74 yr with a clear cell adenocarcinoma of the right ovary at an early stage of its development (stage T1aN0M0) revealed by moderate and persistent hypercalcemia (variable level between 2.7 and 3.2 mmol/l without any treatment) over six months. PTH-rP and 1,25-dihydroxyvitamin D3 were measured in blood samples taken before and after hysterectomy and bilateral salpingooophorectomy and in blood samples taken intraoperatively from the right ovarian vein and a peripheral vein. High levels of plasma PTH-rP and 1,25-dihydroxyvitamin D3 concomitant with high serum calcium and low PTH levels were found before surgery, which was followed by normalisation of all parameters studied. A concentration gradient was found regarding plasma PTHrP (right ovarian vein 60.4 pmol/l, peripheral vein 4.5 pmol/l), not 1,25-dihydroxyvitamin D3. 1) moderate and persistent hypercalcemia can be observed at an early stage of an ovarian carcinoma; 2) the gradient of PTH-rP concentration between the samples taken from the right ovarian vein and a peripheral vein provides evidence for a direct secretion of PTH-rP by the ovarian tumor; 3) the increased 1,25-dihydroxyvitamin D3 level is not related to a direct ovarian production, but is a consequence of PTH-rP secretion.
    Journal of endocrinological investigation 06/2006; 29(5):443-9. · 1.65 Impact Factor
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    ABSTRACT: The distinction between benign and malignant well-differentiated endocrine tumours is hard to achieve. The aim of the present study was to determine whether detection of telomerase or quantification of human telomerase reverse transcriptase protein subunit (hTERT) differ between benign and malignant endocrine tumours. This retrospective study investigated 31 well-differentiated primary endocrine tumours. Based on clinical and histopathological criteria, tumours were categorized with the most recent WHO classification as 'benign' (n = 14), 'uncertain' (n = 5) or 'malignant' (n = 12) with (n = 7) or without (n = 5) metastasis after a mean follow-up of 40.4 +/- 25.8 months (4-122 months). All these tumours were assayed for telomerase activity and hTERT mRNA expression [real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR)]. Telomerase activity was detected in 7 malignant and metastatic tumours, in 1 malignant tumour without metastases, in 1 uncertain tumour and in 1 benign tumour. hTERT mRNA levels were significantly higher in malignant endocrine tumours with or without metastases (P = 0.001) when compared to benign tumours. The negative predictive value of hTERT mRNA quantification for the diagnosis of malignancy was 88.9%, whereas the positive predictive value was 68.7%. The presence of telomerase activity within the primary endocrine tumour might indicate a malignant tumour and might suggest the need for an attentive search for concomitant metastases. Quantification of hTERT mRNA could be used in clinical practice to exclude malignancy in most endocrine tumours.
    Clinical Endocrinology 02/2006; 64(1):63-7. · 3.40 Impact Factor

Publication Stats

191 Citations
82.78 Total Impact Points

Institutions

  • 2008
    • Centre Hospitalier Universitaire Rouen
      • Service d'Urologie
      Rouen, Upper Normandy, France
  • 2002
    • Institut Claudius Regaud
      Tolosa de Llenguadoc, Midi-Pyrénées, France
  • 2001
    • Centre Hospitalier Universitaire de Toulouse
      Tolosa de Llenguadoc, Midi-Pyrénées, France