ABSTRACT
OBJECTIVE: The aim of our study was to assess prevalence of geriatric assessment (GA) in patients over 75years with nonmetastatic invasive bladder cancer (MIBC). MATERIAL AND METHODS: We performed a retrospective study between 2000 and 2015. We assessed comobidity by Charlson score and ASA score, geriatric assessement (GA) and treatments. RESULTS: One hundred and twenty one patients were inclued. Median age was 81 (73-95) at diagnosis. Thirty nine patients (32%) were evaluated by GA, G8 screening tool was performed in 16% of patients. Patients without GA were older (82 vs. 81years) and had less comorbidities (Charlson≥2 à 61% vs. 69%). Seventy-four percent of patients received a curarive therapy: 60% were treated by RC, 9% by chemoradiotherapy, 26% received palliative therapy and 15% were only in observation. CONCLUSION: Patients with MIBC over 75years were less evaluated and less treated. Patients in pallative care received mostly observation. Although practices have improved, GA was underused. Care of these patients needs standardization in order to adapt therapeutic to their comorbidities and to treat them with curative intent. LEVEL OF PROOF: 4.
Subject(s)
Urinary Bladder Neoplasms , Aged , Aged, 80 and over , Cystectomy , Geriatric Assessment , Humans , Muscles/pathology , Neoplasm Invasiveness , Retrospective Studies , Urinary Bladder Neoplasms/drug therapy , Urinary Bladder Neoplasms/therapyABSTRACT
Rosai-Dorfman disease (RDD) is a benign lymphoproliferative disorder characterized by cervical lymph node enlargement with a consistent risk of airway compression and esthetic damage. Extranodal localizations are also described. There is no therapeutic consensus for pediatric forms of RDD. Through 2 pediatric cases with nodal involvement in 1 patient and a sinonasal and soft tissue localization in the other, we focus on the management problems of both nodal and extranodal RDD.
Subject(s)
Histiocytosis, Sinus/therapy , Adolescent , Humans , MaleABSTRACT
INTRODUCTION: Necrotizing fasciitis is a rapidly progressive and often fatal infection of the soft-tissue fascia deep to the skin but superficial to the muscles. We report a case of necrotizing fasciitis of the anterior chest wall complicating a percutaneous needle biopsy. CASE: A 49-year-old diabetic patient, presented persistent excavated right pulmonary opacities. A percutaneous biopsy was obtained and complicated by a necrotizing fasciitis. The patient underwent surgery for total resection of the necrotic tissues followed by antibiotic treatment. Outcome was favorable after 30 days of antibiotic therapy. DISCUSSION: Necrotizing fasciitis is a life threatening complication of transthoracic percutaneous biopsy. Prognosis depends on rapid diagnosis and treatment.
Subject(s)
Biopsy, Needle/adverse effects , Fasciitis, Necrotizing/etiology , Anti-Bacterial Agents/therapeutic use , Diabetes Complications , Fasciitis, Necrotizing/drug therapy , Female , Humans , Middle Aged , Pneumonia, Bacterial/diagnosis , Streptococcal Infections/diagnosis , Streptococcus constellatus/isolation & purification , Thorax , Treatment OutcomeABSTRACT
The authors report a case of cervico-thoracic region hydatid cyst suspected by the presence of a palpable right lower neck mass. This location is very rare. Neck ultrasound and computed tomography showed the cyst. Magnetic resonance imaging can be useful for diagnosis and provided the best anatomo-topographic evaluation before surgery.
Subject(s)
Echinococcosis/diagnosis , Magnetic Resonance Imaging , Mediastinal Diseases/diagnosis , Neck , Tomography, X-Ray Computed , Adult , Contrast Media/administration & dosage , Diagnosis, Differential , Echinococcosis/surgery , Gadolinium , Humans , Male , Mediastinal Diseases/surgery , Neck/surgeryABSTRACT
Although rare, the possibility of pituitary tuberculoma should be considered in the diagnosis of non-pituitary intrasellar masses, especially in an endemic area and if radiologic imaging shows pituitary stalk thickening. We describe the case of a 52-year-old patient who presented tuberculous meningitis complicated by a pituitary abscess. He was treated with antituberculous drugs. The follow-up MRI 16 and 48 months later showed the decreased size of the pituitary mass. Radiological features and a review of the literature of pituitary tuberculoma are briefly discussed.
Subject(s)
Abscess/complications , Abscess/diagnosis , Pituitary Diseases/complications , Pituitary Diseases/diagnosis , Tuberculoma/complications , Tuberculoma/diagnosis , Tuberculosis, Meningeal/complications , Tuberculosis, Meningeal/diagnosis , Abscess/drug therapy , Antitubercular Agents/therapeutic use , Humans , Male , Middle Aged , Pituitary Diseases/drug therapy , Tuberculoma/drug therapy , Tuberculosis, Meningeal/drug therapyABSTRACT
Gardner's syndrome is an autosomal dominant condition characterized by multiple colorectal polyposis associated with various soft and hard tissue tumors. We report a case of adrenal adenoma in a 37-year-old woman with Gardner's syndrome. Although extraintestinal neoplasms, particularly adrenal lesions, are a rare association, an increased awareness is important.
Subject(s)
Adenoma/complications , Adrenal Gland Neoplasms/complications , Gardner Syndrome/complications , Adult , Female , HumansABSTRACT
Lymphocytic hypophysitis is a rare inflammatory disease of the pituitary gland which may be related to an autoimmune process. Only twenty cases are reported in male. Patients usually present with symptoms of an expanding intrasellar mass or varying degrees of hypopituitarism. Most of the cases are misconsidered preoperatively as pituitary adenomas. We report a case of lymphocytic hypophysitis which has occurred at a 37-year-old-man.
