Necrotizing fasciitis of the breast: case report and brief review of literature

Necrotizing fasciitis of the breast is a rare entity, with very few cases reported in the literature. It is rapidly progressive and can lead to sepsis and multi-organ failure without prompt medical and surgical management. In this particular case, a 71-year-old diabetic female presented with primary necrotizing fasciitis affecting her right breast. Upon arrival, she was in septic shock, exhibiting noticeable breast necrosis and nipple discharge. Immediate resuscitation was administered, followed by a muscle-sparing mastectomy. A vacuum-assisted closure (VAC) device dressing was applied during the procedure, and the patient was subsequently managed in intensive care postoperatively. As of now, the patient is free from the disease, and her wound has completely healed.

A rare urogenital malformation “Herlyn-Werner-Wunderlich syndrome” (Ohvira syndrome) discovered during an acute pelvic pain

The Herlyn-Werner-Wunderlich syndrome (OHVIRA syndrome) is a rare urogenital malformation, characterized by a blind hemivagina, a didelphic uterus, and homolateral renal agenesis, it results from a defect in the development of the muller and Wolf ducts during the embryonic period, of unknown origin, the diagnosis is most often made at puberty during the first menstruation, sometimes late, particularly for non-obstructive forms: infertility or obstetrical complications, the diagnosis is based on pelvic ultrasound especially with 3D reconstructions and pelvic magnetic resonance imaging (MRI) which remains the standard gold for the detection of mullerian anomalies, laparoscopy can also play a double diagnostic and prognostic role in order to study the consequences of the blood reflection (hematosalpinx, inflammatory pelvis, endometriosis. In this work we report the case of an OHVIRA syndrome diagnosed late at the age of 36 years in a multiparous woman with acute pelvic pain simulating the picture of a torsion of the adnexa, we will discuss through this case the clinical, diagnostic and therapeutic aspects of this uterine malformation

Krukenberg's tumor: about 2 cases

Krukenberg's tumor is a rare metastatic malignant tumor of the ovary, it represents 1 to 2% of ovarian tumors, the most frequently described primary site is the gastrointestinal tract. It is an aggressive tumor with a poor prognosis. Surgery is the treatment of choice. It consists of removal of the primary gastrointestinal cancer with bilateral adnexectomy, total hysterectomy, locoregional lymphadenectomy and omentectomy when the gastric tumor is discovered secondary to the ovarian lesion. We have collected over a period of 1 year, between April 2021 and May 2022, 2 observations of Krukenberg tumors secondary to digestive neoplasia that were followed in the department of obstetrics and gynecology of the CHU Mohammed VI Oujda. The aim of this article is to make practitioners aware of the difficulties of diagnostic and therapeutic management of this disease in order to improve its poor prognosis. In our observations, the patients certainly complained of digestive signs but it is the gynecological picture made of pelvic pain which was dominant and the main reason for consultation, the two patients were in very bad general state at their admission. The histological study is the only one able to affirm the diagnosis. On the hormonal level, CA-125 is the marker most frequently used by the authors in Krukenberg tumors. This work reconfirms the poor prognosis of Krukenberg's tumor given its insidious evolution

Breast tuberculosis: a case report

Mammary tuberculosis is a rare disease that affects young women during the genital period, usually between the ages of 20 and 40 years, and remains rare in postmenopausal women. Its risk factors are multiparity, breastfeeding, breast trauma and chronic mastitis. Depending on the mode of contamination, there are 2 forms of mammary tuberculosis: primary or secondary. On ultrasound, breast tuberculosis often appears as a heterogeneous hypoechoic image, poorly limited with minimal posterior enhancement. It may also appear as a hypoechoic, homogeneous or heterogeneous image, well limited with posterior enhancement and some calcifications. Histological criteria suggestive of breast tuberculosis are the presence of epithelioid follicles and Langhans-type giant cells, which may or may not be associated with caseous necrosis. A certain number of diagnoses must be eliminated before the diagnosis of breast tuberculosis can be made, in particular breast cancer; it should be noted that the literature describes forms associating cancer and breast tuberculosis, hence the need for a histological study of the breast tissue in order to eliminate an associated carcinoma. It poses diagnostic and therapeutic problems. Current treatment is based on antituberculosis chemotherapy sometimes associated with surgery. The evolution of the disease is usually favourable with a well conducted treatment