Léiomyosarcome de l’estomac : quelle prise en charge ?

Primary leiomyosarcoma of the stomach is rare, representing 1% of all malignant gastric tumours. Little is known about its symptomatology, and ultrasound endoscopy with a biopsy is the most effective way of making a diagnosis. Full surgical resection is the most common treatment for gastric leiomyosarcoma.We are reporting on a rare case of a massive leiomyosarcoma of the stomach, in a patient aged 40 years with no specific symptomatology, and in whom the diagnosis was made following an exploratory laparotomy. The patient was treated with a partial gastrectomy, extended to the spleen.     

Development of an Enzyme-Linked Immunosorbent Assay for Serotyping Ureaplasma urealyticum Strains Using Monoclonal Antibodies

Ureaplasma urealyticum comprises 14 serotypes. The existing serotyping methods all use polyclonal antibodies. These methods are time-consuming and labor-intensive, and they cannot always be performed on primary isolates; in addition, the results are difficult to interpret. We developed a new enzyme-linked immunosorbent assay (ELISA) method using serotype-specific monoclonal antibodies (MAbs) to enable the serotyping of U. urealyticum isolates from primary broth cultures. Each of the 14 serotype reference strains was tested against 14 selected MAbs. Homologous reactions were very strong, while heterologous reactions were negligible. Three cross-reactions were observed: MAb 5 cross-reacted with serotype 2, MAb 14 cross-reacted with serotype 3, and MAb 8 cross-reacted with serotype 13. Despite the cross-reactions observed, all the serotype reference strains of U. urealyticum could be identified and differentiated using a combination of MAbs. Reproducibility was analyzed with a fractionated antigenic preparation and with several freshly prepared antigens of the same strain. No significant interrun variation was found with the fractionated antigen, but significant variations in optical density (OD) values were found when freshly prepared antigens were tested. However, the variation in OD values did not influence the overall interpretation of the ELISA: reactions with homologous MAbs were always prominent compared to those of the negative controls. This newly developed ELISA using MAbs seems promising for serotyping of U. urealyticum clinical isolates.     

Maladie de Behçet avec localisation gastrique: à propos d’un cas

Behçet’s disease (BD) is a vasculitis characterized by oral and genital ulcers and uveitis. Involvement of the digestive tract is called entero-Behçet’s disease. The most frequent sites of gastrointestinal involvement are the colon and the ileocecal region. Gastric involvement is rarely seen. We report the case of a 45-year-old man with a history of Behçet’s disease, in whom an upper gastrointestinal endoscopy performed because of gastric pain revealed a large gastric ulcer which was diagnosed as related to Behçet’s disease.     

Liposarcome rétropéritonéal géant. À propos d’un cas

The authors report a case of giant retroperitoneal liposarcoma revealed by an abdominal mass and non specific digestive symptomatology. They discuss, through a review of the literature, the different clinical, radiological, anatomopathological, therapeutic and evolutive aspects of abdominal liposarcoma.     

Kyste bronchogénique intramural de l’œsophage

We report the case of an intramural cystic lesion of the esophagus, inducing a diagnostic and management problem.     

Tumeurs intracanalaires papillaires et mucineuses du pancréas découvertes fortuitement : à propos d’un cas

Intraductal papillary mucinous neoplasms of pancreas (IPMN) are cystic lesions of the pancreas than can be associated with extra-pancreatics malignancies. We report a case of intraductal papillary mucinous neoplasm discovered incidentally during the staging of rectal adenocarcinoma. This observation illustrates the high frequency of IPMN incidentally discovered, for instance during the work-up of an extrapancreatic tumor.     

Traitement endoscopique des complications biliaires du kyste hydatique du foie

Objective

To evaluate the contribution of endoscopic retrograde cholangiopancreatography (ERCP) in diagnostic and especially therapeutic biliary complications of a liver hydatid cyst (LHC).

Patients and Methods

We included 20 patients received for endoscopic management of biliary complications of LHC over 8 years. The mean age was 47 years with male predominance at 64%.

Results

The prevalence of biliary complications of LHC is 3.4% in our series. ERCP allowed the objectifying of a kysto-biliary fistula in 43% of the cases, and incomplete images in the bile duct in 85.7% of the cases related to hydatid material. Endoscopic sphincterotomy was performed in all patients, allowing the extraction of hydatid material with cuff or basket extraction, and a bile duct dilatation by candle. The evolution was marked by the disappearance of jaundice after an average of 5 to 12 days after the endoscopic procedure and the depletion of the external biliary fistula after 10 to 12 days.

Conclusion

The endoscopic treatment of biliary complications of a liver hydatid cyst is an effective method with acceptable mortality and morbidity.