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Biomedical subjects

J Kerisit

Publications and source records attributed to J Kerisit.

At least 19 recordsLinked to original sources

High prevalence of cervical intra-epithelial neoplasia in women treated for pelvic inflammatory disease.

Because human papillomavirus (HPV) is sexually transmitted, as are pelvic inflammatory disease (PID) agents, the authors investigated whether cervical intra-epithelial neoplasia (CIN) are more frequent in women under treatment for PID. The study involved 298 patients hospitalized for PID, in whom CIN were investigated by smears and colposcopy. CIN were diagnosed in 42 patients, i.e. in 14% of patients: 21 low-grade CIN and 21 high-grade CIN, including one case of early-stage microinvasion. These figures are to be compared to the 0.5-4% of pre-cancerous lesions found in the general population. Screening smears are frequently inaccurate and direct colposcopy appeared preferable. No clinical study of this type has been published before, but certain authors have mentioned a high CIN incidence in patients with PID histories or followed up in sexually transmitted disease centers. These results show that CIN are more frequent in patients treated for PID; CIN should be investigated systematically in this population.

Adolescent↗

[Uterine leiomyosarcoma. Nine case reports, review of the literature].

OBJECT OF THE STUDY: To evaluate management and outcome of the treatment of uterine leiomyosarcoma. PATIENTS AND METHODS: Retrospective study of a series of 9 patients treated for uterine leiomyosarcoma in this hospital from 1982 to 1994. RESULTS: The condition is rarely suspected preoperatively, diagnosis is usually made on histological examination of the operative specimen. The outcome is related to the mitotic activity of the tumour and to the infiltration of nearly structures. Surgery is the only effective treatment, chemotherapy is ineffective, adjuvant radiotherapy improves local control of the tumour but has no incidence on survival. CONCLUSION: In the absence of an effective adjuvant treatment uterine leiomyosarcoma bears a poor prognosis with the only exception of small non infiltrating tumours with a low mitotic activity.

Adult↗

[Müllerian mixed tumors. Experience of the Rennes Regional University Hospital].

Seventeen cases of mixed Muller tumours (tumours of the uterus with malignant epithelial and mesenchymal components) are presented. These recently described tumours are rare and occur in menopaused women. Bloody discharge is the usual clinical manifestation, together with an increase of the volume of the uterus. Pathology examination of the surgical specimen is required for diagnosis using immunolabeling to distinguish between homologous tumours (the sarcomatous component occurs in the primary mesenchyma) and heterologous tumours (the mesenchymatous component results from a metastasis). Prognosis, usually poor, depends on the stage of the tumour. Overall survival at 5 years is about 30%. Survival in early stage I and state II tumours is no greater than 50% at 5 years. Treatment is based on radiosurgical techniques in less advanced tumours and requires radiochemotherapy in more advanced stage tumours. Recurrence is usually seen within 2 years, involving the pelvis alone in 10% of the cases and metastasis in most of the others. Because of their rapid development and poor prognosis, these tumours should be identified separately as a separate entity within a larger group of mixed mesodermic tumours.

Aged↗

[Borderline ovarian tumors. A review and 11 cases].

OBJECTIVE: To clarify and classify the still debated diagnostic and prognostic elements of borderline tumours of the ovary and analyze the data obtained in our series. AIM: Develop an adapted management scheme, integrating relatively good prognosis and known or suspected factors of poor prognosis. SIEGE: Department of Gynaecology-Obstetrics, Hôtel-Dieu (CHU) Rennes, France. SUBJECTS: Eleven patients with borderline tumour of the ovary diagnosed and managed over the last 5 years. RESULTS: Current morphology and macroscopy examinations of the tumour do not provide data capable of predicting malignancy. The borderline nature of the tumour is not a histological diagnosis. The problems encountered lead to a search for new techniques such as digitalized nuclear morphology. Some progress has been made in classifying prognosis factors. Other than stage, important factors appear to be age, histological type, mitotic index, atypical cells and invasive peritoneal implants. Management decisions depend on prognosis factors but should especially take into account parity. Methods include cystectomy and total hysterectomy with annexectomy. Evaluation of chemotherapy and radiotherapy is still to preliminary. CONCLUSION: The slow clinical course, allowing good mid-term prognosis, is still the best reason for a moderated therapeutic approach relying on conservative or more aggressive surgery alone.

Adult↗

Malignant cystosarcomas phyllodes of the breast in adolescent females.

The authors report a case of cystosarcoma phyllodes occurring in an adolescent female, thus raising to 19 the number of reported cases. The prognosis of those composite fibro-epithelial tumours is ruled by the malignancy of the connective component: the diagnosis shows no distinctive feature compared with what can be observed in adults. The prognosis (classically better) appears in fact totally similar, justifying the same therapeutic rigour, particularly in the surgical field. A multidisciplinary approach should ensure complete recovery while limiting the harmful effects of the therapy in very young women.

Adolescent↗

[Primary seropapillary peritoneal carcinoma. 16 case reports. Review of the literature].

OBJECTIVE: Review of primary seropapillary carcinoma of the peritoneum. TYPE OF STUDY: Retrospective. PLACE: Department of Gynaecology and Oncology, University Hospital, Rennes. SUBJECT: 16 patients who underwent chemotherapy and surgery. RESULTS: Mean age at onset was 62 years with a late clinical diagnosis at an advanced stage. Macroscopically, peritoneal miliary was often associated with a predominant tumoural formation on the epiploon. Treatment included surgical exeresis with endoxan-cisplatin chemotherapy. The prognosis was equivalent to ovarian tumours at similar stages. CONCLUSION: Primary seropapillary carcinosis of the peritoneum is a separate group of peritoneal carcinosis distinguishable from peritoneal mesotheliomas and which have a prognosis similar to ovarian tumours. These tumours should be classed as part of the large group of mullerian tumours.

Adult↗

[Immature teratoma of the ovary. Apropos of 3 cases. Review of the literature and an evaluation].

Immature teratoma of the ovary is a rare tumour (1% of cancer of the ovary) usually seen in adolescents or young women. It is a malignant tumour derived from an abnormal germ-cell which undergoes meiotic division. The diagnosis is based on the pathological examination which reveals immature tissue derived from two or three types of embryonic tissue (endo-, meso- and ectoderm). Intraperitoneal dissemination occurs and immature or mature recurrence is observed. The prognosis was particularly severe before the use of polychemotherapy which has also made conservative surgery possible. At the present time, the consensus is to reduce the duration of the chemotherapy with a regular clinical and laboratory (tumour markers, aFP) monitory. A second look laparotomy verifies successful treatment.

Adolescent↗

[Juvenile ovarian granulosa tumor associated with pregnancy. A case report. Review of the literature].

A case of juvenile tumour of the granulosa occurred in a pregnant woman. Outcome was rapidly fatal. These tumours are classed as mesenchyma tumours of the sexual cords of the ovaries. The juvenile form occurs before the age of 30 years in 97% of the cases and has characteristic endocrine and anatomic features. The tumour remains localized in the ovary for a long period and may be treated with conservative surgery to preserve fertility in these young patients. Follow-up is aimed at detecting relapse which may occur early. Prognosis in such cases is very poor. Pregnancy does not modify the prognosis which is generally good.

Adult↗

[Giant juvenile fibroadenoma in an adolescent. A case report].

Fibroadenomas occupy the first place, in terms of prevalence, among benign breast disorders in adolescent girls. Juvenile giant fibroadenoma is a special though rare form, which must be recognised in terms of differential diagnosis from virginal hyperplasia in its asymmetrical early form and phylloid tumours, the prognosis of which is different. The authors describe the clinical and pathological features necessary for diagnosis and report the results of breast reconstruction after excision via a lateral radial approach in a 14-year-old adolescent girl.

Adolescent↗

[Primary pure carcinoid tumor of the breast: a case report. Review of the literature].

The authors present a case of primary pure carcinoid tumour of the breast and point out how rare it is and how they made their diagnosis mainly by histology. A review of the literature makes it possible to assess the prognosis which should be good and they also describe the anatomo-pathological findings in these tumours. Finally these tumours show a strange histogenesis which if it is understood makes it possible to understand certain processes of cellular differentiation in breast tissue.

Aged↗

[Trophoblastic tumor at the site of placental implantation. Apropos of a new case].

The authors report a case in which a trophoblastic tumour developed at the implantation site in a 34-year-old woman in her second pregnancy. She had previously had trophoblastic disease that had persisted after a molar pregnancy. Using monoclonal anti-beta-hCG antibodies in order to localise the tumour by clinical radio immunodetection made it possible to cure the patient. The tumour was a secretory tumour and hysterectomy was the cure.

Adult↗

[Circumstances in the detection of carcinoma in situ of the breast. Apropos of 12 cases].

In France, 7,000 women die yearly of cancer of the breast, and 25,000 new cases are registered. The seriousness of the illness and its frequency show how important it is to diagnose it early at a stage before invasion or in situ (where 95 to 100% can be cured). In 4 years, at the University Hospital of Rennes, 90 out of 446 patients who were operated on for breast lesions had invasive cancer of the breast, i.e. 20%. 12 had a carcinoma in situ of the breast (C.I.S.E.), constituting 2.6%, of which 9 were in situ duct carcinomas and 3 in situ lobular carcinomas. In situ carcinoma of the breast can take almost any clinical form (a nodule, pain in the breast, mastitis, blood stained discharge from the nipple or Paget's disease). This means that lobular carcinoma in situ is always a surprise when diagnosed histologically in a lesion that is clinically benign. Since the anatomo-pathological diagnosis is difficult, a simple examination of the breast is not to be relied on in cases of carcinoma in situ of the breast. Mammography is the only truly valuable investigation in early diagnosis of C.I.S.E.

Breast Neoplasms↗

[Lobular carcinoma in situ of the breast. Apropos of 3 cases].

The authors explain the particular nature of these multifocal tumors: absence of node involvement, difficulties of diagnosis, relatively favorable prognosis and a therapeutic dilemma: limited procedure with strict surveillance, subcutaneous bilateral mastectomy.

Breast Neoplasms↗

[Ovarian goiter. Apropos of a case].

When the authors had a case of ovarian goitre with the Demons-Meigs syndrome they started to look at the literature for the incidence, the clinical presentation, the prognosis and the ways of treating this anatomopathological entity. Although histological examination can rarely make sure that the lesions are benign they are in most cases, as in the remainder of ovarian tumours, so that the outlook should be good.

Ascites↗

[Pathology of the umbilical cord].

The pathology of the umbilical cord is an important factor in placental pathology, and may be the cause of acute fetal distress or antenatal death, though many unknown factors still remain.

Cysts↗