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2.  Relevance of expandable titanium cage for the treatment of cervical spondylotic myelopathy 
European Spine Journal  2012;21(8):1545-1550.
Background
In patients with cervical spondylotic myelopathy, ventral disease and loss of physiological cervical lordosis are indications for anterior approach. As bone graft and titanium cage present many drawbacks, expandable titanium cage has been recently introduced for this indication. The authors present the clinical and radiological outcomes in patients undergoing the placement of an expandable cage in the treatment of spondylotic myelopathy with straight or kyphotic cervical spine alignment.
Methods
This was a retrospective review of prospectively collected data. A total of 26 patients underwent cervical corpectomy and reconstruction using an expandable titanium cage and anterior plate between 2005 and 2008. Pain and functional disability were measured using VAS and mJOA preoperatively and at 3 months, 6 months, 1 year and 2 years. Kyphosis was measured using lateral radiographs at the same points of follow-up. Fusion was evaluated on flexion–extension radiographs at 2 years.
Results
The mean VAS improved from 4.2 to 1.7 and the mean mJOA increased from 12.85 to 16.04 at 2 years postoperatively (p < 0.05). The mean kyphosis angle decreased from 17° to 2° at the last follow-up (p < 0.05). The fusion rate was 100 % at 2 years. Three complications were reported including a transient dysphagia, an epidural hematoma and an early hardware migration.
Conclusion
Expandable titanium cage is an effective device, which achieves good clinical and radiological outcomes at a minimum 2-year follow-up.
doi:10.1007/s00586-012-2380-2
PMCID: PMC3535245  PMID: 22639300
Spondylotic myelopathy; Kyphosis; Expandable cage; Cervical spine
3.  Extragonadal mixed germ cell tumor of the right arm: description of the first case in the literature 
Background
Extragonadal localization of germ cell tumors (GCTs) is rare; to the best of our knowledge, a location in the soft tissue of the arm has never been previously reported in the literature.
Case presentation
We report the case of a 37-year-old man who presented with a primary malignant mixed non-seminomatous GCT (teratocarcinoma variety) in the right arm, treated by a combination of cisplatin-based chemotherapy and surgery. After 18 months of close follow-up, no locoregional recurrence or distant metastases have been detected.
Conclusions
A combination of chemotherapy and surgery is the most appropriate treatment strategy for extragonadal GCTs, to ensure both local and systemic control.
doi:10.1186/1477-7819-10-69
PMCID: PMC3356599  PMID: 22540884
Chemotherapy; Embryonic carcinoma; Extragonadal; Mixed germ cell tumors; Surgery; Teratoma
4.  Periductal stromal sarcoma in a child: a case report 
Introduction
Periductal stromal sarcoma is an extremely rare malignant fibroepithelial tumor of the breast which is characterized by its biphasic histology with benign ductal elements and a sarcomatous stroma made of spindle cells and lacking phyllodes architecture. Its therapeutic management is based on wide surgery with free margins. Adjuvant therapies are not needed. Periductal stromal sarcoma may evolve into a phyllodes tumor with time, as well as a specific soft-tissue sarcoma. To the best of our knowledge, this tumor has never been described in a child.
Case presentation
A 14-year-old Arabic boy was presented to our hospital one year ago with a nodule of the right breast that was gradually increasing in size without signs of inflammation. The histological examination after lumpectomy revealed a periductal stromal sarcoma with free surgical margins. No adjuvant treatment was given. At 50 months of close follow-up, no recurrence was observed.
Conclusion
Periductal stromal sarcoma in a child is a very rare disease which has the same indolent behavior as it does in adults. Therefore, close follow-up is required.
doi:10.1186/1752-1947-5-249
PMCID: PMC3141703  PMID: 21714873
5.  Liposarcome dédifférencie du cordon spermatique: difficultés thérapeutiques des grosses tumeurs 
Le liposarcome du cordon spermatique est une entité rare : environ 100 cas ont été rapportés dans la littérature. Nous rapportons l’observation d’un homme âgé de 42 ans, chez qui a été décelée une masse tumorale développée aux dépens du cordon spermatique droit. Une orchidectomie droite avec exérèse large de la tumeur a été difficilement réalisée en raison de la taille importante de la masse. En post opératoire, le patient a présenté une progression locale et métastatique pulmonaire. Une mono chimiothérapie a été administrée à base d’anthracycline mais le patient a décédé suite à une progression rapide de la maladie. À travers cette observation, nous rapportons brièvement les données de la littérature de cette entité rare. Une exérèse large avec des marges saines, tant que possible, est indispensable pour le contrôle local de la maladie. Néanmoins, en cas de taille tumoral importante, comme le cas de notre patient, une exérèse complète est souvent difficile. Vu le taux élevé de rechute locale, une stratégie combinée associant chirurgie et radiothérapie adjuvante peut être envisagée. Le rôle de la chimiothérapie, bien qu’incertain, garde son indication dans les cas métastatiques, surtout dans les sous types dédifférenciés.
PMCID: PMC3221406  PMID: 22121456
Liposarcome; cordon spermatique; Chirurgie; radiothérapie

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