[Recurrence of palpebral basal cell carcinoma according to histological margins]. / Récidive des carcinomes basocellulaires palpébraux selon les marges histologiques.

BACKGROUND: Basal cell carcinomas (BCCs) represent 90% of malignant tumors of the eyelids, which can be locally invasive and destructive. The observation of histological safety margins (MHS) allows for the prevention of recurrence while maintaining a fair compromise between aesthetics and functionality. However, to date, there is no consensus or national recommendations concerning the MHS to be observed according to the various histological subtypes of BCCs. METHODS: Through a retrospective analysis of patient records and corresponding excisional slides, we studied the 6-year recurrence rate of 98 patients who underwent surgery for palpebral BCC. RESULTS: MHS were mostly absent in the excisional specimens of recurrent BCCs and significantly more narrow than in non-recurrent BCCs, on average over 2mm. CONCLUSION: The results of our study suggest that an average MHS greater than 2mm prevents most recurrences.

[Bilateral central retinal vein occlusion associated with moderate acute rejection of a cardiac graft]. / Oblitération bilatérale de la veine centrale de la rétine sur un rejet aigu léger de greffe cardiaque.

We report a case of bilateral central retinal vein occlusion following moderate acute rejection of a cardiac transplant. A 27-year-old man was admitted for sudden bilateral decreased vision due to bilateral central retinal vein occlusion. Visual acuity was 20/63 in the right eye and 20/25 in the left eye. This patient had undergone a heart transplant 6 months before and had presented with moderate acute rejection for a few days. The moderate acute rejection phenomenon includes inflammatory lymphocyte infiltrates, reflecting persistent immune response activation. Moderate acute rejection of a cardiac transplant graft might cause a bilateral central retinal vein occlusion.

[The importance of flow cytometry and the cell proliferation index in choroidal melanoma]. / Intérêt de la cytométrie en flux et de l'index de prolifération cellulaire dans le mélanome choroïdien.

PURPOSE: To evaluate the prognostic value of DNA ploidy and proliferative activity in metastasis occurrence after enucleation for choroidal melanomas. METHODS: This retrospective study investigated 14 patients (eight males, six females) using flow cytometry and immunohistochemistry with the Ki67 antibody. RESULTS: Two of the tumors were aneuploid, 12 were diploid. The proliferation index was between 0% and 16%. Two tumors progressed to metastatic disease; both were diploid and had a low proliferation index. They were mixed cell type. The median observation period was 3 years and 9 months. CONCLUSION: DNA content and proliferative activity are not correlated with metastasis occurrence. Sclera invasion is the best prognostic factor.

[Low grade pulmonary sarcoma preceding the discovery of a uterine primary]. / Sarcome pulmonaire de bas grade précédant la découverte d'un primitif utérin.

INTRODUCTION: Low grade pulmonary sarcomas are very rare tumours. We report the case of a low grade sarcoma of the lung occurring two years prior to the finding of a uterine primary. CASE REPORT: Complete surgical excision of a low grade pulmonary sarcoma was performed. The initial search for dissemination was negative. Two years later a follow-up scan discovered a uterine mass as well as a para-aortic shadow that proved to be the primary tumour (low grade uterine sarcoma) and a metastasis. CONCLUSION: This is the second case of a pulmonary metastasis discovered before a primary low grade uterine sarcoma. The first was found during the investigation of a pulmonary sarcoma. The main differential diagnosis to consider is metastatic leiomyosarcoma. In both cases their finding justifies the search for a uterine primary by immunohistochemical examination for oestrogen and progesterone receptors as well as pelvic ultrasound or even magnetic resonance imaging.

Orbital sinus histiocytosis (Rosai-Dorfman disease): a lacrimal gland involvement.

We report the clinical and histopathological features of 2 cases of orbital Rosai-Dorfman disease with lacrimal gland involvement but no lymphadenopathy or cutaneous involvement. The first case was a 7-year-old boy, who was referred to the ophthalmology department with a proptosis in the left eye. The second case involved a 57-year-old African man, who developed oedema of the right upper eyelid over a 4-month period. Ocular involvement in Rosai-Dorfman disease is rare (10%). The diagnosis is histological in combination with immunohistology and is often delicate, especially in extranodal localizations. Histopathologically, normal gland morphology was altered by fibrosis and inflammatory cells. To our knowledge, this is the first report on lacrimal involvement in incomplete, thus uncommon sinus histiocytosis with massive lymphadenopathy.

[Erdheim-Chester disease. Apropos of a case with autopsy findings]. / La maladie d'Erdheim-Chester. A propos d'un cas avec étude autopsique.

Erdheim-Chester's Disease is a very uncommon variety of non-Langerhans histiocytosis of unknown etiology, which characteristically affects long bones bilaterally and symmetrically in adults. It may be accompanied by visceral foci of variable localization and extension determining prognosis. Bone scintigraphy is characteristic enough to evoke the disease but histologic examination of a peripheral specimen is required to confirm the diagnosis: spumous histiocytes CD68+, PS100+/-, CD1a-. We describe a case revealed by a severe lung disease with detailed autopsy.