A pragmatic non-invasive assessment of liver fibrosis in patients with psoriasis, rheumatoid arthritis or Crohn's disease receiving methotrexate therapy.

Background And Aims: The reported hepatotoxicity of methotrexate underlines the need for a repeated non-invasive and reliable evaluation of liver fibrosis. We estimated, using a non-invasive strategy, the prevalence of significant liver fibrosis in patients treated by methotrexate and the predictors of significant fibrosis (fibrosis≥F2).

Methods: Fibrosis was prospectively evaluated using 9 non-invasive tests in consecutive patients with psoriasis, rheumatoid arthritis, or Crohn's disease.

Common peroneal nerve palsy following TNF-based isolated limb perfusion for irresectable extremity desmoid tumor.

Hyperthermic isolated limb perfusion (ILP) (2 mg, TNF-alpha and 100mg, melphalan) was performed for an irresectable right thigh desmoid tumor with calf extension in a 49-year-old man. The patient had a history of four resections since the age of 19 years. Local ILP toxicity appeared with extensive edema and common peroneal neurologic impairment including paresis that remained severe 10 months later.

Sarcomas and malignant phyllodes tumours of the breast--a retrospective study.

Background: Although most breast cancers are adenocarcinomas of the mammary gland, primary breast sarcomas may also arise from mammary gland mesenchymal tissue. The annual incidence of primary breast sarcoma is low and has been estimated at 45 new cases per 10 million women. These tumours are at high risk of recurrence and are known to have poor prognosis.

[Neoadjuvant chemotherapy and ovarian cancer].

Primary surgical cytoreduction followed by chemotherapy usually is the preferred management of advanced (stage III or IV) ovarian cancer. The presence of residual disease after surgery is one of the most important adverse prognostic factors for survival. Neoadjuvant chemotherapy has been proposed as an alternative approach to conventional surgery as initial management of bulky ovarian cancer, with the goal of improving surgical quality.

Pseudoaneurysm of the superficial temporal artery.

Ours is the first report of pseudoaneurysm of the superficial temporal in a 90-year-old woman. Although falls with associated head and scalp injuries in the geriatric population are common, pseudoaneurysm of the superficial temporal artery is rarely reported, probably due to the generally protected course of the superficial temporal artery across the skull. Clinicians' familiarity with this entity is important for early diagnosis and intervention.

[Surgery of pulmonary metastasis from malignant melanoma. Results and criteria of surgical excision].

Lung metastases from malignant melanoma are frequent and they often inaugurate the metastatic stage. Exceptionally, they present as one or a few nodules, and in the absence of any other secondary lesion these cases raise the problem of surgical eradication. A retrospective multicentre study was carried out in a series of 38 patients and its results were compared to the data obtained from a review of 435 published cases in order to assess the value of surgery in terms of survival and to delimit its indications as closely as possible.

[Developments in the treatment of osteosarcoma since 1979. Report of the statistics at the Centre Léon-Bérard].

Seventy-two patients with a localized osteosarcoma were treated between September 1979 and December 1987 by neoadjuvant chemotherapy, local surgery and post-operative chemotherapy. Chemotherapy regimens varied throughout the years but always comprised high dose methotrexate with leucovorin rescue and adriamycin pre-operatively for children under the age of 15, and ifosfamid and cis platinum in adults. Post-operative chemotherapy for bad responders (greater than 10% of residual malignant cells), was at first an association of adriamycin and cis platinum, and later of holoxan and cis platinum.

Prognostic value of the topographic grid method in women with T2 N- breast cancer. Statistical results from a series of 203 patients.

In 1977, the authors described the grid method, a topographic technique for mapping the microscopic spread of breast cancer. The current report describes the relapse-free survival of a series of 203 patients with T2 N- mammary cancer (T2 N0 N1 ab N-) who were treated by mastectomy and regional lymph node dissection and have been followed since 1974. A good prognosis did not prevent relapse in 15% to 20% of patients within the first 5 years.

Skin preservation by programmed freezing.

There are several occasions when it may be useful to preserve skin grafts for at least 15 days, in a good enough state to provide viable autografts. We describe a technique of cryopreservation which facilitates this type of procedure. Stretched sheets of skin are incubated in a protective medium.

Results of combined chemosurgical therapy for pulmonary metastases.

The authors study the results of the combined surgery and postoperative chemotherapy, for treatment of pulmonary metastases. At Léon-Bérard Center, 50 patients have been operated on since 1963. The sites and histologies of the primitive cancers are varied, corresponding to 12 epidermoid cancers, 12 adenocarcinomas, 10 osteogenic sarcomas, 1 Ewing's tumor, 3 malignant melanomas, 6 testicular tumors, and 4 others.

A topographic approach to breast cancer: the relation of topographic and mammographic findings.

One hundred and twenty-eight patients with breast cancer who, on the basis of mammographic study, were treated by mastectomy were analyzed. The purpose of this endeavor was to correlate the roentgenologic features with the pathologic findings. The correlation between them was very good: the type of tumor opacity, the microcalcifications, and the various other radiologic patterns were compatible with both localized and extensive breast cancer.

A new topographic approach to the spread of breast cancer: the grid method.

In a series of 181 patients with breast cancer treated by mastectomy with axillary lymph node dissection, the authors developed and used an improved topographic technique, which they call the "Grid Method", which maps out the extent of a given cance of the breast. Three types of tumor spread are defined: Type 1, limited (L)(31%); Type 2, multifocal (M)(13.2%); and Type 3, extensive (E)(55.