Collision epithelial and stromal tumours of the stomach: a case report.

Collision epithelial and stromal tumours of the stomach are uncommon, and only a few cases have been reported in the literature. We describe a new case of a 54-year-old man who presented with bloody emesis. An oesophagogastroduodenoscopy revealed a stomach induration, and preoperative histological diagnosis was signet ring carcinoma. Total gastrectomy was performed and histological examination revealed a gastric collision tumour composed of gastrointestinal stromal tumour intermixed with a primary signet ring carcinoma. The neoplastic cells of the gastrointestinal stromal tumour were diffusely positive for CD117, while the signet ring cells were positive for cytokeratin. There was no transition between the two components.

Placental mesenchymal dysplasia with beckwith-wiedemann syndrome fetus in the context of biparental and androgenic cell lines.

Placental mesenchymal dysplasia (PMD) is a distinct placental disorder that may coexist with a normal fetus. In one-third of cases, the fetus exhibits Beckwith-Wiedemann Syndrome (BWS). In the present study, we report a case of PMD changes associated with an unusual genetic constitution. Pathological examination showed an enlarged placenta with a mixture of normal but also numerous clusters of grape-like fluid-filled vesicles confined to the stem villi without trophoblast proliferation. Some stem villi contained many large vessels filled by partially organized thrombi consistent with PMD. The fetus presented an enlarged liver and cytomegaly in the adrenal glands, hyperplastic islets of Langerhans in the pancreas, and some microcysts with cuboidal epithelium in the kidneys. These findings suggest the Beckwith-Wiedemann syndrome phenotype. DNA genetic markers showed three alleles for three independent markers and two alleles for the 12 others. Fluorescent in situ hybridization (FISH) demonstrated that villous trophoblast and fetal tissues are diploid. The haploid paternal complement found in the androgenetic cells was different from that found in biparental cells, suggesting a double fertilization event. Preferential distribution of the androgenetic cells into the placenta explains the predominance of molar villi with an apparently normal fetus. This represents a well-documented case of androgenic and biparental mixture of cell types in both fetal and placental tissues.

[Radiation induced breast sarcoma: a case report]. / Sarcome radio-induit du sein: à propos d'un cas.

Radiation-induced breast sarcoma is a late complication of radiation treatment. We report a case of an undifferentiated sarcoma occurring 8 years after breast conserving treatment, which required mastectomy taking pectoralis major.

[Mixed connective tissue disease revealed by chronic lymphocytic meningitis in an infant]. / Connectivite mixte révélée par une méningite lymphocytaire chronique chez un nourrisson.

UNLABELLED: Mixed connective tissue disease (MTCD) is a systemic inflammatory disorder individualised by Sharp et al. in 1972. This entity is rare in children. CASE REPORT: We report an exceptional case of MTCD revealed by lymphocytic meningitis in a two-month-and-a-half-old infant. The disease was diagnosed at the age of nine months when clinical symptomatology was completed by common signs of the illness (Raynaud's phenomenon, swollen hands), systemic lupus erythematosus-like symptoms (lymphadenopathy, squamous erythema of the limbs, hepato-splenomegaly, pleuritis and ascites) and polymyositis-like findings (muscle weakness with increased serum levels of myogenic enzymes). Laboratory investigations showed an important inflammatory syndrome and the presence of speckled anti-nuclear and anti-U(1)RNP antibodies. Specific antibodies of the other connective tissue diseases were also positive (anti-DNA, anti-Sm, anti-SSA and SSB, anti-Scl 70 and JO1) pleading for the mixed feature of the illness. The follow-up after corticosteroid treatment was marked by clinical and biological improvement. But after five months, the patient died following a severe infectious complication. CONCLUSION: Chronic lymphocytic meningitis can be part of Sharp's syndrome even in infants. However, the diagnosis relies on the evidence of characteristic clinical and biological abnormalities of MTCD.

[Mandibular odontogenic carcinosarcoma: a case report]. / Carcinosarcome odontogène mandibulaire.

The last W.H.O classification of odontogenic tumors (1992) individualized a new entity called odontogenic carcinosarcoma. We report a case in which we encountered some difficulties to establish the diagnosis. The patient J.Z., a 26 year-old woman was operated on for a left mandibular tumor corresponding, histologically, to an ameloblastic fibrosarcoma. One year later, we noted a submandibular swelling considered as a local recurrence. After resection, the pathologic examination diagnosed a lymph node metastasis from the same tumor. We decided to observe the patient. Three years post operatively, metastatic lymph nodes appeared, involving a double-component tumor: ameloblastic fibrosarcoma and malignant ameloblastoma. These features allowed the diagnosis of odontogenic carcinosarcoma. We insist on difficulties of the diagnosis and the necessity of radical resection of the tumor with neck dissection.

[Bladder leiomyosarcoma: report of a case]. / Léiomyosarcome de la vessie: à propos d'un cas.

Leiomyosarcoma of the urinary bladder is an extremely rare disease. In this study, which also includes a review of the literature, a new case of urinary bladder leiomyosarcoma has been reported in a 65-year old male, which was detected during an investigation of total hematuria accompanied by burning upon micturition. The clinical examination was normal, but ultrasonography followed by bladder endoscopy showed the presence of a large bladder tumor. The definitive diagnosis of this type of tumor can only be made after histological and immunohistochemical investigation, and to avoid unnecessary surgery it is essential to first differentiate it from an inflammatory pseudosarcoma. Although in the present study the outcome following total cystoprostatectomy was favorable at 3 months follow-up, in general the prognosis is uncertain due to the potentially invasive character of this type of tumor. Given the limited number of studies on the subject treatment still remains controversial, but is essentially based on surgical excision, possibly with adjuvant chemotherapy.