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Purpose: To prospectively evaluate fluoroscopic-assisted insertion of self-expanding metallic stents before surgery or for palliative treatment of soft tissue colorectal obstruction. Materials and methods. From January 1999 to October 2000, 18 consecutive patients with colorectal obstruction were included in the study. Treatment with self-expanding metallic stent was either the first line of treatment before surgery (n=8) (group I) or purely palliative (n=10) (group II). Colic stenosis was located proximal to the sigmoid in seven cases., Results: Technical success was achieved in 83.3% of cases and colic decompression was observed after 48 hours in all patients with a stent. Thirty days mortality and stent related complications were respectively 0% and 37.5% for group I, and 20% and 50% for group II. All complications were minor except for one colic perforation by a guidewire., Conclusion: Stent insertion was effective and provided relief of colic obstruction in the majority of cases. Randomized studies would be necessary to demonstrate a definitive reduction in mortality and morbidity with this technique as compared to the classical surgical approach.

The authors report the MR features of a non functioning and hemorragic islet-cell tumor of the pancreas. This tumor was composed of a central cystic component with a fluid-fluid level seen on T1- and T2-weighted images and a peripheral hypervascular soft tissue component which showed hyperintensity on T2-weighted images with fat saturation.

The authors report 2 cases of congenital mesothelial cyst of the diaphragm diagnosed in adults. The differential diagnosis will be discussed and the literature reviewed.

Thirteen epidemiological studies of the relations between electromagnetic fields and childhood cancers have been published. Eleven have shown some associations between the presumed intensity of exposure to residential magnetic fields and the childhood cancers incidence, either for all cancers or for the 3 most frequent types (leukaemias, brain tumours and lymphomas). These associations are not often significant because of the weak statistical power of these studies in relation with both the low incidence of cancers in childhood, and specially of each particular type, and the little number of subjects considered to be exposed at a high level exposure for residential magnetic fields. All these studies fall in with the same difficulties, particularly for identification and assessment of the exposure to magnetic fields and for the manner to take into account all the potential confounders. So even significant associations do not imply their causality, all the more as the carcinogenicity of extremely low frequency electromagnetic fields, although biologically conceivable, has never been experimentally proven. Today it is impossible to claim or invalidate the influence of residential magnetic fields in the genesis of childhood cancer. Setting up of new epidemiological studies based on large number of cases issued from population based registries and conducted with a best defined methodology seems to be highly desirable.

We report a case of angiosarcoma of the large bowel in a 66 year old man with histochemical, immuno histochemical and ultra structural study. The patient subsequently completed non surgical staging, showing no extension of the tumor. No etiologic factor was found. Despite complete surgical exeresis, the clinical course is rapidly fatal with occurrence of numerous metastases. Primary angiosarcoma of the gastro intestinal tract are very uncommon. According to the degree of differentiation the diagnosis of large bowel's primary angiosarcoma can be difficult with others large bowel sarcoma, a benign blood vessel tumor or an undifferentiated carcinoma. The immuno histochemical and ultra structural study are useful to perform the diagnosis of angiosarcoma.

About a case in a six year old Negro boy, the existence of a special pattern among the malignant renal tumors in children is emphasized; this tumor is marked from the Wilms' tumor by its peculiar behaviour (frequently poor evolution, high incidence of osseous metastasis in contrast with the rate occurrence of pulmonary involvement) and by a sarcomatous appearance at the pathologic examination. The classification and the suitable therapeutic management are discussed.

One case of hepatic portal venous gas is reported and here in the results of ultrasound and CT Scan imaging and the relevant literature are reviewed. These examinations are of great interest in the diagnostic and in the etiology of this disease.

This study involves 3 children ranging from 10 to 13 years and an eight-month-old infant who received Cis-DDP (30-100 mg/m2) every fourth week by means of a short-term infusion (20-35 minutes). Platinum levels in plasma and urine were determined by flameless atomic absorption spectrophotometry. The decrease in total plasma platinum is triphasic, consistent with the distribution expected for a 3 compartment model. In the elimination phase, the half-life values are high and vary between 149 and 541 hours. The total plasma clearances are extremely low and range from 0.027 to 0.187 litre/hour. The urinary excretion of platinum during the first 5 and 7 days respectively, in two children following administration of Cis-DDP results in large platinum concentrations (40-71 mg/litre) in the first urine excreted from each child. The cumulative urinary platinum excretion in the first twelve hours is high i. e. 27.2 to 32.5% of the administered dose but them it does not exceed 50% even after 5 days. These results confirm that after a short-term infusion of Cis-DDP in a single dose, the kidneys are suddenly subjected to platinum in high concentrations. In order to minimize the nephrotoxicity of this platinum complex, while maintaining sufficient plasma levels to ensure its anti-neoplastic activity, we recommend a schedule consisting of fractionated doses.

Following the well-known European CCRs of Manchester and Turin, 2 regional CCRs have been recently created in France: in Nancy (1983) and Marseille (1984); both are population based CCRs, covering respectively 535,200 and 809,200 children (0-14 yrs). All malignant neoplasms are included, as well as brain tumours (whatever grading) and borderline malignancies. Data are collected from medical and administrative sources. Registration is active and every source is recontacted annually. The registries contact all physicians who might include children among their patients (private and hospital practice), and laboratories of pathology-cytology. The University Hospital Centers and Anti-Cancer Centers in adjacent regions, and in Paris are contacted. Death certificates for children dying of a malignant neoplasm are also sent to the registry. Data collected are as follows: name, age, sex, address, date and method of diagnosis, histological type, anatomical site, stage, treatment and sources of information. We added the data of a general cancer registry, created in Strasbourg in 1975 and covering 205,900 children. reliability of the methodology is attested by the similarity of the results obtained in other European, US and Australian CCRs. In conclusion, this type of registry is needed to organize multicentric epidemiological studies about the role of etiological factors, the survival, and the long term sequelae.