[Squamous cell carcinoma on a leg ulcer in the West Indies]. / Carcinome épidermoïde sur ulcère de jambe aux Antilles.

INTRODUCTION: The epidemiology of carcinoma developing on a leg ulcer is poorly, although high incidence rates are reported in Africa. PATIENTS AND METHODS: Retrospective study of cases reported in Guadeloupe, a tropical country with a large population from African descent and with high quality health care level. RESULTS: Sixteen cases, mean age 71, were diagnosed over a 10-Year period in the only referral hospital. The annual incidence was an estimated 0.4/100,000. Preceding ulcers had a long course (mean of 27 Years) and had various causes. Social distress was the rule (14/16 patients). One third of the clearly differentiated (15/16) squamous cell-type tumors exhibited metastatic extension on presentation. At Year 3, the mortality rate was of 40 p. cent. The best survival rate (6 remissions/8 cases) was associated with primary limb amputation. DISCUSSION: Malignant ulcers appeared more frequent in Guadeloupe than in the influent countries of the North, but with an instance 4-fold lower than in Africa. Like many other tropical diseases, socio-behavioral factors may play a major role.

[Cysticercosis in Guadeloupe]. / Cysticercoses en Guadeloupe.

We report two cases of cysticercosis proved by histology, one in the brain, the other in the orbit. The first case was observed in a traveller, heavy smoker, serologically negative to cysticercosis in whom an isolated cerebral tumoral metastasis was suspected and resected. The lesion was centered by a typical cysticercus of Taenia solium. The second was a periorbital intramuscular nodule observed in a child who had never left our island. The fibroinflammatory nodule was centered by a cysticercus with a scolex without rostellum and without suckers. Its histological aspect led us to the diagnosis of cysticercosis. Three species of Taenia are discussed : T. solium, T. crassiceps and T. bovis. This case shows that the human transmission of the disease may exist in Guadeloupe.

Osteolyttic cryptococcal infection without immunodeficiency: a case report

A 54-year-old previously healthy man presented with paraplegia. CT scan showed a lytic lesion of the sixth dorsal vertebra and cord compression suggesting malignant metastasis. Open biopsy of the vertebra showed a granulomatous lesion with Cryptococcus spores. Culture for fungus confirmed an A serotype Cryptococcus neoformans. HIV and HTLV-1 antibody tests were negative. Surgical treatment combined with oral fluconazole was without clinical or CT scan resolution within a follow-up of three months. The paper underlines the role of the pathologist in the diagnosis of mycotic diseases (AU)

The resorption of bone-implanted corals varies with porosity but also with the host reaction.

Three different exoskeletons of coral species Porites asteroides (P), Montastrea annularis (M), and Dichocoenia stokesi (D) were implanted for 2-20 weeks in rabbits. At 2, 4, 8, or 20 weeks, the exoskeletons presented variations in their resorptions depending on the species. To understand the variations in the decreasing speed of the implants despite their similar chemical composition, a study of the surface and architecture of the coral was carried out using scanning electronic microscopy, porosity was evaluated, and growth and differentiation of osteogenic cells cultured in vitro were observed for more than 1 month. At the cellular level, the surface of the implants was identical. Three-dimensional structures of the implants were variable, but the porosity values [P = 42.7%, M = 40.7%, and D = 17.4%] could not completely account for the differences in the resorbing process of the species. Standard histologic studies performed at 2, 4, 8, and 20 weeks after implantation produced the same pattern with P or M, showing aspects of rapid resorption; however, with D there were images resembling those of a foreign-body reaction. It seems that when resorption is not quick enough, a foreign body reaction develops which further slows down the process. This work focuses on the importance of porosity when using coral as bone substitute.

Abdominal angiostrongyliasis: third case in Guadeloupe - abstract

Angiostrongylus costaricencis causes a clinicopathologic disease, abdominal angiostrongyliasis (AA), first observed in Costa Rica by Morera and Cespedes. AA is mainly observed in children, and is characterized by abdominal pain typically localized to the right lower quadrant. The disease is mostly endemic to Central and South America. However, the disease has begun to appear outside of its endemic area and may simulate Crohn's disease, and is observed in old persons. We report 3 cases of AA, all diagnosed in the Department of Pathology in the CHU in Guadeloupe, FWI, since 1987. The 3 cases are instructive of the disease and the physician needs to be aware of it. It is also a priority to identify intermediate hosts to prevent the disease (AU)

[Genital Schistosoma mansoni bilharziasis in women: apropos of 2 cases in Guadeloupe]. / Bilharziose génitale de la femme à Schistosoma mansoni: à propos de deux cas en Guadeloupe.

Schistosoma mansoni is the only cause of bilharziasis in Guadeloupe (French West Indies). Ectopic ovarian and endometrial involvement is rare with only one case of bilharziasis of the endometrium having previously been described in the literature. This report describes two cases of Schistosoma mansoni bilharziasis revealed by genital tract involvement. In one case involvement was endometrial and led to metrorrhagia. Histological examination of the biopsy sample obtained by curettage of the endometrium demonstrated the presence of eggs with lateral spurs. In the other case ovarian involvement was detected during assessment for associated infertility and chronic pelvic pain. Celioscopic examination showed pelvic and perihepatic adhesions secondary to sexually transmissible infection. Histologic examination of an ovarian growth demonstrated the presence of Bilharzia eggs. Both patients underwent antiparasitic treatment using oxamniquine (Vansil) which led to the resolution of metrorrhagia in the first case.

[Natural murine infestation by Angiostrongylus costaricensis Morera and Cespedes, 1971 in Guadeloupe]. / L'infestation murine naturelle par Angiostrongylus costaricensis Morera et Céspedes, 1971 a la Guadeloupe.

In 1992, two cases of abdominal angiostrongylosis were reported in young Guadeloupean children. With a view to determine the natural infestation rate of Guadeloupe rodents (Rattus rattus, R. norvegicus) by Angiostrongylus costaricensis, 656 rats caught in the country have been examined. Both murine species are naturally infested (6.2% in R. rattus and 14.9% in R. norvegicus), which gives a total prevalence of 7.5%. This total prevalence is higher in the tourist area. A complementary investigation proves to be necessary to identify in Guadeloupe the alleged intermediate hosts (slugs, land snails) in which the human illness has its direct origins.

[Presence of abdominal angiostrongylosis in Guadeloupe. Apropos of 2 recent cases]. / Présence de l'angiostrongylose abdominale en Guadeloupe. A propos de deux cas récents.

The authors describe the first two cases of abdominal angiostrongylosis in Guadeloupe, confirmed by a histological analysis. Physicians must be aware of the presence of Angiostrongylus costaricensis in the West Indies in order to provide better care for children presenting with fever, abdominal pain and rectorragiae, along with intense biological markers of inflammation.