Tumeur glomique de la capsule antérieure du coude. À propos d’un cas

Glomus tumors are rare tumors, benign but painful and responsible for a major functional impairment. Although their preferential localization is digital, 35% of glomus tumors are extradigital. Ignorance of this disease characterized by atypical clinical signs and the absence of specific imaging are responsible for a significant diagnostic delay, 7 to 10 years in extradigital forms. Treatment by surgical excision simply ensures immediate disappearance of pain without recurrence in 90% of cases. It is therefore necessary to emphasize the existence of this sometimes debilitating condition benefiting from effective therapeutic solution. We report the case of a glomus tumor of the anterior capsule of the left elbow in a 24-year-old woman with a diagnostic delayed by 12 years.     

Fracture-luxation trans-scapho-rétrolunaire du carpe avec énucléation antérieure du lunatum et du fragment proximal du scaphoïde. À propos d’un cas

We report the case of a patient who suffered from an unusual anatomic form of trans-scaphoid trans-styloid volar dislocation of the lunate with proximal displacement of both the lunate and the proximal pole of scaphoid, proximal to the radiocarpal joint line. Proximal row carpectomy was performed. A good anatomic and functional result was observed at 3 years of follow-up. Etiopathogeny, therapeutic and outcome modalities are discussed.     

Le syndrome d’Adams-Oliver. À propos d’un cas clinique

The authors report a case of Adams-Oliver syndrome in an 11 months child. This child was referred to our unit at the age of six months with right hand brachydactyly and alopecia on the vertex. We decided not to treat hand malformations, given the lack of functional impact. Alopecia of the vertex was corrected by tissue expansion of the scalp, with a satisfactory cosmetic result at five months.     

Îlot osseux bénin solitaire géant. À propos d’un cas suivi au long cours

A dense bone lesion raises immediate concern about the possibility of a primary or secondary tumor. Stability of the image over time is a strong argument against a malignancy. Benign solitary bone islands are usually believed to remain stable over time, with no tendency toward growth. We report a case in a patient with 31 years of follow-up, during which marked growth of the island was documented. The bone scan was normal, and histology established the diagnosis of benign bone island. In a patient with an enlarging sclerotic lesion, typical radiographic features and absence of radionuclide uptake are strong arguments in favor of a bone island.     

Métastases osseuses d’un épendymome d’emblée de double localisation. À propos d’un cas

A case of cerebral and sacral ependymoma revealed by cerebellar syndrome and sciatica in a 68-year-old man is reported. Bone metastases were diagnosed seven months after surgical excision of the brain tumor.     

Schwannome géant du nerf musculocutané (à propos d’un cas)

Schwannoma is a tumor that develops from nerve sheath. The authors report an original observation of a giant schwannoma developed in the arm depending on the musculocutaneous nerve. The diagnosis was based on MRI appearance. Confirmation of the diagnosis was made by histological examination. Surgical treatment was resection, taking care preserving adjacent nerve fibers. This allowed recovery without any sequela. Recurrence rate and potential for malignant transformation of this type of tumor is low.     

Spondylarthropathie et fibrose rétropéritonéale. À propos d’un cas

Retroperitoneal fibrosis is an uncommon inflammatory condition in which the retroperitoneal tissue is transformed into a tight sheet of fibrous tissue. It can occur in association with various diseases, including rheumatic conditions. We report a new case in a 66-year-old man with spondyloarthropathy. Nine similar cases have been reported. Axial manifestations predominated, and half the patients carried the HLA-B27 antigen. The relation between retroperitoneal fibrosis and spondyloarthropathy remains controversial.     

Utilisation du lambeau cerf-volant pour le traitement d’un sarcome épithélioïde du pouce. À propos d’un cas

Epithelioid sarcoma is a rare lesion usually involving extremities. We report the case of a patient presenting with an epithelioid sarcoma of the dorsal aspect of the thumb. Surgical treatment consisted in a wide resection, arthrodesis of the metacarpophalangeal joint of the thumb and skin coverage with a kite flap. This case report illustrates a rare diagnosis potentially encountered by hand surgeons and the possible use of a kite flap in a non-traumatic context.     

Une localisation inhabituelle d’un lipome ossifié juxtaosseux. À propos d’un cas

We report a case of juxtaosseous ossified lipoma. Clinical and radiological features make it an exceptional case, because of its location at the hand and presence of cortical erosion of the subjacent bone. However, the histological study of this rare benign tumor showed neither cytonuclear atypia nor increasing number of mitosis. It made easy its surgical treatment, without any functional sequelae. The patient reported no local recurrence in the follow-up; the risk is low, given its histological character.     

Rupture du tendon du fléchisseur radial du carpe après ostéosynthèse percutanée d’une fracture de scaphoïde. À propos d’un cas

We present a rare complication of percutaneous osteosynthesis of a scaphoid fracture. A 19-year-old professional handballer presented with a fracture of the scaphoid classified B2 according to the Herbert classification: the fracture was fixed with a percutaneous screw. The fracture was united by six weeks despite resumption of training eight days postoperatively. Subsequently, the patient presented with pain over the flexor carpi radialis (FCR) tendon together with reduction of wrist flexion strength suggested an FCR tendonitis. A CT scan with injection eliminated the diagnosis of non-union and showed protrusion of the distal end of the screw. After the failure of conservative treatment (corticosteroid injection), removal of the screw and synovectomy of the FCR were scheduled. During the procedure, attrition of the FCR tendon with scar tissue and metal inclusions in its fibres were observed. A visual examination of the screw's distal end showed a distortion of its hexagonal outline due to hammering, leading to metal projection likely to have caused the FCR tendon's attrition. We recommend the systematic burying of these canulated screws as well as changing any screw damaged during its insertion.     

Insuffisance rénale aiguë révélatrice d’un lymphome rénal. À propos d’un cas

Acute renal failure, as the initial manifestation of lymphoma, has been reported only in a few cases. In this work, we report the case of a 28-year-old women admitted for acute renal failure. Her physical examination detected bilateral kidney enlargement. Laboratory evaluation revealed a serum creatinine value 218 μmol/l. A 24-hour urine collection analysis allowed the detection of 1 g of protein. No red cells were found after urinanalysis. Renal ultrasound showed massively enlarged kidneys. Renal biopsy of the kidney and pathologic examination showed diffuse infiltration of the interstitium with lymphocytes and atypical cells positive for CD20 markers. A diagnosis of diffuse large B-cell type non-Hodgkin lymphoma was made. However, investigations revealed the presence of two others sites of lymphoma: gastric and ophthalmic. The patient's renal function and kidney size as well as the other lymphoma locations were normalized after the initiation of chemotherapy.     

Luxation carpo-métacarpienne palmaire du cinquième doigt : à propos d’un cas

Pure carpo-metacarpal dislocations without any fracture are rare, their volar component is exceptional. Untreated injuries can result in instability and early articular degeneration. We report a 72-year-old female patient who underwent an isolated closed volar dislocation of her fifth finger carpo-metacarpal joint after a fall. The clinical examination showed a 10°-defect in rotation with limited adduction (radial deviation). The X-rays showed a gap between the base of the fourth and the fifth metacarpal bones with volar dislocation of the base of the fifth carpometacarpal joint. The dislocation was successfully treated by closed reduction maintained with two K-wires. Immobilisation of the joint was applied for 6 weeks. At 2 years follow-up evaluation, the patient was pain free with no clinico-radiological evidence of instability and had returned to her previous level of activity.     

Abduction permanente isolée du cinquième doigt sans paralysie ulnaire. À propos d’un cas

Wartenberg's sign, or permanent abduction of the little finger, occurs in the context of sequelae of ulnar nerve palsy. Its presence alone is rarely reported in the literature and is due to avulsion of the insertion of the third volar interosseous muscle. Several surgical techniques to correct this sign are reported in the literature. The authors report the case of a Wartenberg's sign without ulnar nerve palsy due to traumatic avulsion of the third volar interosseous muscle that was treated by a transfer of the extensor digiti minimi onto the radial side of the extensor digitorium communis according to technique of Bellan et al. After 1-year follow-up, result was good with no recurrence of any deformities and a normal active extension.     

Tumeur glomique de la face postérieure du poignet : à propos d’un cas

Extra-digital glomus tumors are extremely rare and difficult to diagnose. The authors report a case of glomus tumor of the dorsal aspect of the wrist, discovered incidentally after surgical resection in a 71-year-old patient.