Biomedical subjects
Publications and source records attributed to C Haye.
The authors have reviewed a series of 80 patients treated at the Curie Institute before 1965 for bilateral retinoblastoma. They present their cases of second non-ocular tumours in these patients and discuss their results and the possible factors influencing the percentage of second tumours in these patients.
Fine-needle cytology (FNC) of 292 palpable orbital and eyelid tumors was performed with a 25-gauge (0.5-mm), 3-cm needle and compared with the histopathologic findings in 286 cases. Among these 286 cases, a concordant diagnosis of malignancy and type was achieved in 249 cases (87%). False positive diagnoses were made in four cases (1.6%) and false negative diagnoses in five cases (1.8%). No complications were encountered. These results led to the conclusion that FNC is an accurate tool in the diagnosis of orbital and eyelid tumors, especially when sampling and interpretation are performed by an experienced pathologist.
The authors report 3 cases of uveal melanoma, appeared on young women: 20, 23 and 28 years old. The melanomas were localized on the iris, the ciliary body and on the choroid. The authors studied the different notions of the literature about happened age of these lesions.
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In a retrospective study of 105 retinoblastoma cases, the authors studied the clinical symptoms, survival and ocular conservations. The results are much better in case of early diagnosis. They discuss the therapeutic modalities in their institute and elsewhere.
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Conservative management of choroidal melanoma by radioactive plaques or protonbeam is widely used since 1968. The treatment of these tumors at Curie Institute has been done with cobalt plaques since 1968. Indications were first monophthalmic patients but are now much wide. We have been treating since 1981 all patients with tumor diameter less than 17 mm and tumor height less than 12 mm. The technic includes general anesthesia to place the disc with localisation of the tumor by transillumination or by indirect ophthalmoscopy. A dose of 70 to 90 grays is delivered to the apex of the tumor. We report two cases of patients treated by cobalt 60 plaque for choroïdal melanoma. The first patient has a 5 mm high choroïdal melanoma temporal to the macula. After treatment by cobalt plaque, he showed no echographic changes but angiograms revealed an hypofluorescent zone in the central part of the tumor. The second patient has an 8 mm tumor that after plaque showed only angiographic changes. Evolution after treatment of choroïdal melanoma by radioactive plaque is variable. Echographic changes are very low and it is frequent to observe no modification in the height of the tumor for a long time for this reason, repeated angiograms can be very useful in the follow up of these patients. They frequently show hypofluorescent spot in the central part of a tumor that was hyperfluorescent before treatment. Sometimes there is diffuse lowering of the fluorescence. We think that these modifications of fluorescence can be due to diminution of the vascularisation of the tumor or may be to central necrosis of the tumor.(ABSTRACT TRUNCATED AT 250 WORDS)
Both congenital anophthalmia and severe microphthalmia lead to micro-orbit with early appearance of craniofacial hemiatrophy. There is simultaneous lack of development of the lids (which remain small but complete) and of the conjunctival sac. Use of esthetic ocular prosthesis is thus impossible. The conjunctival sac can be dilated with conformators of increasing size but this technique has no effect on the orbit. The results of repeated plastic surgery are unsatisfactory. Stimulation of ocular growth by an expandable prosthesis in early infancy would appear to be the most logical and effective therapy. The authors propose a "new" technique for the expansion of the orbital cavity of the congenital anophthalmia. They have deviced a silicone prosthesis which is progressively expanded in size. The device has now been in use for over eighteen months with really encouraging results (17 cases).
A retrospective study was undertaken on 33 patients with bilateral retinoblastoma in whom one eye at least was classified as stage IV or V (Reese-Ellsworth classification). In most cases the other eye had been enucleated elsewhere. Conservative therapy consisted of primary chemotherapy (vincristine, actinomycin, cyclophosphamide) followed by external beam irradiation, six courses of chemotherapy and, if necessary, by cobalt-60 plaques, xenon arc photocoagulation or secondary enucleation. Ten patients were lost to follow-up, eight patients died or are currently being treated for recurrence, 15 patients are alive and free from disease and 42% of eyes at stage IV or V were saved. These results indicate that primary chemotherapy does not improve the final outcome of stage IV or V retinoblastoma, as compared with primary irradiation.
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This work presents an immunofluorescent study of the distribution of the photoreceptor-specific S-antigen in human retinoblastoma, using mouse monoclonal antibodies. Three cases of differentiated retinoblastoma displayed S-antigen immunoreactivity with various patterns of labeling which depended on the degree of differentiation of the area studied. Flexner-Wintersteiner rosettes and fleurettes were labeled only with monoclonal antibody S2D2, whereas undifferentiated areas were labeled with four different anti-S-antigen monoclonal antibodies, including S2D2. On the other hand, the three undifferentiated retinoblastomas did not show any labeling with these antibodies. The presence of S-antigen in differentiated retinoblastoma confirms that the origin of this tumor is from the photoreceptors, but the question remains unanswered for undifferentiated retinoblastoma for which another origin--glial or primitive neuroectodermal cells--may be proposed.
The authors report a retrospective study of 129 children with retino-blastoma treated from 1963 to 1977 at the Institute Curie by enucleation of the worst eye and conservative irradiation of the other eye; this irradiation was performed either with Stallard plaque (19 cases) or with electrons (110 cases). In 8 familial cases no enucleation was performed. T.E.M. was used from 1964 to 1973 and iterative photocoagulation has been performed since 1968. Five years absolute NED survival rate was 68% (88/129 children). In these 88 children, 94 eyes were irradiated. Ophthalmological results were as follows: 21 eyes were enucleate secondarily (20/21 were tumoral); the attempt of ocular conservation was succeeded in 78% of the cases: 73 of the 94 irradiated eyes were cured; among these 73 cured eyes, 4 had complications and 15 had sequelae; the others 54 eyes were normal; only 5 eyes escaped ophthalmological survey; for the other 68 eyes vision was evaluated: 2 eyes (3%) were functional but vision could not be measured; 10 (14%) had less than 1/10 of visual acuity; 14 (19%) had vision at least equal to 1/10 but less than 5/10; 42 (57%) had 5/10 or more. 62% of all irradiated eyes (58/94) and 79% of conservated eyes (58/73) had "useful vision". Results are discussed and compared with these published by other teams; the authors try to determine elements of visual prognosis.
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