Case Report: A very rare case of a Pleural Effusion revealing Multiple Myeloma [version 3; peer review: 1 approved, 2 approved with reservations]

Multiple myeloma is a common malignant bone-based disease. Pleural effusions reported in these patients remain rare. It is commonly due to congestive heart disease, pulmonary embolism, nephrotic syndrome or a second neoplasia. The true myelomatous pleural effusion resulting from a direct tumoral invasion of the pleural are extremely rare. We report here the case of a massive pleural effusion revealing multiple myeloma in a 71-year-old patient. The chest ultrasound showed a massive pleural effusion in the left side with a multinodular thickening of the pleura. The medical thoracoscopy showed a grape-cluster appearance. The diagnosis was made by pleural guided biopsy revealing abnormal plasma cells with an intense positive CD 138 (plasma cell marker) and MUM1 (multiple myeloma oncogene1) staining with a light kappa chain in the protein electrophoresis associated with a myeloma. Unfortunately, our patient died one month after the initial diagnosis. We present also a review of the recent literature in order to highlight the clinical presentations of the myelomatous pleural effusion, the diagnostic tools, the therapeutic strategies as well as the outcomes

Pitfall of I-131 whole body scan: a mucinous adenocarcinoma of the ovary

False positive radioiodine uptake following thyroidectomy for differentiated thyroid cancer has been reported in some cases. A 57-year-old female patient was referred for ablative radioiodine treatment four weeks after undergoing total thyroidectomy for papillary thyroid carcinoma. Posttherapeutic I-131 scintigraphy showed uptake in the neck and large focus in the lower abdomen and pelvis. Pathology revealed a mucinous adenocarcinoma of the right ovary

Le kyste hydatique du cordon spermatique : une localisation exceptionnelle

L� hydatidose est une anthropozoonose due au developpement chez l�homme de la forme larvaire du taenia Echinococcus granulosis. La plupart des kystes hydatiques se localisent dans le foie et les poumons. Le kyste hydatique du cordon spermatique est extremement rare avec seulement 4 cas rapportes dans la litterature. Les auteurs rapportent dans cet article un nouveau cas d�hydatidose du cordon spermatique. Il s�agissait d�un homme de 40 ans qui consultait pour des douleurs scrotales evoluant depuis huit mois. L�examen clinique a mis en evidence une tumefaction mobile, inguino-scrotale, droite. L�echographie testiculaire a objective une hernie inguinale droite associee a deux kystes epididymaires bilateraux. Le patient a ete opere pour cure de son hernie avec decouverte en per-operatoire d�un kyste du cordon spermatique qui a ete reseque. L�examen anatomopathologique a conclu a une hydatidose du cordon spermatique

Urothelial bladder carcinoma in childhood: a case report

We report an exceptional case of transitional cell carcinoma of the bladder in a 14-years old boy without personal nor family history who consulted for a total hematuria. Work-up showed a bladder lesion sized 5cm with histology of urothelial cancer. Treatment consisted of a transurethral surgery with carcinologic complete resection. Patient is alive, free of disease with a follow-up of 36 months

Paratesticular Angiomyofibroblastoma-Like Tumor: Unusual Case of a Solidocystic Form

The angiomyofibroblastoma-like tumor of the male genital tract is a rare benign tumor. A total of 34 cases have been reported in the literature. We herein report an exceptional case of solidocystic form in its paratesticular location, in a 79-year-old man. Clinical examination objectified a right testicular induration. Macroscopic examination of the orchidectomy objectified a paratesticular solidocystic tumor formation. Microscopically, the solid area was composed of vessels with small caliber and turgidity of endothelial cells. These vessels were surrounded by clusters of epithelioid cells, sometimes having the appearance of giant cells. They were associated with spindle cells. The cystic area was uncoated. Immunohistochemically, the fusiform cells expressed Desmin and Smooth Muscle Actin. Endothelial cells and clusters of cells surrounding large vessels expressed CD34. The expression of receptors for estrogen and progesterone was negative. To our knowledge, this is the second solidocystic case of angiomyofibroblastoma-like tumor of male genital tract

Symptomatic macroglossia and tongue myositis in Dermatomyositis

The involvement of the tongue in dermatomyositis is rarely described in the literature. We report the case of a patient having a macroglossia whose etiologic was a dermatomyositis. The diagnosis was established by biopsy of the tongue which showed an interstitial lymphocytic infiltration associated with destruction of muscle fibers and perifascicular atrophy. The treatment was based on corticosteroids. The functional prognosis was dominated by the gene to speech and the swallowing disorders