[Bilateral adrenalectomy for advanced breastcarcinoma (author's transl)]. / La surrénalectomie bilatérale dans le cancer du sein en phase avancée. Résultats et place dans la politique de traitement.

Two hundred and seventy-one consecutive charts of all patients who underwent a bilateral adrenalectomy from 1955 till 1974 were studied. Of those 267 could be retained for this study. The operation was performed through a bilateral subdiaphragmatic or transabdominal approach. The postoperative corticosteroid substitution therapy did not pose grave problems. A remission was obtained in 36.2% of all cases (average 18 months, median 10 months with 4% 5 years later. The mortality was 20.7% and is the exponent of an aggressive approach with few criteria for exclusion from surgery. Massive liver and neurons system metastases were contra-indications for surgery. When a remission the survival attained 24.7 months with a median of 20 months and 8% at 5 years. A few survived much longer. Presently, the bilateral adrenalectomy, a major procedure, should be reserved for those women with a hormone dependent tumor. Criteria are the study of the hormone receptors or the observation of a prior remission after a premenopausal oophorectomy. A multi-disciplinary approach including several types of chemotherapy can be applied to those patients for whom surgery is contraindicated. (Acta chir. belg., 1981, 80, 1-9).

Intracerebral extravasation of contrast medium after head injury.

A case of intracerebral extravasation of contrast medium is reported. In cases of head injury this occurrence is rare and is manifested by persistent images on both frontal and lateral views of the angiogram. This indicates severe cerebral trauma with active hemorrhage and the prognosis is generally bad. A possible mechanism seems to be contrecoup.

[Hernial contusion : a little known lesion (author's transl)]. / La contusion herniaire: Une pathologie méconnue.

A personal case and a review of the literature are presented. The clinical picture consists essentially in a persistant pain in the hernia, following a benign trauma to the abdomen, that simulates a false strangulation and a peritonitis. The best diagnostic procedure is a median laparotomy with or without a herniotomy both allowing treatment of the lesions, of which the most common is a rupture of the small bowel on the side opposite to the mesenteron. This complication of a hernia, usually inguinal, often goes unrecognized because it is rare and has therefore a poor prognosis.

Malignant lymphomas and undifferentiated small cell carcinoma of the thyroid: a clinicopathological review in the light of the Kiel classification for malignant lymphomas.

The paper reports a re-evaluation--based on the Kiel classification for non-Hodgkin lymphomas--of a group of cases initially diagnosed as undifferentiated small cell carcinomas or primary lymphomas of the thyroid. Twelve such cases were found among the 155 cases of primary malignant tumours of the thyroid recorded at the Institut Jules Bordet between 1955 and 1975. The review of the clinical charts and the histology showed that all the cases were in fact malignant lymphomas fitting easily into one of the groups described in the Kiel classification. These findings support the growing opinion that undifferentiated small cell carcinoma of the thyroid does not exist as a distinctive clinicopathological entity. Furthermore, the Kiel classification proved to be an excellent prognostic indicator, since all the cases classified as highly malignant were indeed fatal, whereas the surviving cases--three of which had shown tumoral extension beyond the thyroid capsule--fell into the group of low malignancy. Lastly, this study acknowledges the frequently observed association of malignant lymphoma of the thyroid with stigmata of Hashimoto's disease, and thus supports the concept that the continuous antigenic stimulation observed in the latter could trigger the development of a malignant lymphoma.

[Double blind study of the action of two topic drugs on the thrombosis of the carotid artery of rats after microsuture (author's transl)]. / Etude en double aveugle de l'action de deux agents locaux sur la thrombose de la carotide primitive du rat après microsuture.

The action of 2 topic agents on the thrombosis of the carotid artery after microsuture was studied in rats. These drugs were magnesium sulfate whose antithrombotic effect has been demonstrated in vitro, and Ringer lactate considered inactive on coagulation. Twenty-two randomized rats underwent an end-to-end microsuture of the primitive carotid artery, the solutions being used to wash the lumen of the vessel and to irrigate the operative field. Arterial patency was controlled after one hour and after 10 days. No statistically significant difference was found between the two series.

[Latero-cervical branchial cysts and fistulas]. / Les kystes et fistules branchiaux latéro-cervicaux

Twenty-four cases of cysts and fistulae of the lateral part of the neck are presented. They come from the very important modification in the branchial apparatus arising during the embryogenesis of the neck. We found these vestigal anomalies moreover under the mandibula before the sterno-cleido-mastoidean muscle, but every where in the lateral part of the neck too. The differential diagnosis must be done between lymph nodes infections, dermoid cysts, benign and malignant tumors. Therefore the puncture seems very contributive. The best therapy is for everybody the radical removal.