[Sternal metastasis from differentiated thyroid carcinoma: what management?]. / Que faut-il faire devant une métastase sternale d'un cancer différencié de la thyroïde?

OBJECTIVE: The aim of this study was to evaluate results of surgical management for sternal metastasis from differentiated thyroid carcinoma. METHODS: A retrospective study has been completed on patients treated in our department for sternal metastasis from differentiated thyroid carcinoma. RESULTS: Among the 235 patients who underwent thyroidectomy for thyroid cancer, seven (3%) had sternal metastasis during follow-up. These sternal metastasis were metachronous with an average delay of 10 years. Treatment corresponded to an excision of the upper half of the sternum including internal parts of the clavicle and the adjacent ribs (four cases), a reduction of the metastatic tumour mass (two cases) and one biopsy with no resection (one case). After sternal excision, reconstruction of the chest wall was obtained with the use of polyester prosthesis covered with pectoral muscle flap. Radioiodine was assigned to all patients as a complementary therapy. With an average follow-up of 58 months, no local or distant recurrence was observed in five patients (71%). Two patients had local and/or distant metastasis. CONCLUSION: Incidence of sternal metastasis is rare but does not preclude a large surgical resection. When possible, an aggressive management (surgical resection and radioiodine therapy) allows more than 70% relapse-free survival at 5 years.

[Desmoid tumors of the abdominal wall: three cases]. / Les tumeurs desmoïdes de la paroi abdominale. A propos de trois cas.

Desmoids tumors are rare. They often develop from the fascia and muscles of the abdominal wall. They are considered as benign, but endowed with local aggressiveness. Treatment is primarily surgical. Complete resection with large safety margins and sometimes complex reconstruction is necessary to reduce the risk of local reccurrence. WE report three cases of histology proven desmoids tumors of the abdominal wall treated between 2000 and 2007. Etiologic factors, diagnosis, surgical management and adjuvant therapy in case of incomplete resection or reccurrence are discussed.

[Thyroid cancer in patients with Grave's Disease]. / Maladie de Basedow et cancers différenciés de la thyroïde.

OBJECTIVE: To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. PATIENTS AND METHODS: Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. RESULTS: 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. CONCLUSION: This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

[Not Available]. / Maladie de Basedow et cancers différenciés de la thyroïde.

UNLABELLED: R. Mssrouri, S. Benamr, A. Essadel, J. Mdaghri, El H. Mohammadine, M.-K. Lahlou, A. Taghy, A. Belmahi, B. Chad Objective: To evaluate the incidence of thyroid carcinoma in patients operated on for Graves' disease, to identify criteria which may predict malignancy, and to develop a practical approach to determine the extensiveness of thyroidectomy. PATIENTS AND METHODS: Retrospective study of all patients who underwent thyroidectomy for Graves' disease between 1995 and 2005. RESULTS: 547 patients underwent subtotal thyroidectomy for Graves' disease during this period. Post-operative pathology examination revealed six cases of thyroid cancer (1.1%). All six cases had differentiated thyroid carcinoma (papillary carcinoma in 3 cases, follicular carcinoma in 2 cases and papillo-follicular carcinoma in 1 case). The indication for initial thyroidectomy was a palpable thyroid nodule in 3 cases (50%), failure of medical treatment for Grave's disease in 2 cases (33%), and signs of goiter compression in 1 case (17%). Five patients underwent re-operative total thyroidectomy. CONCLUSION: This study shows that while malignancy in Grave's disease is uncommon, the presence of thyroid nodule(s) in patients with Grave's disease may be considered as an indication for radical surgery. The most adequate radical surgery in this situation is to perform a total thyroidectomy.

[Hibernoma: a rare case of massive weight loss]. / L'hibernome: une cause rare d'amaigrissement massif.

Hibernoma is a rare soft tissue benign tumor composed of cells similar to those of brown fat observed in fetus and hibernating animals. Brown fat has thermogenous properties, by the way of carbohydrates and lipid catabolism, and can be of an important mean in thermoregulation. A massive weight loss is a rarely reported sign in patients with hibernoma. We report herein the case of a 47 man with a history of isolated weight loss, of 16 kg over 4 months. Clinical examination has shown a swelling of the right flank. Surgical resection has been made and histopathological examination has shown hibernoma. The post-operative weight gain confirmed the relationship between hibernoma and weight loss.

[A rare complication of ileal pouch anal anastomosis: superior mesenteric artery syndrome]. / Une complication rare de l'anastomose iléoanale avec réservoir: le syndrome de la pince mésentérique.

The aim of this study was to report a new case of superior mesenteric artery syndrome following total proctocolectomy and ileal pouch-anal anastomosis for chronic ulcerative colitis. Diagnosis was made following a prolonged gastric stasis and was based on upper gastrointestinal X-ray series. Medical treatment was unefficient and gastro-jejunostomy was performed. The early outcome was good.

[Apropos of a case of gas gangrene of the abdominal wall after cholecystectomy]. / A propos d'une observation de gangrène gazeuse de la paroi abdominale après cholécystectomie.

The authors report a new case of gas gangrene following cholecystectomy with a fatal outcome. Mode of infection and principles of diagnosis and therapy are discussed together with a review of the literature.