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

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

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

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

Modeling and optimization of a ball-burnished aluminum alloy flat surface with a crossed strategy based on response surface methodology

In this work, a new ball-burnishing strategy, in two crossed passes, was applied on the flat machined surface of 2017A-T451 aluminum alloy to investigate the influence of three classical ball-burnishing factors (burnishing speed Vb in mm/min, depth of penetration ab in μm and lateral feed f in mm) on the treated surface integrity enhancement. Experimental work is based on the application of an experimental face-centered composite design (CCD) formed by three factors at three levels. The mathematical modeling of the average roughness Ra, of the mean spacing of roughness profile irregularities Sm and of the surface hardness HIT of the treated surfaces was performed by the response surface methodology (RSM). Best ball-burnished surface integrity has been established by the application of optimal ballburnishing studied factors (Vb = 500 mm/min, ab=40 μm, and f = 0.2 mm). High surface quality is then characterized by a gain in average roughness Ra of 81 %, an enhancement in the mean spacing of profile irregularities Sm of 34%and an improvement in surface nano-hardness HIT of 17 % when compared to the machined surface. Machined and ballburnished optimized surface characterization confirms surface finishing process power and contribution to surface integrity enhancement of treated flat surface

Fertility sparing surgery for stage Ic ovarian cancer: An eight case series

Introduction. One case out of 3 cases of primary ovarian cancer is diagnosed at an early stage. Almost 15% of ovarian cancers are diagnosed in women who are within the range of procreation age, raising the debate on the feasibility of fertility-sparing surgery (FSS) for those tumors. In the case the patient is admitted with stage 1A or 1B in most histologic types, it is still controversial in stage 1C. Results and Discussions. This is an eight-patient-case series. The median age is 27 years old (ranging from 18 to 42). The main clinical manifestation was pelvic pain (87.5%). Four patients (50%) presented with tumor torsion. All patients underwent FSS; five of them (62.5%) had conservative staging, two (25%) underwent salpingooophorectomy and one (12.5%) ovariectomy, type histo + stade Figo. The chemotherapeutic treatment was administered to four patients (50%) following surgery without major side effects. One patient (12.5%) presented a loco regional recurrence that occurred 14 months later. She was treated with combined chemotherapy and radical surgery. One patient out of eight (12.5%) achieved a natural pregnancy after the treatment and another one (12.5%) was submitted to an assisted reproductive procedure which did not result in a viable pregnancy. Conclusion. FSS seems to be a suitable approach for stage 1C ovarian cancer. However, more case series and meta-analyses should be conducted

Experimental study of a six new ball-burnishing strategies effects on the Al-alloy flat surfaces integrity enhancement

Abstract: In the literature, the most studies conducted on the flat surface ball-burnishing process have been focused on the most important classical factors like burnishing speed, lateral feed, and the ball-burnishing load or pressure on the treated surfaces integrity enhancement. In this research, ballburnishing strategies are studied as a new ball-burnishing factor. The aim of this research is to show the improvement of the flat surface integrity of 2017A-T451 aluminum alloy using six new ball-burnishing strategies. Ball-burnishing tests were conducted in two passes using the recommended values of the ball-burnishing factors (the penetration depth ab is 40 μm, the linear ball-burnishing speed Vb is 500 mm/min and a lateral feed f of 0.2 mm). Two ball-burnishing strategies in two successive and perpendicular passes to the machining direction and four ball-burnishing strategies in two crossed passes have been designed and tested to improve the flat surfaces integrity of the samples. The characterization and the micrographic observations of the ball-burnished surfaces show that using the best ball-burnishing strategy leads to a great enhancement in surface quality. The latter is predicted by a gain in average roughness Ra of 81 %, an improvement in the mean spacing of profile irregularities Sm of 34 %, an enhancement in surface Nano-hardness HIT of 17 %, and sub-layer hardness betterment up to a depth of 500 μm

Fertility sparing surgery for ovarian sex cord stromal tumors: a nine case series

Ovarian Sex Cord Stromal Tumors (SCST) are a rare disease carrying a good prognosis. They generally affect young women; therefore fertility preservation is a critical issue. Fertility Sparing Surgery (FSS) showed promising results in both oncologic safety and fertility preservation. A retrospective case series involving 9 patients diagnosed with SCST and treated with fertility sparing surgery at our institution was conducted between January 2000 and May 2015. The median age was 24 years old (10 to 39). The main clinical manifestation was pelvic pain seen in seven patients. Five patients complained about menstrual cycle disorders. The nine patients went through fertility sparing surgery; seven had conservative staging and the other two had a unilateral salpingo-oophorectomy. Three patients out of nine had a pelvic unilateral lymphadenectomy. Two patients received adjuvant chemotherapy. Only two patients presented locoregional recurrence that occurred respectively after 7 and 192 months. The treatment combined chemotherapy and surgery based on mass resection. One patient achieved a natural pregnancy after the treatment. FSS seems to be a suitable approach for SCST. However, more case series and meta-analysis should be conducted

Fertility-sparing surgery in advanced stage malignant ovarian germ cell tumor: a case report

Abstract Background Malignant ovarian germ cell tumor is a rare type of disease, which generally has a good prognosis due to the high chemosensitivity of this type of tumor. Fertility preservation is an important issue because malignant ovarian germ cell tumor commonly affects young women. Although conservation is the standard for early stage, it becomes more debatable as the disease progresses to more advanced stages. Aim: Report the case of a patient with an International Federation of Gynecology and Obstetrics Stage IIIc malignant ovarian germ cell tumor, who had conservative surgery and chemotherapy with a good fertility outcome. Case presentation A 23-year-old North African woman with a left malignant ovarian germ cell tumor stage IIIc was treated by left adnexectomy and omentectomy followed by chemotherapy. A 15-year follow-up showed no signs of relapse, and she completed three full-term natural pregnancies. Conclusions Malignant ovarian germ cell tumor is a rare ovarian tumor with a good prognosis. It is usually associated with a good fertility outcome in early stages. However, due to the rarity of the disease in advanced stages, the fertility outcome for this group of patients is not clear. This lack of data surrounding advanced stages points to the need for a meta-analysis of all published cases

Carcinome épidermoïde du bassinet découvert par un envahissement pariétal et cutané: une présentation inhabituelle

A travers cette étude clinique nous présentons un cas rare de carcinome épidermoïde du bassinet avec envahissement cutané de la paroi abdominale chez une patiente aux antécédents d'infections urinaires hautes à répétition sur des calculs rénaux. Le motif de consultation était la découverte d'une lésion cutanée lombaire droite. L'uro-scanner montrait une masse rénale droite étendue aux parties molles adjacentes dont la biopsie a révélé un carcinome épidermoïde du bassinet. Après une revue de la littérature, c'est le premier cas d'un carcinome épidermoïde du bassinet découvert par un envahissement cutané