Le pseudo-anévrisme du trigone fibreux aorto-mitral est une complication rare des endocardites, plus rarement d’une chirurgie de remplacement valvulaire aortique. Nous rapportons ici le cas d’un ...volumineux pseudo-anévrisme apparu chez un homme de 70
ans, trois ans après un remplacement aortique, en l’absence de tout contexte infectieux. L’originalité de cette observation réside en trois points : la survenue tardive après chirurgie, l’absence de contexte infectieux et le caractère chronique du pseudo-anévrisme persistant après une réintervention pour désinsertion de prothèse, non compliqué au cours d’un suivi de douze mois. L’échographie transœsophagienne reste le meilleur outil diagnostique.
Pseudo-aneurysm of the fibrous continuity zone between the aortic and mitral valves, the so-called “mitral-aortic intervalvular fibrosa” is a rare complication of acute infective endocarditis, rarely after an aortic valve replacement. We report the case of a large pseudo-aneurysm occurred in a 70-year-old man, who had a history of surgical aortic valve replacement 3 years before. There were no biological or clinical evidence for infective acute endocarditis. The originality of this observation can be summarized in three points: the late onset after surgery, the absence of any infectious context and the chronic nature of pseudo-aneurysm, without any complication during a follow-up of 12 months. Transesophageal echocardiography remains the best diagnosis tool.
To present data pointing out that small tumour size might not be a sufficient predictor of good prognosis of choroidal melanoma and present a new promising therapy of hepatic metastasis.
...Retrospective, noncomparative case report of two patients with small choroidal melanoma.
Two cases of small choroidal melanoma which developed metastases are described. Both patients underwent radiotherapy of the primary tumour. Metastases were treated by combined therapy in patient 1 while in patient 2 a new therapeutic modality of stereotactic radiotherapy, Cyberknife, was applied. Patient 1 died from metastatic spread 7,6 years after primary therapy despite a very good local tumour control. Patient 2 died 11,3 years after primary therapy due to intercurrent disease with a very good local eye findings and hepatic metastasis in regression.
Choroidal melanoma of a small size can develop into metastatic disease even long time after satisfactory primary treatment. Further studies are required to assess the risk factors of metastatic spread in small uveal melanomas. Cyberknife stereotactic radiotherapy seems to be a promising therapeutic method of a solitary hepatic metastasis. Key words: choroidal melanoma, metastasis, prognostic factors, stereotactic radiotherapy.
Un myosis louche Agard, É.; Biotti, D.; Malclès, A. ...
La revue de medecine interne,
November 2015, 2015-11-00, Letnik:
36, Številka:
11
Journal Article
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