[The REVELA13 observatory to study new cases of bladder tumor among women living in Bouches-du-Rhône county]. / Rôle de l'observatoire REVELA13 dans l'épidémiologie des tumeurs de vessie des femmes dans les Bouches-du-Rhône.

INTRODUCTION: The REVELA13 observatory is a unique epidemiological tool listing the new cases of kidney tumors, bladder tumors and acute leukaemias in the Bouches-du-Rhône county (France). Aim was to exploit for the first time data from this observatory regarding new cases of bladder tumors≥T1 in women from 2012 to 2014. MATERIALS: This epidemiological study was observational and descriptive. Fifteen non-nominative variables from the REVELA13 database were analyzed in order to describe the clinical and pathological characteristics of the incident cases as well as their spatial and temporal distribution. The incidence rates expressed in new cases per year per 100000 inhabitants were standardized on the world age, calculated with 95 % confidence intervals and compared to national estimates for the same period. RESULTS: Incident bladder tumor cases were recorded in 291 women, corresponding to a standardized incidence on the world age of 3.85 [3.32-4.37] new cases per year per 100,000 population, 54 % higher than the national estimates of 2012 and 2015. Median age of diagnostic was 75.9 years. Sex ratio was 19.41 % (W/M). Tumors were predominantly non-muscle-invasive (52 %), high grade (69 %) and without associated carcinoma in situ (Cis) (49 %). The two most affected territories were Marseille and Aubagne-La Ciotat. CONCLUSION: The REVELA13 observatory has improved our epidemiological knowledge on female bladder tumors in Bouches-du-Rhône county and highlighted a local over incidence. LEVEL OF EVIDENCE: 3.

[Epidermoid cyst of the testis. Conservative surgery in 3 cases]. / Kyste épidermoïde du testicule. Chirurgie conservatrice à propos de 3 cas.

The authors report 3 cases of epidermoid cyst of the testis. Clinical, laboratory and ultrasound data were relatively nonspecific. Precise histological criteria were defined by PRICE in 1969. The diagnosis is based on frozen section examination after transnnguinal testicular exploration. The authors describe the most conservative therapeutic approach for a constantly benign testicular tumour.

[Ureteral replacement with non-modelled isoperistaltic ileoplasty]. / Remplacement urétéral par iléoplastie isopéristaltique non modelée.

OBJECTIVES: To study the long-term morbidity and efficacy of ureteroileoplasty in a retrospective series of 18 patients. MATERIALS AND METHODS: 12 men and 6 women with a mean age of 50 years underwent ureteroileoplasty with unilateral replacement in 15 patients and bilateral replacement in 3 patients. A total of 21 units renoureteral units were repaired by this technique. The pelvic ureter was replaced in 16 renoureteral units, the lumbar ureter was replaced in 1 case and the entire ureter was replaced in 4 cases. The commonest ureteral lesions were strictures secondary to ureteroscopy or ureterolithotomy (40%). All patients had normal renal function, except for one patient with serum creatinine of 224 mumol/l. RESULTS: With a mean follow-up of 25 months (range: 3 to 64 months) all ureteroileoplasties were patent with no major morbidity. Only the patient with preoperative renal failure developed hyperchloraemic acidosis with deterioration of her renal function. CONCLUSION: In the absence of renal failure, ureteroileoplasty is an operation with low morbidity achieving good medium-term results.

Fine-needle percutaneous biopsy of renal masses with helical CT guidance.

PURPOSE: To evaluate the feasibility, accuracy, and clinical role of fine-needle percutaneous biopsy of renal masses, with helical computed tomographic (CT) guidance. MATERIALS AND METHODS: In 63 patients (mean age, 62 years), 73 biopsies were performed. The median tumor size was 4.0 cm. Tumor biopsy was performed with an 18-gauge needle by using helical CT guidance in an outpatient setting. Two to four cores per tumor were obtained. RESULTS: Biopsy material was insufficient for analysis in 15 (21%) procedures. The median tumor size of failed or successful biopsies was 3.0 or 4.8 cm, respectively (P =.03). A benign lesion was found at eight biopsies. Two samples were suspicious for renal cell carcinoma (RCC). RCC was found in 38 biopsy samples. The remainder were transitional cell carcinoma, metastasis, lymphoma, or sarcoma. Twenty-six patients underwent nephrectomy. The accuracies of biopsy for histopathologic and Fuhrman nuclear grade evaluation were 89% and 78%, respectively. For tumors of 3.0 cm or smaller or larger than 3.0 cm, 37% (11 of 30) or 9% (four of 43) had failure of biopsy, respectively (P =.006). No substantial morbidity occurred. CONCLUSION: Fine-needle biopsy with helical CT guidance is accurate for the histopathologic evaluation of renal masses without morbidity. Indications are renal lesions that do not have the typical radiologic features of RCC, Bosniak category III or IV cystic lesions, and locally advanced or metastatic RCC.

[Diagnostic value of percutaneous biopsy of the renal masses. 73 cases]. / Valeur diagnostique des biopsies percutanées des masses rénales. A propos de 73 cas.

The aim of this study is to evaluate the diagnostic value of percutaneous biopsies of renal masses with comparison of pathological data between the biopsies and the surgical specimens. Thus, we retrospectively studied 73 biopsies of patients, who were referred to our institution between 1995 and 1997. The mean age of the patients was 60 +/- 14 years with a male predominance (67%). Twenty per cent of the biopsies were negative. Eleven per cent of the biopsies were benign lesions (oncocytoma, angiomyolipoma, infectious lesions). For renal cell carcinomas, the correlation coefficient between biopsy histology and final pathology was 0.87. Conversely, it was only 0.36 for the Führman grading. Nevertheless, low (1-2) and high (3-4) grades were accurately separated (0.92). We conclude that the percutaneous biopsy is a useful tool for diagnosis of renal masses.

[CT-guided percutaneous fine needle biopsy of solid tumors of the kidney]. / Les biopsies percutanées à l'aiguille fine des tumeurs solides du rein sous guidage tomodensitométrique.

OBJECTIVE: This study was designed to evaluate the reliability and the role of percutaneous needle biopsy in the diagnosis of renal masses. MATERIALS AND METHODS: 85 biopsies were performed in 74 patients (mean age: 62 +/- 14 years). The median tumour diameter was 4.44 +/- 2.53 cm. Biopsies were performed with an 18G ASAP* needle with CT guidance. 2 to 4 cores were obtained per patients. All biopsies were performed as an outpatient procedure. RESULTS: Biopsies were uninterpretable in 15 cases (17%) (13 with normal or no renal tissue and 2 necrotic samples). A benign lesion was detected in 8 cases (4 fibrous lesions, 4 infectious lesions). In 3 cases, biopsies were suspicious of cancer, which was confirmed on definitive histology. In 59 cases, biopsies were neoplastic: 6 benign tumours (4 oncocytomas, 1 angiomyolipoma, 1 cystadenoma), 42 renal cell carcinomas (RCC) (conventional: 32, chromophobe: 3, tubulopapillary: 7), 5 urothelial carcinomas, 3 metastases, 2 lymphomas and 1 sarcoma. The median Fürhman grade was 2. 30 RCC were operated. The correlation coefficient for the biopsy and pathology histological type was 0.90. The median pathological Fürhman grade was 2. The biopsy results modified therapeutic management in 38% of cases. There was no morbidity, post-biopsy medical management was never required. CONCLUSION: Biopsy of renal masses is reliable for evaluation of the histological type. The introduction of the CT scope should increase the accuracy of biopsies. The morbidity is low compared to that of diagnostic surgery.

[Malignant histiocytofibroma of the bladder. A case report]. / Histiocytofibrome malin de la vessie. A propos d'un cas.

Malignant histiocytofibroma of the bladder is a rare (16 cases reported in the literature) and very aggressive sarcoma. It is sometimes associated with a haematological malignancy. The authors report a case of malignant histiocytofibroma of the bladder in a 72-year-old haemodialysed woman with a poor general status. She had a history of chemotherapy and radiotherapy for gastrointestinal lymphoma 6 years previously. Treatment consisted of palliative cystectomy for bladder pain and haematuria. A massive pelvic and abdominal wall recurrence occurred two months after cystectomy and the patient died. The authors review the 16 cases of malignant histiocytofibroma of the bladder reported in the literature. Histiocytofibroma is a tumour which requires aggressive treatment with a combination of radical surgery and systemic chemotherapy.