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Carsuzaa F, Chabrillac E, Marcy PY, Mehanna H, Thariat J. Advances and residual knowledge gaps in the neck management of head and neck squamous cell carcinoma patients with advanced nodal disease undergoing definitive (chemo)radiotherapy for their primary. Strahlenther Onkol 2024:10.1007/s00066-024-02228-4. [PMID: 38600366 DOI: 10.1007/s00066-024-02228-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/03/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE Substantial changes have been made in the neck management of patients with head and neck squamous cell carcinomas (HNSCC) in the past century. These have been fostered by changes in cancer epidemiology and technological progress in imaging, surgery, or radiotherapy, as well as disruptive concepts in oncology. We aimed to review changes in nodal management, with a focus on HNSCC patients with nodal involvement (cN+) undergoing (chemo)radiotherapy. METHODS A narrative review was conducted to review current advances and address knowledge gaps in the multidisciplinary management of the cN+ neck in the context of (chemo)radiotherapy. RESULTS Metastatic neck nodes are associated with poorer prognosis and poorer response to radiotherapy, and have therefore been systematically treated by surgery. Radical neck dissection (ND) has gradually evolved toward more personalized and less morbid approaches, i.e., from functional to selective ND. Omission of ND has been made feasible by use of positron-emission tomography/computed tomography to monitor the radiation response in cN+ patients. Human papillomavirus-driven oropharyngeal cancers and their cystic nodes have shown dramatically better prognosis than tobacco-related cancers, justifying a specific prognostic classification (AJCC) creation. Finally, considering the role of lymph nodes in anti-tumor immunity, de-escalation of ND and prophylactic nodal irradiation in combination are intense areas of investigation. However, the management of bulky cN3 disease remains an issue, as aggressive multidisciplinary strategies or innovative combined treatments have not yet significantly improved their prognosis. CONCLUSION Personalized neck management is an increasingly important aspect of the overall therapeutic strategies in cN+ HNSCC.
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Affiliation(s)
- Florent Carsuzaa
- Department of Oto-Rhino-Laryngology & Head and Neck Surgery, Poitiers University Hospital, Poitiers, France
| | - Emilien Chabrillac
- Department of Surgery, University Cancer Institute of Toulouse-Oncopole, Toulouse, France
| | - Pierre Yves Marcy
- Department of Radiology, Clinique du Cap d'Or, La Seyne-sur-mer, France
| | - Hisham Mehanna
- Institute for Head and Neck Studies and Education (InHANSE), University of Birmingham, Birmingham, UK
| | - Juliette Thariat
- Department of radiotherapy, Centre François Baclesse, Caen, France.
- Laboratoire de physique Corpusculaire, IN2P3/ENSICAEN/CNRS, UMR 6534, Normandie Université, Caen, France.
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Marcy PY. Editorial Comment: Percutaneous Thermal Ablation of Thyroid Nodules-Where Do We Stand, Where Shall We Go? AJR Am J Roentgenol 2024. [PMID: 38598359 DOI: 10.2214/ajr.24.31256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Affiliation(s)
- Pierre Yves Marcy
- Interventional Radiology department, PolyClinics les Fleurs, ELSAN MEDIPOLE SUD, Quartier Quiez; 83189 - Ollioules Cedex, France
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Marcy PY, Tassart M, Marchand JG, Thariat J, Bizeau A, Ghanassia E. Percutaneous Radiofrequency Ablation of Thyroid Carcinomas Ineligible for Surgery, in the Elderly. Curr Oncol 2023; 30:7439-7449. [PMID: 37623020 PMCID: PMC10453376 DOI: 10.3390/curroncol30080539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 07/28/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
Thirty to 50% of differentiated thyroid carcinomas include papillary thyroid microcarcinomas (mPTC). Most of these tumors remain clinically silent, have a bright prognosis and a disease-specific mortality <1%. Surgery has been recommended as first line-treatment by current guidelines, the standard treatment being lobectomy. However, surgery has some drawbacks, including potential recurrent laryngeal nerve paralysis, hypothyroidism, hypoparathyroidism, in -patient basis hospital stay, lifelong medication, scarring of the neck, and general anesthesia related risks. Moreover, elderly patients who present severe comorbidities, could be ineligible for surgery, and others may refuse invasive surgery. Another option supported by the American Thyroid Association is active surveillance. This option can be considered as unattractive and difficult to accept by European patients, as there is a 2-6% risk of disease progression. Percutaneous image-guided thermal ablation has been successfully applied in the treatment of liver and lung tumors in the 1990s and 2000s; and has recently been proposed as an alternative to surgery in patients presenting with thyroid diseases. This minimally invasive treatment has similar efficacy, fewer complications, better quality of life and cosmetic outcomes than surgery. We report herein two cases of radiofrequency ablation of mPTC and T2 PTC in elderly patients who were ineligible for surgery.
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Affiliation(s)
- Pierre Yves Marcy
- PolyClinics ELSAN Group, Medipole Sud, Quartier Quiez, 83189 Ollioules, France; (M.T.); (J.-G.M.); (J.T.); (A.B.); (E.G.)
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Marcy PY, Bauduer F, Thariat J, Gisserot O, Ghanassia E, Chetaille B, Boudin L, Morvan JB. Fast Track Management of Primary Thyroid Lymphoma in the Very Elderly Patient. Curr Oncol 2023; 30:5816-5827. [PMID: 37366918 DOI: 10.3390/curroncol30060435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/06/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
A rapid growing cervical mass mobile while swallowing is the most common clinical presentation of severe thyroid malignancy. A 91-year-old female patient with a history of Hashimoto thyroiditis presented with clinical compressive neck symptoms. The patient had gastric Maltoma diagnosed that was surgically resected thirty years ago. A straightforward process was needed to reach full histological diagnosis and initiate prompt therapy. Ultrasound (US) showed a 67 mm hypoechoic left thyroid mass with reticulated pattern without signs of locoregional invasion. Percutaneous trans isthmic US-guided 18G core needle biopsy (CNB) disclosed diffuse large B cell lymphoma of the thyroid gland. FDG PET revealed two distinct thyroid and gastric foci (both SUVmax 39.1). Therapy was initiated rapidly to decrease clinical symptoms in this aggressive stage III primitive malignant thyroid lymphoma. The prognostic nomogram was calculated by using a seven-item scale, which disclosed a one-year overall survival rate of 52%. The patient underwent three R-CVP chemotherapy courses, then refused further treatment and died within five months. Real-time US-guided CNB approach led to rapid patient's management that was tailored to patient's characteristics. Transformation of Maltoma into diffuse large B cell lymphoma (DLBCL) into two body areas is deemed to be extremely rare.
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Affiliation(s)
- Pierre Yves Marcy
- Radiodiagnostics and Interventional Radiology Department, Polyclinics ELSAN Medipole Sud, Quartier Quiez, 83189 Ollioules, France
| | - Frederic Bauduer
- Department of Hematology, Centre Hospitalier de la côte Basque, College of Health Sciences, Bordeaux University, 64100 Bayonne, France
| | - Juliette Thariat
- Department of Radiation Therapy, Francois Baclesse Cancer Research Institute, Laboratoire de Physique Corpusculaire IN2P3/ENSI CAEN/CNRS UMR 6534, Normandy University, 3 Avenue General Harris, 14076 Caen, France
| | - Olivier Gisserot
- Department of Medical Oncology, CH Sainte Musse, 54 Rue Sainte-Claire Deville, 83100 Toulon, France
| | - Edouard Ghanassia
- Department of Endocrinology, PolyClinics Sainte Therese, 06 quai du mas Coulet, 33200 Sete, France
| | - Bruno Chetaille
- MEDIPATH Toulon, Pathology Center, 146 Avenue Foch, 83300 Toulon, France
| | - Laurys Boudin
- Department of Medical Oncology, University Military Hospital Sainte Anne, 2 Boulevard Sainte Anne, BP 600, 83300 Toulon, France
| | - Jean Baptiste Morvan
- Department of Head & Neck Surgery, University Military Hospital Sainte Anne, 2 Boulevard Sainte Anne, BP 600, 83000 Toulon, France
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Marcy PY, Russ G, Saba L, Sanglier J, Ghanassia E, Sharara H, Thariat J, Morvan JB, Bizeau A. Opinion: leading position of ultrasound in decision algorithm for small papillary thyroid carcinoma. Insights Imaging 2022; 13:101. [PMID: 35670930 PMCID: PMC9174402 DOI: 10.1186/s13244-022-01240-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/22/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
- Pierre Yves Marcy
- Department of Radiodiagnostics and Interventional Imaging, Polyclinics ELSAN Group, PolyClinics Les Fleurs, Quartier Quiez, 83189, Ollioules, France.
| | - Gilles Russ
- Centre de Pathologie et d'Imagerie Paris 14ème, Unité Thyroïde et Tumeurs Endocrines. Hôpital La Pitie Salpetriere, 83 Bd de l'Hopital, Sorbonne Université, Paris, France
| | - Luca Saba
- Department of Radiology, Humanitas Mater Domini, Castellanza, VA, Italy
| | - Julie Sanglier
- Department of Ultrasound, Antoine Lacassagne Cancer Research Institute, Sophia Antipolis University, 33 Avenue Valombrose, Nice Cedex, France
| | - Edouard Ghanassia
- American Hospital of Paris, 63 bd Victor Hugo, Neuilly sur Seine, France
| | - Haithem Sharara
- Department of Radiology, University Hospital, Place du Pr R. Debré, Nîmes Cedex 9, France
| | - Juliette Thariat
- Department of Radiation Oncology, Cancer Research Institute Francois Baclesse, 3 Avenue Général Harris, Caen, France
| | - Jean Baptiste Morvan
- Department of Head and Neck Surgery, University Military Hospital Sainte-Anne, 2, Boulevard Sainte Anne, BP 600, Toulon, France
| | - Alain Bizeau
- Department of Head and Neck Surgery, Sainte Musse Hospital, 54, Rue Henri Sainte Claire Deville, Toulon, France
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El Hajjam M, Morvan JB, Thariat J, Marcy PY. Gianturco Z-stent vena cava stenting potential complications in oncology. Diagn Interv Radiol 2022; 28:285. [DOI: 10.5152/dir.2022.21255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Debourdeau P, Lamblin A, Debourdeau T, Marcy PY, Vazquez L. Venous thromboembolism associated with central venous catheters in patients with cancer: From pathophysiology to thromboprophylaxis, areas for future studies. J Thromb Haemost 2021; 19:2659-2673. [PMID: 34363736 DOI: 10.1111/jth.15487] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/02/2021] [Accepted: 08/05/2021] [Indexed: 11/30/2022]
Abstract
Symptomatic catheter related thrombosis (CRT) occurs in 4%-8% of cancer patients. The mean incidence of CRT, detected either by echography or Doppler ranges between 12 and 14% with a high negative predictive value of about 95%, allowing the subsequent occurrence of CRT (symptomatic and asymptomatic) to be safely excluded. Despite its frequency and its medico-economic consequences, no thromboprophylaxis has been validated to date. In most patients, CRT occurs immediately after catheter insertion, most often within the first week and almost all within the first month after insertion. Meta analyses show a reduction of asymptomatic and symptomatic CRT incidence by about 55%-60% using either vitamin K antagonists or low molecular weight heparins without an increased risk of major bleeding. This pharmacological prophylaxis is only effective when started before the central venous catheter insertion at prophylactic doses and thereafter continued at subtherapeutic doses. Since no population at high risk of CRT has been identified, this review focuses on pathophysiology, epidemiology and clinical supportive data that could lead to a new CRT prophylaxis strategy.
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Affiliation(s)
| | | | | | - Pierre Yves Marcy
- Department of Diagnosis & Interventional Imaging, Polyclinics Les Fleurs, Ollioules, France
| | - Léa Vazquez
- Supportive Care Unit, Sainte Catherine Institute, Avignon, France
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Lacout A, Marcy PY, Perronne C. Chronotherapy in COVID-19 Disease. J Gen Intern Med 2021; 36:2466-2467. [PMID: 33772438 PMCID: PMC7997534 DOI: 10.1007/s11606-021-06719-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/14/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Alexis Lacout
- Centre de diagnostic, ELSAN, Centre médico -chirurgical, 83 avenue Charles de Gaulle, Aurillac, France.
| | - Pierre Yves Marcy
- Radiodiagnostics and Interventional Radiology Department, ELSAN, Polyclinique Les Fleurs, Quartier Quiez, Ollioules, France
| | - Christian Perronne
- Infectious Diseases Unit, University Hospital Raymond Poincaré, APHP, Versailles Saint Quentin University, Garches, France
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Saba L, Saba F, Dagan R, De Filippo M, Marcy PY. Technical efficacy and safety of CT-guided transforaminal periradicular infiltration using CT foot switches and MPR images. Acta Biomed 2021; 92:e2021315. [PMID: 35075089 PMCID: PMC8823553 DOI: 10.23750/abm.v92i6.10588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 10/19/2020] [Indexed: 11/07/2022]
Abstract
PURPOSE To demonstrate the technical efficacy and safety of CT-guided transforaminal periradicular infiltration in the treatment of the radicular pain without surgical intervention, using CT foot switches and MPR images. MATERIALS AND METHODS Four hundred and eighty two patients (286 males and 196 females, age range 27-71 years, mean age 56 years) with a unilateral or bilateral radiculopathy who underwent CT-guided transforaminal periradicular infiltration without surgical intervention, were retrospectively selected in the period from January 2019 to February 2020. Patients who had received surgery for herniated disc or laminectomy, patients with a previous vertebral fractures, and patients with inflammatory syndrome or risk of bleeding were excluded. RESULTS There were no major or minor clinically relevant complications. Many patients a marked reduction or resolution of pain after the CT-guided infiltration (P<0.05). No patient required hospitalization. One patient reported an episode of intense headache, which resolved after twenty minutes. In eleven cases, a slight increase in pain related to spinal compression caused by the administration of the drug was reported, even if administrated extremely slowly. Sixteen patients reported pain in the upper limbs during and after the procedure, however this was not related to infiltration but to the forced and prolonged arm position. CONCLUSION CT-guided transforaminal periradicular infiltration is a semi-invasive and well tolerated procedure, moreover it has a reduced comorbidity and no observed major or minor complications. The CT foot switches and MPR evaluation may help to make the procedure more efficient.
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Affiliation(s)
- Luca Saba
- Department of Radiology, Clinique Les Fleurs (Groupe ELSAN), Ollioules (France), Department of Radiology, Clinique du Cap-d’Or (Groupe ELSAN), La Seyne-sur-Mer (France), Departement of Radiology, Humanitas Mater Domini, Castellanza VA (Italy)
| | - Francesco Saba
- Departement of Gastroenterology, University of Sassari, Sassari (Italy)
| | - Robert Dagan
- Department of Radiology, Clinique Les Fleurs (Groupe ELSAN), Ollioules (France), Department of Radiology, Clinique du Cap-d’Or (Groupe ELSAN), La Seyne-sur-Mer (France)
| | - Massimo De Filippo
- Departement of Radiology, University of Parma, Parma Hospital, Parma (Italy)
| | - Pierre Yves Marcy
- Department of Radiology, Clinique Les Fleurs (Groupe ELSAN), Ollioules (France), Department of Radiology, Clinique du Cap-d’Or (Groupe ELSAN), La Seyne-sur-Mer (France)
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Lacout A, Marcy PY, Perronne C. Re: 'Effect of hydroxychloroquine with or without azithromycin on the mortality of COVID-19 patients' by Fiolet et al. Clin Microbiol Infect 2020; 27:134-135. [PMID: 32987193 PMCID: PMC7518844 DOI: 10.1016/j.cmi.2020.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 09/06/2020] [Accepted: 09/15/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Alexis Lacout
- Centre de Diagnostic, ELSAN, Centre Médico-Chirurgical, 83 avenue Charles de Gaulle, 15000 Aurillac, France.
| | - Pierre Yves Marcy
- Radiodiagnostics and Interventional Radiology Department, ELSAN, Polyclinique Les Fleurs, Quartier Quiez, 83190 Ollioules, France
| | - Christian Perronne
- Infectious Diseases Unit, University Hospital Raymond Poincaré, APHP Versailles Saint Quentin University Garches, France
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Galperine T, Lacout A, Marcy PY, Perronne C. Favorable Outcome after Treatment Using Antibiotics and Hydroxychloroquine in a Patient with Tumor Necrosis Factor Receptor-associated Periodic Syndrome: A 7-Year Follow-Up. J Glob Infect Dis 2020; 12:159-160. [PMID: 33343170 PMCID: PMC7733427 DOI: 10.4103/jgid.jgid_7_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/26/2019] [Accepted: 01/20/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- Tatiana Galperine
- Infectious Diseases Department, University Hospital Raymond Poincaré, APHP, Versailles Saint Quentin University, Garches, France
| | - Alexis Lacout
- Department of Diagnostic, ELSAN, Medico-Surgical Center, Aurillac, France
| | - Pierre Yves Marcy
- Department of Radiodiagnostics and Interventional Radiology, ELSAN - Polyclinique Les Fleurs, Ollioules, France
| | - Christian Perronne
- Infectious Diseases Department, University Hospital Raymond Poincaré, APHP, Versailles Saint Quentin University, Garches, France
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Saba L, De Filippo M, Saba F, Fellini F, Marcy PY, Dagan R, Voituriez P, Aelvoet J, Klotz G, Bernard R, Salinesi V, Agostini S. Efficacy of ultrasound-guided percutaneous treatment of the rotator cuff calcific tendinopathy with double needle technique. J Orthop 2020; 20:195-197. [PMID: 32025148 DOI: 10.1016/j.jor.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 12/11/2019] [Indexed: 10/25/2022] Open
Affiliation(s)
- Luca Saba
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Massimo De Filippo
- Department of Radiology, University of Parma, Via Gramsci 21, 43126, Parma, Italy
| | - Francesco Saba
- University of Sassari, Via Vienna 2, 07100, Sassari, Italy
| | - Federica Fellini
- Department of Cardiology, St Musse Hospital, 54 Rue Henri Sainte-Claire Deville, 83100, Toulon, France
| | - Pierre Yves Marcy
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Robert Dagan
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Philippe Voituriez
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Jacques Aelvoet
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Gérard Klotz
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Roland Bernard
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Valérie Salinesi
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
| | - Serge Agostini
- Groupe ELSAN Department of Radiology, Clinique Les Fleurs, Avenue Frédéric Mistral, 83190, Ollioules, France.,Groupe ELSAN Department of Radiology, Clinique du Cap-d'Or, 1361 Avenue des Anciens Combattants Français d'Indochine, 83500, La Seyne-sur-Mer, France
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Lacout A, Thariat J, Hajjam ME, Marcy PY, Perronne C. Lyme disease & co-infections: role of adaptive immune system. Future Microbiol 2018; 13:613-615. [PMID: 29745726 DOI: 10.2217/fmb-2017-0252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale, Centre de diagnostic ELSAN, Centre Medico-Chirurgical, 83 An. Charles de Gaulle, 15000 Aurillac, France
| | - Juliette Thariat
- Department of Radiation Therapy, Centre Francois Baclesse/ARCHADE, Normandie Université, Unicaen 3 av general Harris, 14033 Caen, France
| | - Mostafa El Hajjam
- Department of Radiology, Centre Hospitalier Universitaire Ambroise Paré, APHP, Université de Versailles, Saint-Quentin en Yvelines, 92100 Boulogne-Billancourt, France
| | - Pierre Yves Marcy
- Radiodiagnostics and Interventional Radiology Department, ELSAN-Polyclinique Les Fleurs, Service Imagerie Médicale, 83190 Ollioules, France
| | - Christian Perronne
- Infectious Diseases Unit, University Hospital Raymond Poincaré, APHP, Versailles Saint Quentin University, 92380 Garches, France
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Affiliation(s)
- Jacques Giron
- Service de Radiologie, Hôpital Purpan, Toulouse, France
| | | | - Pierre Yves Marcy
- Service Imagerie Médicale, Polyclinique Les Fleurs, Ollioule, France
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Lacout A, Dacher V, El Hajjam M, Marcy PY, Perronne C. Biofilms busters to improve the detection of Borrelia using PCR. Med Hypotheses 2018; 112:4-6. [PMID: 29447935 DOI: 10.1016/j.mehy.2018.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/13/2018] [Indexed: 11/24/2022]
Abstract
Lyme disease is an affection caused by a spirochete infection called Borrelia Burgdorferi which may harbor a varied and misleading clinical symptomatology. The serology tests commonly used for diagnosis show a wide sensitivity varying from 34% to 70,5%, leaving many infected patients with false negative tests. Alternative techniques such as polymerase chain reaction (PCR) could be helpful but not conclusive enough. Using biofilm busters, such as stevia and serratiopeptidase, could lead to bacterial blood release, thus increasing the spirochete load, making PCR test more sensitive, thus improving the patient's diagnosis and management.
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Affiliation(s)
- Alexis Lacout
- Centre de diagnostic, ELSAN, Centre médico - chirurgical, 83 avenue Charles de Gaulle, 15000 Aurillac, France.
| | - Véronique Dacher
- Centre de diagnostic, 29 ter Avenue Jean Jaurès, 63200 Mozac, France.
| | - Mostafa El Hajjam
- Service de diagnostic, Hôpital Ambroise PARE (APHP), 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France.
| | - Pierre Yves Marcy
- Radiodiagnostics and Interventional Radiology Department, Polyclinique Les Fleurs, Quartier Quiez, 83190 Ollioules, France.
| | - Christian Perronne
- Infectious Diseases Unit, University Hospital Raymond Poincaré, APHP, Versailles Saint Quentin University, Garches, France.
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Lacout A, Chamorey E, Thariat J, El Hajjam M, Chevenet C, Schiappa R, Marcy PY. Insight into Differentiated Thyroid Cancer Gross Pathological Specimen Shrinkage and Its Influence on TNM Staging. Eur Thyroid J 2017; 6:315-320. [PMID: 29234625 PMCID: PMC5704705 DOI: 10.1159/000478774] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/17/2017] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION This study aimed at comparing thyroid cancer staging when taking into account the differences between the "T" assessment" using ultrasound (US) and histopathological measurements. MATERIAL AND METHODS This retrospective study included all consecutive differentiated follicular thyroid cancer (DTC) and medullary thyroid cancer (MTC) patients who underwent postoperative histopathological staging assessment at a single institution. Anaplastic thyroid carcinomas were excluded from the present study. Each malignant thyroid nodule was precisely evaluated by measuring its long axis using both US and gross specimen histopathological examination. T stage classification was attributed to each tumor as regards US (solely according to the tumor dimension) and histopathology: (1) solely according to the tumor dimension and (2) according to the tumor dimension and extrathyroidal extension features when present. RESULTS Retrospective comparison between US and histopathology size of the operated thyroid nodules showed a mean diminution of 7.52% of the tumor long axis. Tumors ≤10 mm at histopathological examination showed a larger decrease in size of 13% (p = 0.054, statistically significant) compared to the US measurements. Ten out of 72 (13.8%) patients showed final T downstaging in comparison to US assessment: (US) T2 to T1b in 6 patients (1 MTC) and (US) T1b to T1a in 4 patients (1 MTC). Two (2.9%) DTC patients were downstaged from stage 2 to stage 1. CONCLUSION Precise thyroid tumor US measurement may differ significantly from that obtained by histopathological assessment, which may result in a different TNM staging and subsequent patient management.
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Affiliation(s)
- Alexis Lacout
- Centre d'Imagerie Médicale, Aurillac, France
- *Dr. Alexis Lacout, Centre d'Imagerie Médicale, 47, Boulevard du Pont Rouge, FR-15000 Aurillac (France), E-Mail
| | - Emmanuel Chamorey
- Unité d'Epidémiologie et Biostatistiques (UEB), Centre Antoine Lacassagne, Nice, France
| | - Juliette Thariat
- Department of Radiation Oncology, Baclesse Cancer Research Institute, Caen, France
| | - Mostafa El Hajjam
- Department of Radiology, Centre Hospitalier Universitaire Ambroise Paré, APHP, Université de Versailles Saint-Quentin en Yvelines, Boulogne-Billancourt, France
| | - Carole Chevenet
- Laboratoire d'Anatomie et de Cytologie Pathologique du CHU Estaing, Clermont Ferrand, France
| | - Renaud Schiappa
- Unité d'Epidémiologie et de Biostatistiques (UEB), Département Recherche Clinique Innovation et Statistiques (DRIS), Centre Antoine Lacassagne, Nice, France
| | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, Ollioules, France
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Horowitz RI, Lacout A, Marcy PY, Perronne C. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis. Clin Microbiol Infect 2017; 24:210. [PMID: 29030171 DOI: 10.1016/j.cmi.2017.09.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 11/30/2022]
Affiliation(s)
- R I Horowitz
- Hudson Valley Healing Arts Center, New York, USA
| | - A Lacout
- Centre d'imagerie Médicale, Aurillac, France.
| | - P Y Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, Ollioule, France
| | - C Perronne
- Infectious Diseases Unit, University Hospital Raymond Poincaré, APHP Versailles Saint Quentin University, Garches, France
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Lacout A, Chevenet C, Salas J, Marcy PY. Dealing with microcarcinoma of the thyroid gland. Endocr Res 2017; 42:169. [PMID: 27472073 DOI: 10.1080/07435800.2016.1212064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | - Carole Chevenet
- b Laboratoire d'anatomie et de cytologie pathologique du CHU Estaing , Clermont Ferrand , France
| | - Joël Salas
- c Service de chirurgie ORL , Centre médico-chirurgical , Aurillac , France
| | - Pierre Yves Marcy
- d Polyclinique Les Fleurs , Service Imagerie Médicale , Ollioules , France
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Lacout A, Marcy PY, El Hajjam M, Thariat J, Perronne C. Dealing with Lyme Disease Treatment. Am J Med 2017; 130:e221. [PMID: 28431674 DOI: 10.1016/j.amjmed.2016.12.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 12/18/2016] [Accepted: 12/19/2016] [Indexed: 10/19/2022]
Affiliation(s)
| | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, Ollioule, France
| | - Mostafa El Hajjam
- Department of Radiology, Centre Hospitalier Universitaire Ambroise Paré, APHP, Université de Versailles, Saint-Quentin en Yvelines, Boulogne-Billancourt, France
| | | | - Christian Perronne
- Infectious Diseases Unit, University Hospital Raymond Poincaré, APHP, Versailles Saint Quentin University, Garches, France
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Lacout A, Carlier RY, El Hajjam M, Marcy PY. VEGF inhibition as possible therapy in spondyloarthritis patients: Targeting bone remodelling. Med Hypotheses 2017; 101:52-54. [PMID: 28351491 DOI: 10.1016/j.mehy.2017.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 01/26/2017] [Accepted: 02/25/2017] [Indexed: 11/18/2022]
Abstract
Spondyloarthritis refers to a group of chronic inflammatory rheumatic diseases that predominantly affects the axial skeleton, causing pain and stiffness. Human bone is highly dynamic organ that interacts with a wide array cells and tissues. Process of bone remodelling relies on a delicate balance between bone formation and bone resorption, orchestrated by osteoblasts and osteoclasts. Disruption of this homeostatic balance of bone removal and replacement can manifest as inappropriate new bone formation found in spondylarthritis. We hypothesize that VEGF may promote bone remodelling, stimulate angiogenesis, and both osteoclastic and osteoblastic activity. Anti VEGF may be tested as a dedicated therapy to prevent bone remodelling in spondyloarthritis patients, namely in cases of aggressive disease. Bone remodelling could be monitored by using [18F]Fluoride PET scan.
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Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale, 47, Boulevard du Pont Rouge, 15000 Aurillac, France.
| | - Robert Yves Carlier
- Service de Radiologie, Hôpital Raymond Poincaré, 104 Boulevard Raymond Poincaré, 92380 Garches, France.
| | - Mostafa El Hajjam
- Service de Radiologie, Hôpital Ambroise pare (APHP), 9, Avenue Charles De Gaulle, 92100 Boulogne Billancourt, France.
| | - Pierre Yves Marcy
- Radiodiagnostic and Interventional Radiology Department, Polyclinique Les Fleurs, Quartier Quiez, 83190 Ollioules, France.
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El Hajjam M, Lacout A, Marcy PY, Binsse S, Lacombe P. Rupture of a pulmonary arteriovenous malformation: a diagnosis not to be missed. Postgrad Med J 2017; 93:570-571. [PMID: 28123003 DOI: 10.1136/postgradmedj-2016-134740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 12/28/2016] [Accepted: 01/05/2017] [Indexed: 11/03/2022]
Affiliation(s)
- Mostafa El Hajjam
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Boulogne Billancourt, France.,Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, Boulogne Billancourt, France
| | | | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service d'Imagerie Médicale, Ollioules, France
| | - Sephen Binsse
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Boulogne Billancourt, France.,Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, Boulogne Billancourt, France
| | - Pascal Lacombe
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Boulogne Billancourt, France.,Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique-Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, Boulogne Billancourt, France
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Marcy PY, Thariat J, Chevenet C, Lacout A. Jugular Vein Invasion Diagnosis and Prognosis in Thyroid Carcinomas. Pol J Radiol 2016; 81:268-9. [PMID: 27354880 PMCID: PMC4907401 DOI: 10.12659/pjr.896757] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 11/25/2015] [Indexed: 01/05/2023] Open
Abstract
Diagnosis of venous jugular invasion by means of traditional imaging is very rarely reported in the literature. Doppler ultrasound definitively helps to diagnose the tumor thrombus, the extent, and helps in redefining the TNM stage of such an aggressive thyroid tumor.
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Affiliation(s)
- Pierre Yves Marcy
- Department of Radiodiagnostics, PolyClinique Les Fleurs, Ollioules, France
| | - Juliette Thariat
- Department of Oncology & Radiation Therapy, Antoine Lacassagne Cancer Research Institute, Nice, France
| | - Carole Chevenet
- Department of Histopathology, Centre de Pathologie, Aurillac, France
| | - Alexis Lacout
- Department of Radiodiagnostics, Surgical Medical Center de Tronquières (CMC) Aurillac, Aurillac, France
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Lacout A, Chevenet C, Thariat J, Marcy PY. Thyroid calcifications: a pictorial essay. J Clin Ultrasound 2016; 44:245-251. [PMID: 26891122 DOI: 10.1002/jcu.22345] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 01/12/2016] [Accepted: 01/20/2016] [Indexed: 06/05/2023]
Abstract
Incidental diagnosis of thyroid nodules is very common on adult neck ultrasonography examination. Thyroid calcifications are encountered in benign thyroid nodules and goiters as well as in thyroid malignancy. Depiction and characterization of such calcifications within a thyroid nodule may be a key element in the thyroid nodule diagnosis algorithm. The goal of this paper is to display typical radio-pathological correlations of various thyroid pathologies of benign and malignant conditions in which the calcification type diagnosis can play a key role in the final diagnosis of the thyroid nodule.
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Affiliation(s)
- Alexis Lacout
- Centre d'Imagerie Médicale, 47 Boulevard du Pont Rouge, 15000, Aurillac, France
| | - Carole Chevenet
- Centre de Pathologie, 23 Avenue de la République, 15000, Aurillac, France
| | - Juliette Thariat
- Department of Radiation Oncology, Antoine Lacassagne Cancer Research Institute, 33 Avenue Valombrose, 06189, Nice Cedex 1, France
| | - Pierre Yves Marcy
- Polyclinique les Fleurs, Service Imagerie Médicale, 332 Avenue Frederic Mistral, 83190, Ollioule, France
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Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale, 47, Boulevard du Pont Rouge, 15000 Aurillac, France *
| | | | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, Ollioule, France ‡
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El Hajjam M, Lacout A, Marzouqi MKA, Lacombe P, Marcy PY. Pedunculated Hepatic Hemangioma Masquerading as a Peritoneal Tumor. A Case Report. Pol J Radiol 2016; 81:51-3. [PMID: 26966471 PMCID: PMC4763809 DOI: 10.12659/pjr.895327] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/03/2015] [Indexed: 11/24/2022] Open
Abstract
Background Although being classically located inside the liver parenchyma, hemangiomas may occasionally develop outside the extra-hepatic capsule, thus appearing as a pedunculated mass. Case Report We report the case of a 66-year-old anal cancer female patient presenting with an asymptomatic sub-hepatic mass. Incidental diagnosis of a pedunculated hepatic hemangioma was strongly suggested by the typical imaging features on computed tomography (CT) and magnetic resonance (MR) examinations, and was confirmed by histopathological examination. Conclusions Exophytic pedunculated growth is a rare and atypical feature of hepatic hemangioma. Thin contrast- enhanced sections and multiplanar CT and MR scan reformations helped to the final diagnosis of hemangioma, showing its origin from the liver edge. Surgical resection is mandatory to prevent threatening mass pedicle torsion.
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Affiliation(s)
- Mostafa El Hajjam
- Department of Radiology, Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France
| | - Alexis Lacout
- Department of Radiology, Centre d'Imagerie Médicale, Aurillac, France
| | - Mohamed Karji-Al Marzouqi
- Department of Radiology, Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France
| | - Pascal Lacombe
- Department of Radiology, Centre Hospitalier Universitaire Ambroise Paré, Boulogne-Billancourt, France
| | - Pierre Yves Marcy
- Department of Interventional Radiology, Polyclinique Les Fleurs, Ollioules, France
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Abstract
Incidental diagnosis of thyroid nodules is very common on adult neck ultrasonography (US) examination. They are primarily assessed on size and greyscale ultrasound criteria such as hypoechogenicity, taller than wide, spiculated margins and calcifications. In difficult situations Doppler US features may improve tumour characterisation and staging.
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Affiliation(s)
| | | | - Joël Salas
- Service de Chirurgie ORL, Centre Médico-Chirurgical, Aurillac, France
| | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, Ollioule, France
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Lacout A, Chevenet C, Marcy PY. Suspicious Thyroid Nodule Management with Nondiagnostic Results at Cytologic Examination: How to Diagnosis Mummified Benign Thyroid Nodules. Radiology 2015; 277:303-4. [PMID: 26402498 DOI: 10.1148/radiol.2015150912] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale, 47, Boulevard du Pont Rouge, 15000 Aurillac, France *
| | | | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, Ollioules, France ‡
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Lacout A, Marcy PY, El Hajjam M, Lacombe P. Metformin as possible therapy of pulmonary arterio venous malformation in HHT patients. Med Hypotheses 2015; 85:245-8. [DOI: 10.1016/j.mehy.2015.05.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 05/02/2015] [Indexed: 01/14/2023]
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Lacout A, Chevenet C, Marcy PY. Thyroid nodules diagnosed as follicular neoplasm: do not forget Doppler US and correlation to previous imaging findings. Clin Endocrinol (Oxf) 2015; 83:287-8. [PMID: 25597327 DOI: 10.1111/cen.12723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Pierre Yves Marcy
- Service de Radiologie, Polyclinique les Fleurs, 83190 Ollioules, France
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Affiliation(s)
- Antoine Iannessi
- Centre de Lutte Contre le Cancer, Centre Antoine Lacassagne, Département d'imagerie diagnostique et de radiologie interventionnelle, 33 Avenue de Valombrose, 06189 Nice, France
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Marcy PY, Dahlet C, Brenet O, Yazbec G, Dubois PY, Salm B, Fouche Y, Mari V, Montastruc M, Lebrec N, Ancel B, Paillocher N, Dupoiron D, Rangeard O, Michel C, Chateau Y, Ettaiche M, Ferrero JM, Chamorey E. [Multicenter validation study of a questionnaire assessing patient satisfaction with and acceptance of totally-implanted central venous access devices]. Bull Cancer 2015; 102:301-15. [PMID: 25799876 DOI: 10.1016/j.bulcan.2015.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Accepted: 01/29/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Most cancer patients require a totally-implanted central venous access device (TIVAD) for their treatment. This was a prospective, multicenter, open study to: (i) develop and validate a French-language questionnaire dubbed QASICC (Questionnaire for Acceptance of and Satisfaction with Implanted Central Venous Catheter) assessing patient's satisfaction with and acceptance of their TIVAD; (ii) develop a mean score of patient's acceptance and satisfaction; (iii) look for correlation between QASICC score and TIVAD patient/tumor pathology/device characteristics. METHODS From 2011 November to 2012 December, the first version of the QASICC questionnaire that included 27 questions assessing seven dimensions was re-tested among 998 cancer patients in eleven French cancer hospitals (eight cancer research institutes and three university/general hospitals). The goal was: (i) to reduce the questionnaire item and dimension number (pertinency, saturation effect, item correlation); (ii) to assess its psychometric properties, demonstrate its validity and independency compared to (EORTC) QLQC30; (iii) to correlate clinical and pathological patient's/tumor's/TIVAD's parameters with the QASICC questionnaire score (the higher the overall score, the greater the acceptance and satisfaction). The questionnaire was administered to the patient 30 days (±15 days) after TIVAD's implantation. RESULTS Among 998 questionnaires given to cancer patients, 658 were analyzed and 464 were fully assessed as there was no missing data. Time to fill-in the questionnaire was five minutes in 90% patients. Final QASICC tool included twenty-two questions assessing four homogeneous dimensions (65%<Cronbach coefficient<85%): (i) impact on daily activities and professional activities; (ii) esthetics and privacy; (iii) pain, contribution to the comfort of the treatment; (iv) local discomfort. Respective assessment scores were 23.6%, 32.9%, 20.4% and 18.0%. Overall satisfaction score was 75.8%; global assessment score was 76.2%. These scores were significantly linked to patient's gender, anesthesia type, TIVAD's implantation side, patient's age and tumor type. CONCLUSIONS This second and final methodological and statistical validation of this auto-questionnaire QASICC allows us to propose it as a dedicated questionnaire to TIVAD's cancer patients by using a score assessing acceptance and satisfaction regarding their device.
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Affiliation(s)
- Pierre Yves Marcy
- Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 1, France.
| | - Christian Dahlet
- Centre Paul-Strauss, 03, rue de la Porte de l'Hôpital, 67065 Strasbourg cedex, France
| | - Olivier Brenet
- Centre Paul-Papin, ICO, 2, rue Moll, 49933 Angers cedex 9, France
| | - Gabriel Yazbec
- Institut Jean-Godinot, 01, avenue du Général-Koenig, BP171, 51056 Reims cedex, France
| | - Pierre Yves Dubois
- Institut Jean-Godinot, 01, avenue du Général-Koenig, BP171, 51056 Reims cedex, France
| | - Bernard Salm
- Centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - Yves Fouche
- Centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 1, France
| | - Veronique Mari
- Hôpital de Jour, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 1, France
| | - Marion Montastruc
- Institut Claudius-Rigaud, 20-24, rue du Pont-Saint-Pierre, 31052 Toulouse cedex, France
| | - Nathalie Lebrec
- Centre Paul-Papin, ICO, 2, rue Moll, 49933 Angers cedex 9, France
| | - Benoit Ancel
- Centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | | | - Denis Dupoiron
- Centre Paul-Papin, ICO, 2, rue Moll, 49933 Angers cedex 9, France
| | - Olivier Rangeard
- Centre Alexis-Vautrin, 6, avenue de Bourgogne, 54511 Vandœuvre-lès-Nancy, France
| | - Cécile Michel
- Unité de recherche clinique, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Yann Chateau
- Unité d'épidémiologie et de biostatistiques, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Marc Ettaiche
- Unité d'épidémiologie et de biostatistiques, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Jean-Marc Ferrero
- Unité de recherche clinique, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
| | - Emmanuel Chamorey
- Unité d'épidémiologie et de biostatistiques, département de recherche clinique, innovation et statistiques, centre Antoine-Lacassagne, 33, avenue de Valombrose, 06189 Nice cedex 02, France
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Lacout A, Marcy PY, Thariat J, Sellier J, El Hajjam M, Lacombe P. Roles of cyclooxygenase 2 and hepatic venous flow in patients with HHT or hepatopulmonary syndrome. Med Hypotheses 2014; 83:302-5. [PMID: 24986705 DOI: 10.1016/j.mehy.2014.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 05/27/2014] [Accepted: 06/01/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Hereditary hemorrhagic telangiectasia (HHT) and hepatopulmonary syndrome are disorders characterized by the development of multiple pulmonary arteriovenous malformations (PAVM). PRESENTATION OF THE HYPOTHESIS COX2 may be at the origin of a cascade of pro inflammatory events to favour angiogenesis and PAVM development. TESTING THE HYPOTHESIS HHT and hepatopulmonary syndrome mouse models may be used to show its effects on PAVM formation. Anti COX-2 therapy could also be tested in human individuals, particularly in patients presenting a hepatopulmonary syndrome or HHT with small PAVM. IMPLICATION OF THE HYPOTHESIS PAVMs are one of the main causes of morbidity in patients presenting with HHT disease, owing to the risks of rupture as well as paradoxical embolism exposing to stroke and/or cerebral abscess. Percutaneous embolization has become the treatment of choice of PAVM. Anti COX2 may prevent from PAVM development and subsequent related complications and avoid either surgery and/or percutaneous embolization and thus subsequent related complication.
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Affiliation(s)
- Alexis Lacout
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France.
| | - Pierre Yves Marcy
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France
| | - Juliette Thariat
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France
| | - Jacques Sellier
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France
| | - Mostafa El Hajjam
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France
| | - Pascal Lacombe
- Pluridisciplinary HHT team, Ambroise Paré Hospital, Groupement des Hôpitaux Ile-de-France Ouest, Assistance Publique Hôpitaux de Paris, Université de Versailles Saint Quentin en Yvelines, 9, Avenue Charles de GAULLE, 92100 Boulogne Billancourt, France
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Lacout A, Marcy PY. Digital tomosynthesis: an innovative tool for challenging diagnoses in urology. Urol J 2014; 11:1511-1513. [PMID: 24807774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 12/16/2012] [Indexed: 06/03/2023]
Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale 47, Boulevard du Pont Rouge, 15000 Aurillac,
| | - Pierre Yves Marcy
- Polyclinique Les Fleurs, Service Imagerie Médicale, 332 Avenue Frederic Mistral, 83190 Ollioule, France
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Marcy PY, Mari V, Figl A, Ben-Taarit I, Fouché Y, Peyrade F, Follana P, Michel C, Chamorey E. Patient Satisfaction with and Acceptance of Their Totally-Implanted Central Venous Catheter: Construction and First Validation of a Questionnaire. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/jct.2014.57079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Troussier I, Barry B, Baglin AC, Leysalle A, Janot F, Baujat B, Fakhry N, Sun XS, Marcy PY, Dufour X, Bensadoun RJ, Thariat J. [Target volumes in cervical lympadenopathies of unknown primary: toward a selective customized approach? On behalf of REFCOR]. Cancer Radiother 2013; 17:686-94. [PMID: 24095636 DOI: 10.1016/j.canrad.2013.07.132] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 06/27/2013] [Accepted: 07/03/2013] [Indexed: 11/25/2022]
Abstract
The treatment of carcinomas of unknown primary revealed by cervical lymphadenopathy is based on neck dissection and nodal and pan-mucosal irradiation to control the neck and avoid the emergence of a metachronous primary. The aim of this review was to assess diagnostic and therapeutic approaches and criteria that may be used for a customized selective approach to avoid severe toxicities of pan-mucosal irradiation. A literature search was performed with the following keywords: cervical lymphadenopathy, unknown primary, upper aerodigestive tract, cancer, radiotherapy, squamous cell carcinoma, variants. The diagnostic workup includes a head and neck scanner or MRI, ((18)F)-FDG PET CT, a panendoscopy and tonsillectomy. Squamous cell carcinoma represents over two thirds of cases. The number of metastatic cervical nodes, nodal level, and histological variant (associated with HPV/EBV status) may determine the primary site origin and might be weighted for the determination of radiation target volumes on a multidisciplinary basis. A selective customized approach is relevant to decrease radiation toxicity only if neck and mucosal control is not impaired. Although no recommendation can yet be made in the absence of sufficient level of evidence, the relevance of systematic pan-mucosal irradiation appears questionable in a number of clinical situations. Accordingly, a customized selective redefinition of target volumes may be discussed and be prospectively evaluated in relation to the therapeutic index obtained.
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Affiliation(s)
- I Troussier
- Service d'oncologie radiothérapie, PRC, CHU de la Milétrie, 2, rue de la Milétrie, BP 557, 86021 Poitiers cedex, France
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Guiffant G, Durussel JJ, Flaud P, Royon L, Marcy PY, Merckx J. Power port contrast medium flushing and trapping: impact of temperature, an in vitro experimental study. Med Devices (Auckl) 2013; 6:133-40. [PMID: 24043959 PMCID: PMC3772707 DOI: 10.2147/mder.s47206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Purpose The use of totally implantable venous access devices (TIVADs) certified as “high pressure resistant” or “power port” has begun to spread worldwide as a safe procedure for power contrast injection. Owing to the thermo-rheological properties of the contrast media, the primary aim of this work is to present an in vitro experimental impact study concerning the impact of the temperature level on flushing efficiency after contrast medium injection. Moreover, we report experimental data that confirms the role of needle bevel orientation. The secondary aim is to answer the following questions: Is there significant device contrast medium trapping after contrast medium injection? Is saline flushing efficient? And, finally, is it safe to inject contrast medium through an indwelled port catheter? Results The experimental results show that in addition to hydrodynamics, temperature is a key parameter for the efficiency of device flushing after contrast medium injection. It appears that this is the case when the cavity is incompletely rinsed after three calibrated flushing volumes of 10 mL saline solution, even by using the Huber needle bevel opposite to the port exit. This leads to a potentially important trapped volume of contrast medium in the port, and consequently to the possibility of subsequent salt precipitates and long term trisubstituted benzene nuclei delivery that might impair the solute properties, which may be further injected via the power port later on. Conclusion We thus suggest, in TIVADS patients, the use of a temporary supplementary intravenous line rather than the port to perform contrast medium injections in daily radiology routine practice.
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Natale R, Thariat J, Vedrine PO, Bozec A, Peyrottes I, Marcy PY, Haudebourg J, Pedeutour F, Saâda E, Thyss A. Conservative multimodal management of a primitive neuroectodermal tumor of the thyroid. Rare Tumors 2013; 5:75-8. [PMID: 23888220 PMCID: PMC3719115 DOI: 10.4081/rt.2013.e20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 03/30/2013] [Accepted: 04/08/2013] [Indexed: 11/23/2022] Open
Abstract
Abstract Primitive neuroectodermal tumors (PNET) represent 1% of sarcomas. Head and neck peripheral PNETs have an intermediate prognosis between abdominopelvic disease and extremities. We here report the case of a 40-year old male who presented with primitive neuroectodermal tumor of the thyroid and was treated by multimodal treatment, including surgery, chemotherapy and intermediate dose radiotherapy. The patient is alive and fit with a functional larynx at 27 months. Multimodal treatments yield five-year survival rates of about 60%. Major drug regimens use vincristine, doxorubicin, ifosfamide or cyclophosphamide, dactinomycin and/or etoposide. Complete surgical excision is undertaken whenever possible to improve long-term survival. However, the relative radiosensitivity of tumors of the Ewing family, suggest multimodal treatment including adjuvant conformal radiotherapy in case of positive margins or poor response to chemotherapy rather than resection with 2-3 cm margins, which would imply laryngeal sacrifice for thyroid tumors. The role of expert rare tumor networks is crucial for optimal decision-making and management of such rare tumors on a case by case basis.
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Affiliation(s)
- Romain Natale
- Centre Antoine Lacassagne, Institut Universitaire de la Face et du Cou , Nice
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Lacout A, Marcy PY, Hajjam ME, Lacombe P. Pulmonary arteriovenous malformations etiologies in HHT patients and potential utility of thalidomide. Med Hypotheses 2013; 80:587-8. [DOI: 10.1016/j.mehy.2013.01.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 01/23/2013] [Accepted: 01/26/2013] [Indexed: 11/30/2022]
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Affiliation(s)
- P Y Marcy
- Medical imaging Department, François Baclesse Center, 3, avenue du Général-Harris, 14076 Caen cedex 05, France.
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El Hajjam M, Marcy PY, Lacout A, Thariat J, Lacombe P. Superior vena cava syndrome: do not miss the Ariadne's thread. Diagn Interv Radiol 2012; 19:70-2. [PMID: 23255071 DOI: 10.4261/1305-3825.dir.5781-12.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
A central venous catheter tip located too high into the superior vena cava (SVC) is known to be a strong risk factor for central venous thrombosis and subsequent SVC syndrome. We report herein the usefulness of catheterizing the implanted port catheter lumen as a salvage procedure to circumvent a complete SVC occlusion in a breast cancer patient. Because the standard central vein catheterization attempt is often unsuccessful, the port catheter should always be considered as the Ariadne's thread and used as an attempt for catheterization.
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Affiliation(s)
- Mostafa El Hajjam
- Department of Radiology, Hôpital Ambroise PARE (APHP), Boulogne Billancourt, France
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Lacout A, Marcy PY, El Hajjam M, Lacombe P. Tranexamic acid-bevacizumab synergy in HHT patients presenting pulmonary arteriovenous malformations. Med Hypotheses 2012; 79:605-6. [PMID: 22959314 DOI: 10.1016/j.mehy.2012.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/29/2012] [Indexed: 11/29/2022]
Abstract
Bevacizumab and tranexamic acid have shown efficacy in the treatment of epistaxis and liver involvement of HHT patients. We suggest therapeutic association of bevacizumab and tranexamic acid should be further evaluated for the prevention and treatment of early lung involvement in HHT.
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Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale, 47, Boulevard du Pont Rouge, 15000 Aurillac, France.
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Marcy PY, Lacout A, Amoretti N, Figl A, Thariat J, Simon JJ. Criteria to choose between distal or proximal venous port device insertion in HNC patients. Cardiovasc Intervent Radiol 2012; 36:874-5. [PMID: 22678237 DOI: 10.1007/s00270-012-0402-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 04/17/2012] [Indexed: 11/25/2022]
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Lacout A, Marcy PY, El Hajjam M. To avoid operating on pseudo tumoral pulmonary infarctions mimicking lung cancer. Pan Afr Med J 2012; 12:11. [PMID: 22826735 PMCID: PMC3396857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2011] [Accepted: 04/09/2012] [Indexed: 10/29/2022] Open
Abstract
Pulmonary infarction usually appears as a hump-shaped triangular opacity with its base applied to a pleural surface. In some cases, pulmonary infarctions may appear as a pseudo tumoral opacity mimicking lung cancer. Thoracotomy could be prevented by repeating CT scan in properly selected patients.
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Affiliation(s)
- Alexis Lacout
- Centre d'imagerie Médicale 47 Boulevard du Pont Rouge 15000 Aurillac, France,Corresponding author: Dr Alexis Lacout (MD), Centre d'imagerie Médicale 47 Boulevard du Pont Rouge 15000 Aurillac, France
| | - Pierre Yves Marcy
- Head and Neck and Interventional Radiology Department Antoine Lacassagne Cancer Research Institute 33, Avenue Valombrose06189 Nice cedex1 France
| | - Mostafa El Hajjam
- Service de Radiologie, Hôpital Ambroise PARE (APHP) 9, Avenue Charles de GAULLE 92100 Boulogne Billancourt France
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Lacout A, Thariat J, Marcy PY. Letter: "Prognostic value of initial tumor parameters after metastatic relapse: do not miss the tumoral stroma". Cancer Invest 2012; 30:493. [PMID: 22506656 DOI: 10.3109/07357907.2012.679346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lacout A, Marcy PY, Carlier RY, Thariat J. Pneumatization of the skull base due to valsalva maneuver. Cleft Palate Craniofac J 2012; 50:113-6. [PMID: 22420630 DOI: 10.1597/11-280] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives : We herewith report the case of a 43-year-old patient who experienced a skull base fracture associated with minimal trauma. The computed tomography scan examination showed unusual extensive pneumatization of the skull base. This patient used to perform repeated Valsalva maneuvers on a daily basis since childhood. Methods : A literature search and analysis of pneumatization mechanisms was performed. Results : Extensive skull base pneumatization has already been reported in patients performing daily Valsalva maneuver. Two pathogenic hypotheses are discussed: the bone cavity expansion through communicating spaces and cavitation secondary to increased intra-osseous pressure transmitted via the venous network with subsequent bone marrow ischemia. Conclusion : Valsalva maneuver may be the cause of an extensive skull base pneumatization. We hypothesize that the Valsalva maneuver may induce bone marrow ischemia that may, if repeated and prolonged, lead to pneumatization.
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Lacout A, Beauchet A, Marcy PY. Real time US-guided biopsy of thyroid nodules. Nuklearmedizin 2012; 51:N47; author reply N47. [PMID: 23494110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Marcy PY, Lacout A, Dassonville O, Thariat J. Imaging Work up of Small Aggressive Lymph Nodes: In Regard to Ghadjar et al. (Int J Radiat Oncol Biol Phys 2010;78:1366-1372). Int J Radiat Oncol Biol Phys 2011; 80:961-2; author reply 962. [DOI: 10.1016/j.ijrobp.2011.02.046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 02/23/2011] [Indexed: 11/15/2022]
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Lacout A, Marcy PY, Ngo TM, El Hajjam M. Multidetector row CT scan in hypersensitivity pneumonitis: Contribution of minimum intensity projection reformation. J Med Imaging Radiat Oncol 2011; 55:291-5. [DOI: 10.1111/j.1754-9485.2011.02267.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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