[Malignant hemangioendothelioma of the thyroid. Pathologic study of a case].

The authors report a case of malignant tumor of the thyroid in a 79 years old woman with a long standing goiter for 20 years but who did not live in endemic mountainous goiter area. The right lobe of the thyroid was surgically removed in February 1992 because increasing in size. Pathologic diagnosis was non malignant cystic lesion.

[Latissimus dorsi myocutaneous flap closure in mastectomies after chemotherapy of advanced and progressive breast cancers].

A latissimus dorsi myocutaneous flap now appears to be the best solution to closing large carcinological exeresis of the breast. After an analysis of a series of 14 cases of advanced cancer (T3 or T4) or of progressive cancers (PeV3) of the breast treated by inductive chemotherapy and which underwent surgery at the Strasbourg CRLCC (France), the authors stress the simplicity and reliability of the method, which can make it possible to carry out an extensive and complete exeresis, which is of primordial importance in the control of the local tumor. Its excellent trophic quality made it possible to start radiochemotherapeutic adjuvant treatments rapidly.

[Treatment of the pelvis after total pelvic exenteration. Experience of the Regional Paul Strauss Cancer Center of Strasbourg].

Intestinal morbidity after total pelvic exenteration presents usually as fistulae. These appear particularly if irradiation has been carried out in the pelvis or the abdomen before surgery, and particularly as a result of the types of surgery carried out in the emptied pelvis. An analysis of 92 exenterations of the pelvis of which 52 were total exenterations led us to look at how treatments in the pelvis have evolved technically and to analyse the contribution they have made to reducing the number of fistulae and obstructions found as a result of this major surgery.

[Primary and secondary carcinomas of the thyroid gland with systematic discovery. Apropos of hundred thyroid glands removed at autopsies and review of the literature].

One hundred thyroids from autopsies performed in a Cancer Center were sectioned at 4 mm intervals. Each slice was processed to obtain one or several sections for histologic examination. Five primary microcarcinomas and ten secondary clinically unknown carcinomas were found.

[Role of total thyroidectomy in the treatment of multinodular goiter].

Although it may seem to be excessive, total thyroidectomy has recently been advocated by several authors for the treatment of diffuse multiheteronodular goiters. As a complement to a recent study on the thyroid function following thyroidectomy for benign goiters, the authors specify the role of this surgical technique, which had been reserved for the sole thyroid neoplasms for a long time. On the occasion of the presentation of a series of 75 cases gathered from 1989 to 1990, the justification of glandular resection is based on the publication of new pathogenetic data and on the absence of any increase in morbidity, subject to precise indications and to a strict technique aimed at preserving recurrents and locating the parathyroid glands while maintaining their vasculature.

[Surgical removal of diaphragmatic metastasis of advanced ovarian cancer. Review of the literature].

Many studies have established the close relationship between the survival and the residual tumoral volume after a first maximal cyto-reducing surgery. In that light, the surgical exeresis of the metastatic lesions should facilitate the response to chemotherapy. In this respect, the diaphragm metastases of ovarian cancers prove to be worthy of the highest interest due to the difficulty of their surgical approach.

[The value of peritoneal cytology in invasive uterine cancers. Analysis of 80 cases].

When they analysed 80 cancers of the uterus, the authors showed how valuable it was both for diagnosis and prognosis to carry out cytological lavage of the peritoneum, particularly in cases of endometrial adenocarcinoma. The results of this study are compared with recent extracts appearing in the international literature. This technique makes it possible to identify groups of patients of high risk for recurrences in the pelvis and abdomen who would benefit from adjuvant therapies, demonstrating that this technique is applicable to the diagnosis of gynaecological cancers with intraperitoneal spread which have long been failed to be recognised.

[Functional cervical lymph node excision with section of the sternocleidomastoid muscle].

Based on 7 cases, the authors update the low section and subsequent suture technique of the sternocleidomastoid muscle in conservative cervical lymphadenectomy, principally for differentiated thyroid cancer. Due to the good exposure obtained, this technique permits functional clearance with excellent visualisation of the structures to be preserved and is associated with very minor functional sequelae. A review of the literature confirms the perfect feasability and reproducibility of this technique and justifies its use from a cosmetic viewpoint.

[Significance of the non-peritonization technic in extended lymphadenocolpohysterectomies in uterine cancer. Analysis and results in a series cases].

The gravity of the pelvic lymphocysts after extended lymphadeno-colpo-hysterectomies for uterine cancers has been outlined in many studies and only a preventive strategy can reduce the morbidity, which is mainly of urinary order. The present technique is in line with this approach and breaches the peritonization dogma in gynaecology. After the presentation of 60 cases of extended colpo-hysterectomies with iliac lymphadenectomy and without reperitonization, the authors study the post-operative lymphorrhea and evaluate the morbidity proper to the technique by comparing their results with the literature data.

[Thyroid microcarcinoma with a fatal outcome and 34 other unusually aggressive cases reported in the literature].

A follicular thyroid microcarcinoma was revealed by scapular metastases. Despite treatment, other metastases were the cause of death after a course of 14 years. In the medical literature there are at least thirty-four other examples of follicular or papillary carcinoma of less than 15 mm (previously called occult) that have either given rise to blood-born metastases or have been the cause of death.

[Extra-skeletal Ewing's sarcoma. A case report with detailed review of the literature].

Extra-skeletal Ewing's Sarcoma (EES): a clinico-pathological entity described in 1975 by L. Angervall and F.M.

[Tamoxifen and endometrial adenocarcinoma].

The authors report a case of endometrial carcinoma treated with tamoxifen introduced after normal initial uterine curettage. Based on recent experimental and clinical data, the importance of a gynecological follow-up in anti-estrogen therapy is emphasized.

Modulation of human breast cancer cell adhesion by estrogens and antiestrogens.

In order to study the effect of estrogens and antiestrogens on the adhesive properties of human breast cancer cells, the attachment on endothelial cells (EC), on subendothelial extracellular matrix (ECM) and on ECM components (collagen I and IV, laminin, fibronectin) of estrogen-dependent (MCF-7, ZR75-1) and estrogen-independent (BT-20) breast cancer cell lines was investigated. The cells were grown under conditions of controlled exposure to estrogen [17 beta-estradiol (E2)] and/or antiestrogens [tamoxifen (Tam) or 4-hydroxytamoxifen (OH-Tam)]. Treatment by E2 enhanced the ability of ZR75-1 cells to adhere to the various substrates, which contrasts with the observed absence of effects with the BT-20 cells.

[Primary or secondary malignant tumors of tonsillar cysts. Apropos of a case of occult papillary cancer of the thyroid disclosed by intracystic metastasis].

The development of a malignant process within a tonsillar cyst is controversial. This phenomenon is exceptionally rare, at present only three cases which have been compatible with anatomo-clinical diagnostic criteria have been clearly established. Based on an original case showing a secondary papillary thyroid cancer in a tonsillar cyst, the authors analyse, in the light of recent data from worldwide literature, the various stages in the diagnostic process in both primary and secondary malignant tumours.

[Pelvic exclusion using polyglactin 910 mesh (Vicryl) for preventing radiation injuries of the small intestine Apropos of a series of 24 cases].

The authors report a surgical procedure for prevention of radiation enteritis performed in 24 cases of advanced gynecological and rectosigmoid malignancies with a 12-month median follow-up. Visualization and resorption of the Vicryl mesh were analyzed by means of magnetic resonance imaging.

Low dose heparin versus low molecular weight heparin (Kabi 2165, Fragmin) in the prophylaxis of thromboembolic complications of abdominal oncological surgery.

Eighty patients undergoing pelvic or abdominal surgery for cancer were randomized in two groups for prevention of postoperative thromboembolism: 40 patients received a 15,000 IU day-1 Calciparine prophylaxis and 40 patients a 5000 anti-Xa U/d Fragmin prophylaxis for 10 days. In the Calciparine group, two patients (5%) developed postoperative pulmonary embolism but none developed it in the Fragmin group. Two patients in the Fragmin group (5%) developed isotopic DVT, which was not confirmed by phlebography.

[Sarcoma of the breast].

Reports of 4 personal cases of breast sarcomas (3 cases of cystosarcoma phyllodes and 1 angiosarcoma), the authors review the literature concerning these rare tumors which account for less than 1% of malignant tumors of the breast. Whilst the usual clinical picture is that of a large tumor deforming the breast with pseudo-inflammatory signs, sarcomas 1 to 3 cm in diameter were discovered and treated with good chances of recovery. The natural history of breast sarcomas is marked above all by the risk of hematogenic metastatic spread (30% of cases) whilst very few (5%) local recurrences are seen following surgical treatment by mastectomy.

The collagenase gene family in humans consists of at least four members.

Stromelysin is a collagenase-related connective-tissue-degrading metalloproteinase. We have detected RNAs capable of hybridizing to a rat stromelysin cDNA in 11 of 69 human tumours tested. Molecular cloning of cDNAs to these RNAs has identified them as a mixture of stromelysin RNA and a transcript of a hitherto-undescribed related human gene, the stromelysin-2 gene.

Adhesion of human breast cancer cell line MCF-7 to human vascular endothelial cells in culture. Enhancement by activated platelets.

The interactions of MCF-7 tumor cells with human vascular endothelial cells (EC) and subendothelial extracellular matrices (ECM) were morphologically observed by electron microscopy and quantitatively evaluated by labelling tumor cells with 111Indium-oxine. MCF-7 tumor cells adhered more rapidly to ECM than to the apical surface of a confluent monolayer of EC. The affinity of MCF-7 cells for type-IV collagen was greater than for fibronectin, suggesting that type-IV collagen contributes to the higher rate of adhesion of MCF-7 cells to the subendothelial ECM.

Characterization of cell types in human breast tumor primary cultures.

Primary cultures of cells from breast carcinomas were attempted in 74 cases. Growth was observed in 46 cases. Using immunochemical demonstration of keratin proteins (KER), epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA), three morphologically distinct cell populations were characterized and described.