Small Bowel Intussusception due to Multiple Intestinal Metastases from Lung Adenocarcinoma

Metastatic small bowel tumors are rare. They often present with small bowel occlusion, bleeding, perforation, or intestinal intussusception. Pulmonary adenocarcinoma with metastasis to the small intestine causing intussusception is exceedingly rare. A 72-yearold male patient with a past medical history of left lung adenocarcinoma, presented to the emergency department with abdominal pain and vomiting. On admission, an X-ray of the abdomen without preparation showed some hydroaeric levels on the small intestine. The abdominopelvic  computed tomography (CT) scan revealed an ileo-ileal invagination, with an image of the invagination rod. The patient underwent a  surgical resection of the small bowel with the removal of the ischemic areas and immediate anastomosis. Macroscopic examination of the surgical specimen revealed five tumor masses varying in size between 1 and 4 cm. The histological examination of the samples taken from these tumors, coupled with an immunohistochemical study confirmed the diagnosis of intestinal metastases of pulmonary origin  expressing cytokeratin 7 (CK7) and thyroid transcription factor 1 (TTF1) but negative for CK20, chromogranin, and synaptophysin. The  postoperative course was uneventful, and the symptoms transiently recovered. However, the patient died 3 months later. We should consider multiple metastatic lesions in adult intussusception, especially in patients with a past medical history of lung cancer. &nbsp

Peritoneal splenosis mimicking carcinomatosis

Splenosis is an uncommon benign condition resulting from heterotopic autotransplantation of splenic tissues onto exposed vascularised intra- and extraperitoneal surfaces following splenic trauma and surgeries. Splenosis may be mistaken for carcinomatosis upon standard imaging techniques. A 69-year-old female patient with a past medical history of hypertension and splenic trauma, underwent total esophagectomy with polar gastrectomy for adenocarcinoma of the gastric cardia. Macroscopic examination of the surgical specimen disclosed a tumour of the cardia measuring 5 cm in greatest diameter and several dark brown nodules of the greater omentum ranging in size between 2 mm and 12 mm. Histological examination of these nodules confirmed the diagnosis of peritoneal splenosis. The authors emphasize that in patients with a previous history of splenic trauma or surgery, clinicians must consider the existence of splenosis.Pan African Medical Journal 2016; 2

Primary renal carcinoid metastasizing to distant sites 12 years after the initial diagnosis

Les carcinoïdes primitifs du rein sont rares avec une centaine de cas rapportés dans la littérature. Sur le plan histologique, il s'agit d'une tumeur bien différenciée dont la morphologie rejoint souvent celle des carcinoïdes dans les autres localisations. Nous rapportons un cas de carcinoïde primitif du rein survenant chez un homme de 41 ans, découvert à la suite de métastases hépatiques. La tumeur était particulière par son architecture tubulo-papillaire, suggérant à tort le diagnostic de carcinome papillaire du rein. Ce diagnostic a été redressé 12 ans après, à la suite de l'apparition d'autres métastases hépatiques, osseuses et pulmonaires.Pan African Medical Journal 2016; 2

Colorectal cancer in young adults: a retrospective study of 32 tunisian patients

Young people under the age of 40 with colorectal cancer represent a distinct subgroup with a more aggressive disease behaviour compared to older patients. This study aim to provide an updated overview on clinicopathological features, treatment and outcome of colorectal cancer in young adults under the age of 40. In our retrospective study, we reviewed 32 cases of colorectal cancer in young adults aged less than 40 years that were diagnosed at the pathology department of Mongi Slim hospital over a fifteen-year period (April 2000 - November 2014). Our study group included 13 male and 19 female patients (sex-ratio M/F = 0,68) between 17 and 39 years of age (mean = 31,25 years). The presenting clinical symptoms were dominated by altered bowel habits (n=17), followed by bleeding per rectum (n=16). Histopathological examination of the surgical and biopsy specimens established the diagnosis of mucinous adenocarcinoma in nine cases, well-differentiated adenocarcinoma in 11 cases, moderately differentiated adenocarcinoma in six cases, poorly differentiated adenocarcinoma in four cases and signet ring cell carcinoma in two cases. The tumours were classified after surgery as stage I (n = 2) (6%), stage IIA (n = 7) (22%), stage IIB (n=4) (13%), stage IIC (n=1) (3%), stage IIIB (n=8) (25%), stage IIIC (n= 4) (12%), stage IVA (n=4) (13%) and stage IVB (n=2) (6%). During the follow-up period which ranged between one month and 9 years, local recurrence of the tumour occurred in six cases, seven patients had hepatic metastases and seven patients died after a mean follow-up period of seven months. Molecular genetic studies are increasing the understanding of the pathobiology of colorectal cancer and may ultimately allow at-risk patients to be identified at an earlier stage

Adult Granulosa Cell Tumours of the Ovary Seven Case Reports

Background:Ovarian granulosa cell tumours are low-grade malignant sex cord-stromal tumours. They represent 2 to 3% of all ovarian cancers and occur mainly within the adult population. Aim:&nbsp; to provide an updated overview on ovarian adult granulosa cell tumours.Patients Methods:in our retrospective study, we reviewed seven cases of adult granulosa cell tumours that were diagnosed at the pathology department of Mongi Slim hospital over a fourteen-year period (2002- 2015). Clinical and pathRIiological characteristics were retrospectively analyzed.Results: The patients of our series ranged in age between 39 and 64 years (mean = 53 years). The&nbsp; most&nbsp; common&nbsp; presenting&nbsp; symptom&nbsp; was&nbsp; abnormal&nbsp; uterine&nbsp; bleeding&nbsp; (n=5)&nbsp; followed&nbsp; by&nbsp; pelvic pain&nbsp; (n=4).&nbsp; All&nbsp; patients&nbsp; underwent&nbsp; surgical&nbsp; treatment&nbsp; including&nbsp; total&nbsp; hysterectomy&nbsp; with&nbsp; bilateral salpingo-oophorectomy&nbsp; (n=4),&nbsp; hysterectomy&nbsp; with&nbsp; right&nbsp; salpingo-oophorectomy&nbsp; (n=1)&nbsp; and&nbsp; salpingo-oophorectomy (n=2). Histopathological examination of the surgical specimen confirmed the diagnosis of adult granulosa cell tumour in all cases. Conclusions:Adult granulosa cell tumours of the ovary are considered as low grade malignancies with&nbsp; a&nbsp; relatively&nbsp; more&nbsp; favourable&nbsp; prognosis&nbsp; compared&nbsp; with&nbsp; much&nbsp; more&nbsp; commonly&nbsp; encountered epithelial&nbsp; ovarian tumours. A&nbsp; prolonged&nbsp; post-therapeutic&nbsp; follow-up&nbsp; is&nbsp; necessary&nbsp; because&nbsp; of&nbsp; the&nbsp; risk of recurrences.</p