Toward a new strategy in desmoid of the breast?

AIM: To report initial results of observation as well as surgery in patients with desmoid tumors (DTs) of the breast, a rare tumor for which data are scarce. PATIENTS AND METHODS: The initial approaches were categorized as either front-line loco-regional treatment [(surgery or radiotherapy group, SRG) n = 20] or initial observation [(no surgery/no radiotherapy group, NSRG) n = 11]. RESULTS: A total of 27 women and 4 men were assessed between 1992 and 2013 and included in this study. Patient characteristics were adequately balanced in the 2 groups. Fifteen patients (48.4%) had a past history of breast surgery in the previous 24 months. The median initial DT size on MRI was 50 mm. The median follow-up was 36 months. In the SRG, 8/20 patients (40%) experienced recurrence. The median time to recurrence was 29 months. During the study period, 6 patients in the SRG (30%) received a mastectomy at the time of diagnosis (n = 3) or at relapse (n = 3), 7 patients (35%) received a thoracic wall resection and 8 patients (40%) received radiotherapy at the time of diagnosis (n = 2) or at recurrence (n = 5). In the NSRG, the median tumor size change was -4 mm (range -13 to +20). Three patients changed treatment strategies during the observation period; one received surgery, and 2 were administered anti-hormonal treatment. CONCLUSIONS: Loco-regional treatments of breast DTs resulted in undesired disfigurement. Front-line observation yielded encouraging results and could enable the identification of patients who require loco-regional treatment. This strategy needs further evaluation.

[Urinary bilharziasis and sideropenic anemia. Study of their relation in 2 villages in Niger]. / Bilharziose urinaire et anémie sidéropénique. Etude de leurs rapports dans deux villages du Niger.

In order to assess Schistosoma haematobium as an aetiologic factor in sideropenic anaemias, we compared a village with high prevalence of urinary schistosomiasis and a village without urinary schistosomiasis as a control. In the infested village, anaemias (haemoglobin value lower than 12 g/dl) especially affects children between 5 to 14 years old (71%:45/68). Boys being the most infestated group with S. haematobium (prevalence:100%; mean egg output: 496 eggs/10 ml of urine) are also the most anaemic group (82%:23/28). Comparing the two villages shows that urinary schistosomiasis increases the risk of acquiring anaemia by 30% among children aged 5 to 14. Furthermore, the parasitic disease reduces of 1 g/dl the mean haemoglobin level of adult males. On the other hand, S. haematobium is of minor importance as a cause of anaemia among women. The others aetiologies remain preponderant.

[Schistosoma haematobium bilharziosis and urinary infections. Study of their relationship in 2 villages of Niger]. / Bilharziose à Schistosoma haematobium et infections urinaires. Etude de leurs rapports dans deux villages du Niger.

In order to assess the relation between urinary schistosomiasis and urinary tract infections (U.T.T.), a study of two villages in the surroundings of Niamey (Rep. of Niger) was undertaken. In the first village located near a rice plantation irrigation scheme, the global prevalence of S. haematobium infection was 77%. Boys between 5 to 14 years of age were all infected and their mean egg output was 500 eggs/10 ml of urine. In the second village, where water is supplied from wells, schistosomiasis was almost absent. Urinary tract infections were diagnosed upon the cytologic count of the urinary sediment and the urine culture. Comparison between S. haematobium infected and non-infected villages showed that the prevalence of U.T.I. was 3.8 times higher among the females of the infected village. This was also noticed for old men and especially for boys aged 5 to 14 (5.2% U.T.I.) for whom urinary infection is usually uncommon. However the mean blood pressure and the creatininemia showed no difference between the two populations. If schistosomiasis increases the risk of chronic pyelonephritis, that increase could not be accounted for with the measures of these two variables.

[Osteo-onychodysplasia (nail-patella syndrome): a case-report (author's transl)]. / Ostéo-onycho-dysplasie. Un cas avec revue de la littérature.

A case of osteo-onychodysplasia (nail-patella syndrome) is reported. Features of this inherited condition include hypoplastic nails, hypoplastic to absent patellae, subluxation of the patellae, elbow dysplasia, and spurs in the posterior ileum (this last feature was absent in our patient). The nail hypoplasia is the most suggestive abnormality. Patients should be investigated for renal involvement which is a poor prognosis factor. In patients without renal involvement, prognosis is good.