Chronic vulvar Paget’s disease: a therapeutic challenge with a review of the literature

Vulvar Paget’s disease is an uncommon adenocarcinoma of the female genital tract, occuring more often in postmenopausal Caucasian women and accounting for 1-2% of all vulvar malignancies. A 39-year-old female patient was examined for the erythematous and pruritic vulvar lesion, with biopsy and histological examination revealing vulvar Paget’s disease. We did not diagnose any associated neoplasm. The patient underwent four surgical resections for relapsed disease, varying from local excision to extended excision, including radical vulvectomy, with esthetic coverage. The margins were involved. Due to the extended target volumes, radiotherapy was rejected and the patient underwent a local topical therapy with Imiquimod 5%. The patient was free of disease, with three years of regular follow-ups. This case was challenging due to the long recurrence of the disease for approximately 26 years and due to the therapeutics issues that occurred

Metastase cervicale d’un adenome pleomorphe

Introduction : L’adénome pléomorphe est la tumeur la plus fréquente des glandes salivaires. Malgré son caractère bénin, de rares cas de métastases à distance ont été rapportés, touchant plus fréquemment l’os, les poumons et les ganglions lymphatiques. La localisation sous-cutanée, que nous rapportons dans ce travail, est exceptionnelle.Observation : Il s’agit d’une patiente de 41 ans, qui a eu une parotidectomie exofaciale gauche, par voie de lifting, pour un adénome pléomorphe, et qui a consulté, neuf ans plus tard, pour un nodule sous-cutané cervical moyen gauche. Une exérèse sous anesthésie locale a été réalisée. L’examen histologique de la pièce d’exérèse a conclu à une localisation secondaire d’un adénome pléomorphe. Aucune récidive locale ni à distance n’a été détectée, après trois ans de recul.Conclusion : L’adénome pléomorphe métastasant (APM), décrit depuis 1953, est rare. Aucune particularité clinique ni histologique ne permet de distinguer les formes métastatiques des formes classiques non métastatiques. Le mécanisme exact des métastases reste incertain mais semble être lié à une dissémination intra-vasculaire de cellules tumorales, lors de la manipulation chirurgicale de la tumeur primitive ou des récidives. Si la métastase est accessible, le pronostic est excellent après une exérèse complète.Mots-clés : adénome pléomorphe, métastase, peau, couIntroduction : Pleomorphic adenoma is the most common salivary tumor. Although clinically and histologically known as a benign tumor, there are rare reports of metastasis to distant sites, most commonly in bone, lungs, and lymph nodes. The subcutaneous site,reported in this case, is exceptional.Case-report : A 41 year-old patient, with history of left exofacial parotidectomy with a lifting incision, consulted after nine years for a left cervical subcutaneous nodule. An excision was performed under local anesthesia. The histological exam concluded in a secondary localization of pleomorphic adenoma. No local or distant recurrence was detected after three years.Conclusion : Metastasic pleomorphic adenoma, described since 1953, is uncommon. There are no known clinical or histological features that distinguish metastatic from non metastatic forms. The metastasis mechanism is uncertain, but seems to be related to vascular dissemination of tumoral cells, while surgical manipulation of the primary tumor or the recurrences. If metastasis is accessible, the prognosis is excellent after a complete excision.Keywords : pleomorphic adenoma, metastasis, skin, neck

Kyste thymique cervical

Objectifs : Le kyste thymique est une tumeur congénitale rare. Souvent asymptomatique, elle atteint généralement les enfants âgés de moins de 10 ans. Siégeant au niveau du cou, cette tumeur pose essentiellement le problème de diagnostic différentiel clinique. Son traitement est chirurgical avec un excellent pronostic et un très faible risque de récidive locale. Nous rapportons un cas de kyste thymique cervical et nous rappelons la pathogénie et les diagnostics différentiels.Mots clés : kyste thymique, cou, histologiePurpose of study: The thymic cyst is a rare congenital tumor. Usually asymptomatic, this tumor is generally seen in childhood under the age of ten. In the neck, the preoperative diagnosis of this tumor is difficult and is rarely made. The treatment of choice is surgical excision. The long-term prognosis is excellent with a low rate of local recurrence. We report a new case of cervical thymic cyst and review the pathogenesis and the differential diagnosis.Keywords: Thymic cyst, neck, histology

Une etiologie rare d’une ulceration palatine : la sialometaplasie necrosante

La sialométaplasie nécrosante (SN) est une affection salivaire bénigne et rare, touchant principalement les glandes salivaires palatines et présentant des ressemblances cliniques et histologiques avec les carcinomes orales. Nous rapportons un cas de SN chez une patiente de 73 ans, non tarée, édentée, qui rapporte la notion de prothèse ancienne mal adaptée et qui présente une lésion ulcéro-végétante, bien limitée, douloureuse, palatine gauche, évoluant depuis 3 mois. Le scanner du massif facial a montré un épaississement des parties molles palatines avec un aspect aminci et irrégulier de l’os en regard. Une pathologie maligne à type de carcinome muco-épidermoide a été évoquée. Une exérèse radicale de la lésion a été réalisée et l’examen histologique a conclu à une SN.Mots clés : Sialométaplasie nécrosante; orale; palais; histologieNecrotizing sialometaplasia (NS) is a relatively uncommon benign disease of the salivary glands that most commonly occurs in the palate. It is often confused clinically and histopathologically with malignancies, such as squamous cell carcinoma or mucoepidermoid carcinoma. We report a case of NS in an edentate 73-year-old woman, with no medical history, showed up with a painful, well limited ulcerative lesion on the left palate, reporting its appearance three months ago. Reported also that she had a badly adapted removable denture. CT scan showed a thickening of the palate’s soft tissues with bone irregularity and thinning. A mucoepidermoid carcinoma was suspected. The patient underwent a radical excision of the lesion and histopathological diagnosis of NS was made.Keywords: Necrotizing sialometaplasia; oral; palate; histolog

Chronic vulvar Paget’s disease: a therapeutic challenge with a review of the literature

Vulvar Paget’s disease is an uncommon adenocarcinoma of the female genital tract, occuring more often in postmenopausal Caucasian women and accounting for 1-2% of all vulvar malignancies. A 39-year-old female patient was examined for the erythematous and pruritic vulvar lesion, with biopsy and histological examination revealing vulvar Paget’s disease. We did not diagnose any associated neoplasm. The patient underwent four surgical resections for relapsed disease, varying from local excision to extended excision, including radical vulvectomy, with esthetic coverage. The margins were involved. Due to the extended target volumes, radiotherapy was rejected and the patient underwent a local topical therapy with Imiquimod 5%. The patient was free of disease, with three years of regular follow-ups. This case was challenging due to the long recurrence of the disease for approximately 26 years and due to the therapeutics issues that occurred

Lagrangian dispersion characteristics in the Western Mediterranean

Dispersion characteristics in the Western Mediterranean are analyzed using data from Coastal Ocean Dynamics Experiment (CODE) and Surface Velocity Program (SVP) surface drifters deployed in the period 1986–2017. Results are presented in terms of absolute dispersion A2 (mean-squared displacement of drifter individuals) and of relative dispersion (D2; mean square separation distance of drifter pairs). Moreover, the dispersion characteristics are estimated for different initial separation distances (D0) between particles: smaller, larger, or comparable with the internal Rossby radius of deformation. Results show the presence of a quasiballistic regime for absolute dispersion at small time scales and the nonlocal relative dispersion regime related to the submesoscale activities for scales smaller than the internal Rossby radius. At intermediate times, two anomalous absolute dispersion regimes (elliptic and hyperbolic regimes) related with the flow topology are observed, although the relative dispersion involves the Richardson and shear/ballistic regimes only for D0 smaller than the Rossby radius. During the subsequent 20–30 days, absolute dispersion shows quasirandom walk regime and relative dispersion follows the diffusive regime for scales larger than 100 km for which pair velocities are uncorrelated

Spreading of Lagrangian Particles in the Black Sea: A Comparison between Drifters and a High-Resolution Ocean Model

The Lagrangian dispersion statistics of the Black Sea are estimated using satellite-tracked drifters, satellite altimeter data and a high-resolution ocean model. Comparison between the in-situ measurements and the model reveals good agreement in terms of the surface dispersion. The mean sub-basin coherent structures and currents of the Black Sea are well reproduced by the model. Seasonal variability of the dispersion in the upper (15 m), intermediate (150 m) and deep (750 m) layers are discussed with a special focus of the role of sub-basin scale structures and currents on the turbulent dispersion regimes. In terms of the surface relative dispersion, the results show the presence of the three known turbulent exponential, Richardson and diffusive-like regimes. The non-local exponential regime is only detected by the model for scales <10 km, while the local Richardson regime occurs between 10 and 100 km in all cases due to the presence of an inverse energy cascade range, and the diffusive-like regime is well detected for the largest distance by drifters (100–300 km) in winter/spring. Regarding the surface absolute dispersion, it reflects the occurrence of both quasi-ballistic and random-walk regimes at small and large times, respectively, while the two anomalous hyperbolic (5/4) and elliptic (5/3) regimes, which are related to the topology of the Black Sea, are detected at intermediate times. At depth, the signatures of the relative and absolute dispersion regimes shown in the surface layer are still valid in most cases. The absolute dispersion is anisotropic; the zonal component grows faster than the meridional component in any scenario

RHEED digital image analysis system for in-situ growth rate and alloy composition measurements of GaAs-based nanostructures

Monitoring the intensity of the reflected spot in a RHEED image is the most important method used to control the growth of semiconductors in MBE. The accurate control of both layer thickness and alloy composition is particularly important for the growth of high quality heterostructures. Indeed, under such conditions, extremely uniform and high quality epitaxial devices become possible. RHEED intensity oscillation can be used as accurate, quick and direct measure of the growth rates and alloy compositions as well. Although analog signal could be obtained by using an optical fiber associated to a photo-detector PM tube and a plotter, this method is troublesome and limited. In some application, the availability of the intensity signal as a digital voltage is useful to realize further advanced analysis, and achieve feedback between growth dynamic and the external parameters, such as the cells temperatures and the synchronization of the shutters. In this paper we describe the advantages gained with the upgrade of our analog system into a digital package using CCD camera, frame grabber and a home made software. Its main purpose is to track RHEED intensity changes and measures the rate of oscillation. A state-of-the-art RHEED digital image analysis system gives us the necessary tools to gain insight into the thin film growth process and optimize material quality

Amélioration de l’intégrité des surfaces plates usinée de l’alliage d'aluminium 2017A par l'application de six nouvelles stratégies de galetage à bille.

Le galetage à bille est un traitement mécanique superficiel de finition et de parachèvement des surfaces mécanique fonctionnelles [1]. Il est largement pratiqué suite à l’usinage des surfaces de formes cylindriques [2-3-4], sphériques [5], concaves ou convexes [6], plates [7] ou de formes complexes [5] des pièces mécaniques. Généralement l’amélioration de la résistance à l’usure est le résultat de l’amélioration de l’intégrité des surfaces traitées par la recherche, la maitrise et l’optimisation des paramètres significatifs du procédé du galetage à billes. Dans la présente recherche nous révélons l’influence de la variation de l’application des stratégies de galetage à bille sur l’amélioration de l’intégrité des surfaces plates de l’alliage d’aluminium 2017A pour les valeurs optimum de l’avance latérale, la vitesse de galetage, la profondeur de pénétration. Le travail expérimental, mené dans cette étude possède comme objectif l’application de six stratégies de galetage à bille de la surface plate des échantillons en alliage d’aluminium 2017A. L’usinage des surfaces échantillons et leurs traitement superficiel par galetage à bille ont été réalisé sur le même centre d’usinage à commande numérique SPINNER VC650 à trois axes