[Cancer of the urachus. A rare form of tumors of the bladder]. / Le cancer de l'ouraque. Une forme rare des tumeurs de vessie.

Cancers of the middle umbilical fold are very infrequent, making up 0.1% to 0.7% of all bladder tumors. This type of tumor affects male subjects in 60% to 75% of cases, in the 5th or 6th decade of life. In more than 90% of all cases, the lesion is a mucosecretory adenocarcinoma developing from embryonic remains within the wall of the bladder and respecting the superficial urothelium of the bladder, which is affected only secondarily, contrary to what occurs in the other adenocarcinomas of the bladder. The pathogenesis remains controversial, especially the role of middle umbilical fold patency and of bladder carcinogens. The diagnosis is most often established late, because of a long clinical latency. It is mainly based on ultrasonography and computed tomography. Explorations of the bladder are useful only at an advanced stage. The prognosis is very poor, survival at 5 years ranging from 6.5% to 25% according to the authors. The treatment is mainly surgical. Only extensive exeresis with partial cystectomy extending to the peri- and supravesical environment, including the peritoneum and the umbilicus, and associated with pelvic lymphadenectomy may give some hope. Chemotherapy and radiation therapy, either alone or complementary, are disappointing. The prognosis may be improved only by an early diagnosis.

[Cancer of the urachus. A rare form of tumors of the bladder]. / Le cancer de l'ouraque. Une forme rare des tumeurs de vessie.

Cancers of the urachus are very infrequent, making up 0.1% to 0.7% of all bladder tumors. This type of tumor affects male subjects in 60% to 75% of cases, in the 5th or 6th decade of live. In more than 90% of all cases, the lesion is a mucosecretory adenocarcinoma developing from embryonic remains within the wall of the bladder and respecting the superficial urothelium of the bladder, which is affected only secondarily, contrary to what occurs in the other adenocarcinomas of the bladder. The pathogenesis remains controversial, especially in the role of urachus patency and of bladder carcinogens. The diagnosis is most often established late, because of a long clinical latency. It is mainly based on ultrasonography and CT scan. Explorations of the bladder are useful only at an advanced stage. The prognosis is very poor, survival at 5 years ranging from 6.5% to 25% according to the authors. The treatment is mainly surgical. Only extensive resection with partial cystectomy extending to the peri- and supravesical environment, including the peritoneum and the umbilicus, and associated with pelvic lymphadenectomy may give some hope. Chemotherapy and radiation therapy, either alone or adjuvant, are disappointing. The prognosis may be improved only by an early diagnosis.

[Congenital stenosis of the esophagus. A rare diagnosis in children and adults]. / La sténose congénitale de l'oesophage. Un diagnostic rare chez l'enfant et l'adulte.

The authors report about 3 cases of congenital stenosis of the upper third of the esophagus. This is an exceptional condition, for which 3 main types are described: a mucous diaphragm, to be compared with membranous atresia, fibrous stenosis and stenosis caused by bronchial heterotopy. The location of the stenosis in the upper third of the esophagus is extremely rare. It results from a disorder in the revascularization of the esophageal tube. The diagnosis is established in the newborn, and less frequently in children and adults, in cases of vomiting, regurgitation or dysphagia. It is based on esograstroduodenal follow-through and fiberendoscopy, which allows ruling out other causes of benign narrowing. The treatment resorts to endoscopic dilatations and to surgery, which remains the safest method.

[Surgery of the thyroid gland in the Islamic Republic of Mauritania]. / Chirurgie du corps thyroïde en République Islamique de Mauritanie.

The authors on the results of 116 surgical interventions against thyropathy. The indications were: hyperthyroidy (18.10 p.c.), diffuse goiter (10.34 p.c.) thyreonodules (71.55 p.c.). Contrary to what was written in this series, Basedow's disease was the main etiology in hyperthyroidies. Thyreonoduls are predominant in thyropathology with 12.05 p.c. of cancers. These cancers develop themselves on 72.72 p.c. of already existing goiter; that is uncommon; they are essentially papillary carcinoma forms. The seriousness of compressive forms is underline and is responsible for two deaths in this series.