[Long-term follow-up and therapeutic results of the protocol of the National Society of Internal Medicine in centrofacial malignant granuloma. Report of 40 cases].
We have studied 40 cases of mediofacial necrosis with no specific diagnosis on biopsy. After an exhaustive work-up we reached a specific diagnosis in 13 patients (Wegener's granulomatosis in 7, classical malignant lymphoma of the nose in 3, squamous cell carcinoma = "goundou" in 1, syphilis and tuberculosis in 1, aspergillosis in 1). Those patients received the appropriate treatments with good results. The remaining 27 patients, however, had ulcerative lymphomas of the midface (according to the immunofluorescence and molecular biology techniques). Their fate was worse since only 15% remain alive on the long-term, despite intensive treatments with chemotherapy, radiotherapy, interferon, artificial nutrition and antibiotics as needed. We present a new protocol with intensified chemotherapy and growth factor treatment in order to ameliorate the very poor prognosis of these patients.
Cabane
J
J
Service de médecine interne, Hôpital Saint-Antoine, Paris.
Grange
C
C
Meyer
B
B
Lamas
G
G
Raphaël
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006103:Granuloma, Lethal Midline / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D014890:Granulomatosis with Polyangiitis / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged
Suivi à long terme et résultats thérapeutiques du protocole de la Société Nationale de Médecine Interne sur les granulomes malins centro-faciaux. A propos de 40 cas.