Search

Les masses rétropéritonéales regroupent un ensemble de tumeurs très diverses comportant les tumeurs d’organe (reins, voies excrétrices et surrénales), les tumeurs rétropéritonéales primitives et secondaires. Les tumeurs rétropéritonéales primitives sont des tumeurs rares, le plus souvent malignes et de diagnostic tardif. Elles sont représentées pour plus de la moitié d’entre elles par des sarcomes. Leur rareté associée à une grande variété explique les difficultés diagnostiques. L’objectif de cet article est de répertorier les caractéristiques d’imagerie présentes sur le scanner et l’IRM permettant de proposer des hypothèses diagnostiques. En cas de suspicion de sarcome, il est recommandé avant toute prise en charge thérapeutique de se référer à un centre expert permettant une approche multidisciplinaire (pathologiste, radiologue, chirurgien et oncologue) et de pratiquer une analyse histologique par biopsie percutanée radioguidée par voie rétropéritonéale.

L’objectif de cet article est de rappeler pourquoi et comment le dépistage de masse organisé du cancer du sein s’est développé puis généralisé en France en 2004, et d’expliquer ce qu’est le classement BI-RADS de l’ACR. Des perspectives sur le futur du dépistage seront données.

Le but de cet article est de décrire les caractéristiques morphologiques des principales tumeurs digestives, de montrer l’intérêt de l’injection intraveineuse de produit de contraste et du balisage intestinal. Quelques rappels sur les aires ganglionnaires et l’anatomie du péritoine seront faits.

L’IRM pelvienne permet une analyse morphologique plus fine de l’utérus (col et corps) et des ovaires par rapport au scanner que ce soit sans ou avec injection. Elle permet de faire un bilan d’extension locorégional et à distance, des cancers utérins, influençant ainsi la prise en charge. Elle évalue la réponse tumorale sous traitement, détecte les récidives locales ou à distance. Elle permet une meilleure caractérisation des lésions ovariennes.

A large number of tools are available in the software industry to support different aspects of knowledge management (KM). Some comprehensive applications and vendors try to offer global solutions to KM needs; other tools are highly specialized. In this paper, state-of-the-art KM tools grouped by specific classification areas and functionalities are described. Trends and integration efforts are detailed with a focus on identifying current and future software and market evolution.

To evaluate transthoracic needle aspiration biopsies of pulmonary lesions in patients with squamous cell cancer of head and neck. Retrospective series of 85 patients with squamous cell cancer of head and neck cancer and pulmonary nodules who underwent CT-guided needle aspiration biopsy. Diagnostic samples were obtained in 85% of patients. There were 8 benign and 77 malignant lesions. Among the 73 proved cases, 4 were false-negative cases. CT-guided biopsy had an accuracy of 81%, a sensitivity of 94%, and a negative predictive value of 60%. Accuracies were 68% for lesions of 20 mm or smaller and 89% for lesions greater than 20 mm. In a subset of 45 solitary lesions, among 30 positive biopsies, 15 were categorized as primary malignancies, 3 as metastatic, and 12 as indeterminate malignancies. In head and neck cancer patients, the prevalence of thoracic malignancies is high when a pulmonary lesion is detected. CT-guided biopsy of pulmonary lesion is an accurate procedure. However, a third of positive biopsies were categorized as indeterminate malignancies. © 2003 Wiley Periodicals, Inc. Head Neck 25: 000–000, 2003

A total of 22 women with fibroadenomas had preoperative dynamic MR study (T1-weighted images every 47 s after injection of Gd-DOTA). Their age, hormonal status, breast MR studies and histopathological slides were retrospectively reviewed. Eleven pre- (n = 2) or post-menopausal (n = 9) women showed no early contrast enhancement. The absence of early contrast enhancement correlated with hyalin stromal component. Eleven pre- (n = 7) or post-menopausal (n = 4) women showed focal (n = 9) or diffuse (n = 2) early contrast enhancement. Early focal contrast enhancement correlated with myxoid (n = 9), mixed hyalin/myxoid (n = 1) or hyalin (n = 1) fibroadenomas. Early diffuse contrast enhancement of the breast correlated with myxoid (n = 1) or hyalin (n = 1) stromal component associated with proliferative fibrocystic disease of the breast parenchyma. The presence of contrast enhancement correlated with myxoid fibroadenomas, whereas absence of contrast enhancement correlated with hyalin fibroadenomas. As hyalin fibroadenomas occurs in post-menopausal women, the diagnostic accuracy of dynamic MRI may be improved in this age group.

Cardiac leiomyosarcoma is a rare tumour which can grow either intramurally or extramurally. Its prognosis is dismal. Surgery lengthens survival, but recurrences usually occur in the short term. Gated MRI is useful for the assessment of cardiac masses since it provides fine spatial and contrast resolution. We present the case of a left atrial leiomyosarcoma whose recurrence was diagnosed by gated MRI. Our patient underwent a second resection but died soon after.

Abstract.: We report a case of renal cell carcinoma with solitary metachronous contralateral adrenal metastasis occurring 23 years after radical nephrectomy. The patient was treated with adrenalectomy. He is alive with no evidence of disease 1 year postoperatively. Solitary metachronous contralateral adrenal metastases from renal cell carcinoma are rare clinical conditions that may occur very late. Metastasectomy is advocated and is probably beneficial for limited metastatic renal cell cancer.