[Multiple metastases of a mandibular ameloblastoma]. / Métastases multiples d'un améloblastome mandibulaire.

INTRODUCTION: Ameloblastoma is a benign odontogenic tumor which can be locally aggressive and invasive. Metastases are rare but possible and must be considered as a malignant form of the tumor. OBSERVATION: A 50-year-old woman presented a jugal metastasis of a mandibular ameloblastom which had been treated several times 28 years earlier. Six months after resection of the metastasis, the patient developed multiple cervical node metastases which were removed by radical curettage. Five months later, new metastases developed on the scalp and three months later a voluminous metastasis involving the right hemiface extended to the base of the skull. Surgical resection was only partial followed by radiotherapy. Ten months later the outcome was favorable. DISCUSSION: The absence of any histological sign of malignity in the primary tumor and in the metastases, as observed in our patient, is remarkable. Metastases generally develop in the lung (61-80% of cases). Metastases to the scalp have never been described. The time to development of a metastasis is generally very long and metastases usually remain asymptomatic. Progression is very slow, like for the primary tumor. Several factors predictive of metastasis have been described: female gender, age at onset of primary tumor (2nd to 3rd decade) and multiple local recurrences. There is no standard treatment for metastases. Chemotherapy is not effective. Radiotherapy may be effective, particularly when lesions are not accessible to surgery. Surgical resection remains the treatment of choice.

[Mandibular metastasis revealing thyroid carcinoma. Two cases]. / Métastase mandibulaire révélatrice d'un cancer de la thyroïde.

Although thyroid cancer is not the first cause of bone metastases, this diagnosis must be always entertained because when it is found to be the cause of the metastasis, the survival is good. Bone metastases can take on different appearances and thyroid cancer discovered secondarily. We report two cases of mandibular metastases revealing a thyroid cancer and we stress on diagnosis and therapeutic difficulties.

[The oculomotor effects of the fractures of the floor of the orbit]. / Les séquelles oculomotrices des fractures du plancher de l'orbite.

PURPOSE: Fractures of the orbit floor have very disabling oculomotor after effects. The objective of this study was to report that close collaboration between the maxillo-facial specialist and ophthalmologist is necessary to avoid oculomotor after effects. METHODS AND PATIENTS: Our study included 10 cases of the fracture of the orbit floor. These cases were recorded between 1992 and 1996. RESULTS: This pathology affected young subjects aged between 20 and 40 years in 70 % of the cases. 80 % of the subjects were males. 90 % of the patients presented a vertical diplopia as a result of a transitory oculomotor deficit. 20 % of the subjects presented a permanent oculomotor deficit at the stage of after effects. All these deficits were of a mechanical origin and, contrary to other authors, we found no deficit with nervous sensory origin. CONCLUSION: Therapeutic success is based on early diagnosis and treatment that requires close collaboration between the maxillo-facial and ophthalmology teams.

[Zygomatic-orbito-malar fractures. Apropos of 85 cases]. / Les fractures zygomato-orbito-malaires. A propos de 85 cas.

Our retrospective study has concerned 85 cases of zygomatic-orbito molar fractures, hospitalised and treated from january 1983 to december 1992. 86% of patients were men. The young adult is interested in 78% of cases. The traffic accidents are predominant in 45%. The diagnosis is especially, made by the clinic and confirmed by the radiology. The abstension is justificate in 27, 1% due to the absence of deplacement and associated disorders. The orthopedic treatment concerns the len deplaced (20% of cases) and stable molar fractures. The surgery such as reduction with osteosynthesis or reconstruction of floor is realised in 55% of patients presenting deplaced fractures with norphologic and/or fonctionel disorders. The evolution is good in general. Few sequellaes has been noted in 25% cases. The authors insist on the interest of the precocity of diagnosis and treatment and on the multidisciplinar collaboration which permit an adapted treatment with few sequellaes.

[Tobacco and cancer of the larynx: a prospective survey of 58 patients]. / Tabac et cancer du larynx: enquête prospective à propos de 58 malades.

A prospective investigation about the influence of the tabagism and its characters on the laryngeal cancer has been led in the department of oncology in the Hospital Center Ibnou Rochd in Casablanca from December 1990 to June 1991. The investigation concerned 58 new patients. We conclude from this investigation that the risk of cancer increases with the intensity of the tabagism (the precocious age at the beginning, long duration, high number of packets/years; black tobacco, deep inhalation of the smoke, absence of weanling). The risk increases with the association with an intense alcoholism. We don't find the professional exposition. These cancers related to tobacco have epidermoid predominance. Finally, the major interest of this study is to convince us about the ampleness of this flail and to lead us through an educative action for the preventive fight against tobacco because of the risk of laryngeal cancer.

[Mucocele of the maxillary sinus. Apropos of 3 cases]. / Les mucocèles du sinus maxillaire. A propos de trois cas.

Mucocele of the maxillary sinus is a rare affection his pathogenesis is still discussed, with a prevalence of the injury's and inflammatory's theories. The diagnosis being confirmed by computed tomography imaging ... We report in this study, 3 cases of maxillary sinus mucocele, with a review of literature.