Prise en charge du carcinome papillaire du kyste du tractus thyréoglosse: Intérêt de la thyroïdectomie totale

Thyroglossal duct cysts are a common developmental abnormality but carcinoma within is rare. A 68 year old male patient was diagnosed with a thyroglossal duct cyst (TGDC) which on imaging studies demonstrated suspicious features within the cyst alone. Fine needle aspiration cytology was suspicious of papillary thyroid cancer. A Sistrunk's procedure (SP) was performed and demonstrated papillary carcinoma within. A decision to perform a total thyroidectomy (TT) and central compartment neck dissection was made. Final histological analysis showed no disease within the thyroid gland or in the neck nodes. The presence of cancer suspected within the TGDC by relevant diagnostic modalities may necessitate treatment to the thyroid gland and neck in addition to a Sistrunk's procedure as part of a definitive treatment policy due to the high incidence of associated thyroid malignancy. In our institution, in patients presenting with thyroglossal duct cyst carcinoma and are at high risk for having thyroid cancer, we perform both SP as well as TT and central compartment neck dissection.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Lobular capillary haemangioma of the nasal cavity during pregnancy

Objective: We report a pregnant patient with a rapidly growing mass within the nasal cavity' which required pre-operative super-selective embolisation and subsequent removal under general anaesthesia after childbirth. We also discuss the clinical' radiological and histological characteristics of lobular capillary haemangioma' and its treatment.Method: Case report and literature review.Results: Lobular capillary haemangioma is a benign lesion originating in the vascular tissue of skin' mucosa' muscles' glands and bone. These lesions grow rapidly. Nasal localisation is rare. Microtrauma and pregnancy are the most commonly proposed aetiological factors. Reported incidence during pregnancy ranges from less than 2 per cent to approximately 5 per cent. The management of a pregnant woman with such a lesion may be complex' and depends on the severity of symptoms and the status of the pregnancy. Complete surgical excision' with or without pre-operative embolisation' is the treatment of choice.Conclusion: This uncommon lesion should be considered in any pregnant patient with a mass in the mouth or nasal cavity. © JLO (1984) Limited 2011.SCOPUS: re.jinfo:eu-repo/semantics/publishe

Computer-assisted-endoscopic Surgery of a Large Trigeminal Schwannoma in the Pterygopalatine Fossa

Case Report: A 33 year-old woman presented with a history of many years of a tumor in the pterygopalatine fossa. The tumor (5x 4.5 cm) extended to the sphenoid and maxillary sinuses, the nasal cavity, the skull base with an erosion of the cavernous sinus and the orbit with a close contact with the ophthalmic nerve. The patient had first refused to undergo the surgery because only an external approach through a paranasal and Caldwell-Luc incision had been proposed to her. We proposed a strictly endoscopic surgery after embolisation that allowed the diagnosis and the complete removal of this extended trigeminal schwannoma. The computer-assisted endoscopic surgery allowed the preservation of the intracranial structures, the internal carotid artery and the ophthalmic nerve; the morbidity was minimal and the patient was totally free of pain after surgery. There was no recurrence of the tumor after a follow-up of 2 years

Characterization of patterns of expression of protein kinase C-alpha, -delta, -eta, -gamma and -zeta and their correlations to p53, galectin-3, the retinoic acid receptor-beta and the macrophage migration inhibitory factor (MIF) in human cholesteatomas.

Cholesteatoma is a benign disease characterized by the presence of an unrestrained growth and the accumulation of keratin in the middle ear cavity. Due to roles in cell proliferation, apoptosis and differentiation members of the protein kinase C (PKC) family could be involved in disease progression. This study focuses on the expression of protein kinase C-alpha, -delta, -eta, -gamma and -zeta in the epithelial tissues of 56 human cholesteatomas and their correlations with those of previously characterized distributions of p53, galectin-3, retinoic acid receptor-beta (RARbeta) and macrophage migration inhibitory factor (MIF). We have previously reported this marker set to be correlated with keratinocyte differentiation in human cholesteatomas. Our present data clearly show that the percentage of PKC-alpha (but not PKC-delta, -gamma, -eta and -zeta)-immunopositive cells in epithelial tissue fro recurrent cholesteatomas was significantly higher than in non-recurrent cases. Correlations between the PKC isoenzymes and the biological markers were non-uniform. PKC-alpha (but not PKC-delta, -gamma, -eta and -zeta) expression in epithelial cholesteatoma cells correlated significantly and positively with the percentages of p53-immunopositive cells. The patterns of PKC-alpha and -delta expression, but not of PKC-gamma, -eta and -zeta, correlated significantly and positively with galectin-3 expression. In addition, the correlation levels between the expression of PKC-alpha and -delta and that of galectin-3 varied depending on the infection and recurrence status. Presence of RARbeta correlated significantly (and positively) with the expression of PKC-gamma and -zeta and also in relation to the infection and recurrence status. MIF correlated presence significantly (and positively) with that of the five PKCs under study, depending on whether the cholesteatomas were non-infected or infected as well as non-recurrent or recurrent. In conclusion, the present study suggests that modifications occurring at the level of keratinocyte differentiation in human cholesteatomas involve distinct effectors, to which the activation of PKC-alpha, -delta, -eta, -gamma and -zeta can be added.Journal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe

From polyuria to renal mass: An unexpected link

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

An unusual cause of central diabetes insipidus

info:eu-repo/semantics/publishe

Detection of macrophage migration inhibitory factor (MIF) in human cholesteatomas and functional implications of correlations to recurrence status and to expression of matrix metalloproteinases-3/9, retinoic acid receptor-beta, and anti-apoptotic galectin-3.

OBJECTIVES: To investigate whether the expression of the macrophage migration inhibitory factor (MIF) 1) is detectable, 2) changes in relation to recurrence and infection status, and 3) relates to the levels of expression of growth regulators/differentiation markers, including galectin-1, -3, and -8, retinoid acid receptors (RAR)]-alpha, -beta, and -gamma, binding sites for sarcolectin, and invasion markers (cathepsins -B and -D, and matrix metalloproteinases [MMP]-2, -3, and -9) in human cholesteatomas. STUDY DESIGN: An analysis of 56 cholesteatomas resected by the same surgeon using canal wall up and canal wall down surgical procedures. METHODS: The immunohistochemical levels of expression of MIF and the proteases were quantitatively determined (using computer-assisted microscopy) on routine histologic slides by specific antibodies, and statistically correlated to parameters of the other markers determined previously in conjunction with data on apoptosis/proliferation. RESULTS: MIF expression was detected. It was significantly higher in the epithelium (P =.002) and vessels (P =.04) of the connective tissues (but not in the connective tissue itself) of recurrent as opposed to non-recurrent cholesteatomas. The MIF expression is significantly correlated (P =.006) to the RAR beta expression in non-infected cholesteatomas, and to MMP-3 (P <.01) and anti-apoptotic galectin-3 (P =.01) in infected cholesteatomas. The level of MIF expression was also correlated significantly to MMP-9 (P = 0.003), RAR beta (P <.001), and galectin-8 (P =.003) expression in the cholesteatomas regardless of their infection status. CONCLUSIONS: MIF expression in human cholesteatomas is related to the levels of biologic aggressiveness reflected in their recurrence status and MMP expression, and to the differentiation status reflected in their galactin and RAR beta expressions. Together with galectin-3, it could cooperate to form an anti-apoptotic feedback loop.Journal ArticleResearch Support, Non-U.S. Gov'tFLWINinfo:eu-repo/semantics/publishe

Galectin-1 is overexpressed in nasal polyps under budesonide and inhibits eosinophil migration

Because of the importance of galectins for various cellular activities, the influence of the glucocorticoid budesonide on the level of expression of galectins-1 and -3 was investigated in human nasal polyposis. Ten nasal polyps obtained from surgical resection were maintained for 24 hours in the presence of various concentrations of budesonide. As quantitatively demonstrated by means of computer-assisted microscopy, 250 ng/ml (the highest dose tested) induced a pronounced increase of galectin-1 expression. This feature was observed in nasal polyps from allergic patients but not in those from nonallergic patients. Since eosinophils represent the main inflammatory cell population in nasal polyps, we investigated the effect of galectin-1 on their migration levels by means of quantitative phase-contrast computer-assisted videomicroscopy. Our results show that galectin-1 (coated on plastic supports) markedly reduced the migration levels of eosinophils in comparison to P-selectin. On the cellular level, marked modifications in the polymerization/depolymerization dynamics of the actin cytoskeleton (as revealed by means of computer-assisted fluorescence microscopy) and, to a much lesser extent, an increase in the adhesiveness of eosinophils to tested substrata were detectable. The present study therefore reveals a new galectin-1-mediated mechanism of action for glucocorticoid-mediated anti-inflammatory effects.Journal ArticleResearch Support, Non-U.S. Gov'tinfo:eu-repo/semantics/publishe

Prevalence of starvation or cachexia at early diagnosis of cancer patients

info:eu-repo/semantics/nonPublishe

Correlates of vulnerability amongst old cancer patients

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