[Accuracy of frozen section diagnosis: an analysis of 1695 consecutive cases]. / Fiabilite de l'examen extemporane: analyse de 1695 examens consecutifs.

BACKGROUND: The intraoperative frozen section is a well established procedure for rapid diagnosis that helps in making therapeutic decisions. AIM: Assessment of the accuracy of frozen section diagnosis and analysis of the causes of its discordance. METHODS: A retrospective review of 1695 surgical specimens performed in 1207 patients between January 2002 and April 2005. Frozen section results were compared with the final diagnoses in paraffin sections. RESULTS: The frozen section diagnosis was benign in 84.2%, malignant in 10.2% and borderline in 0.4% of all cases. The frozen section result was deffered to permanent section in 5.2%. The sensitivity, specificity, positive and negative predictive values were 84.6%, 99.8%, 98.2% and 97.8% respectively. Overall diagnostic agreement was 97.5% (Kappa=0.88). Frozen section diagnosis was incorrect in 2.5% of cases. Most of the discrepancies were false negative cases frequently due to sampling errors and misinterpretation. False positive cases were always related with misinterpretation. CONCLUSION: The frozen section evaluation is highly accurate and reliable. However, the surgeon and the pathologist must be aware of its limitations.

[Solid pseudopapillary tumors of the pancreas: a pediatric case report]. / Tumeur solide pseudopapllaire du pancreas: a propos d'une observation pediatrique.

BACKGROUND: Solid pseudopapillary tumors of the pancreas are extremely rare and mostly seen in young females. It is often diagnosed incidentally or during investigations of gastrointestinal complaints. AIM: Report of a pediatric case of this tumor. CASE REPORT: We report the case of a 15-year old teenager who presented with painful abdominal tumefaction. Imaging findings were a 12 cm solid and cystic mass originating from the tail of the pancreas. A distal pancreatectomy with splenectomy was performed. Pathologic examination concluded to solid pseudopapillary tumor. Evolution was favorable with no recurrence 18 months after surgery. CONCLUSION: Histological examination confirms the diagnosis and allows, with the help of immunohistochemical study, to rule out some differential diagnoses such as pancreatoblastoma, acinar tumors and endocrine tumors. Prognosis of solid pseudopapillary tumors of the pancreas is excellent after radical resection and recurrences are rarely seen.

[Rupture of the low thoracic esophagus after blast trauma]. / Rupture de l'oesophage thoracique distal par effet blast.

Closed traumatic rupture of the esophagus is uncommon. Early diagnosis and effective treatment are necessary to avoid death or serious illness. We report a case of a low thoracic rupture after blunt trauma diagnosed at the stage of esophago pleural fistula and mediastinal collection. The patient underwent a bipolar-exclusion of the esophagus. The digestive continuity was restored by a retrosternal coloplasty and an oesophagectomy was performed afterwards. The postoperative course was uneventful and the patient was in a good health three years after operation.