[A curious purely motor paraneoplastic neurological syndrome in bronchial cancer].
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Biomedical subjects
Publications and source records attributed to G Akoun.
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Frequency of ectopic hormonal secretions by lung carcinomas is evaluated about 10 percent. Clinical and biological manifestations are less frequently registered than circulating hormonal products which can be considered as evolution markers of the disease. The main secretions and their clinical consequences are described: parathyroid hormone (PTH), calcitonin (CT), growth hormone (GH), antidiuretic hormone (ADH), corticotrophin hormone (ACTH) and gonadotrophins (HCG, LH, FSH). Problems raised by detection of these hormone-like acting products are studied and different hypothesis are suggested as explanation of these secretions.
Clinical and physiopathological data about 10 cases of bilateral squamous cell bronchial carcinoma with simultaneous revelation, are reviewed. This clinical form is not rare, usually found by a systematic bilateral endoscopy. In these 10 cases, the clinical and radiological data did not allow to predict the diagnosis before the endoscopy. Physio-pathological mechanisms are not well established. Various hypotheses are propounded : air-way, blood or lymphatic metastases, simultaneous tumoral blossoming, superficial propagation, genetic factors intervention. For these 10 cases, the authors develop arguments for one or another of these mechanisms.
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Carcinoid tumor primarily developing in the thymus gland is very rare. A new case is reported to add to the 35 previously reported. In most cases, patients have no endocrinological syndrome; the tumor is rarely associated with a multiple endocrine adenomatosis. This neoplasm probably derived from Kultschizky cells which are present in the normal thymus gland. Histologically they are very similar to the carcinoid tumor of other organs. Complete surgical excision is the best treatment when possible.
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The characteristics of broncho-pulmonary cancers discovered during systematic X-ray were studied over an 11 year period by comparison with cancers discovered through their symptoms. The operability of first group patients was definitely superior (62.5% against 36.7%y and so was the 5 year survival (18.7 against 5.5%). These differences are statistically significant and should be remembered, before the results of extensive anglo-saxon surveys be known, about the value of X-ray detection of bronchial cancer--at least in high risk patients.