Embryonic paratesticular rhabdomyosarcoma: a case report

INTRODUCTION: An embryonic paratesticular rhabdomyosarcoma is a very rare mesenchymal tumor. It is an intrascrotal tumor that is localized in paratesticular structures such as the epididymis or spermatic cord. Rhabdomyosarcoma is most often observed in children and adolescents, presenting as a painless scrotal mass. CASE PRESENTATION: Our patient was an 18-year-old Moroccan man who presented with a painless left scrotal mass that had evolved over four months. An inguinal orchiectomy was performed. A histological examination of the excised tissue revealed an embryonic rhabdomyosarcoma. Our patient had three sessions of chemotherapy with vincristine, actinomycin C and cyclophosphamide. Each chemotherapy session was conducted over five days, with a cycle of 21 days. Our patient was assessed two months after the last chemotherapy session and demonstrated good clinical improvement. CONCLUSION: Paratesticular rhabdomyosarcoma is a rare aggressive tumor manifesting in children and very young adults. Localized forms have a good prognosis whereas metastatic tumors show very poor results. A well-defined treatment based on surgery and chemotherapy yields good results

Bilateral testicular self-castration due to cannabis abuse: a case report

<p>Abstract</p> <p>Introduction</p> <p>The self-mutilating patient is an unusual psychiatric presentation in the emergency room. Nonetheless, serious underlying psychiatric pathology and drug abuse are important background risk factors. A careful stepwise approach in the emergency room is essential, although the prognosis, follow-up, and eventual rehabilitation can be problematic.</p> <p>We present a unique and original case of bilateral self-castration caused by cannabis abuse.</p> <p>Case Presentation</p> <p>We report a case of a 40-year-old Berber man, who was presented to our emergency room with externalization of both testes using his long fingernails, associated with hemodynamic shock. After stabilization of his state, our patient was admitted to the operating room where hemostasis was achieved.</p> <p>Conclusion</p> <p>The clinical characteristics of self-mutilation are manifold and there is a lack of agreement about its etiology. The complex behavior associated with drug abuse may be one cause of self-mutilation. Dysfunction of the inhibitory brain circuitry caused by substance abuse could explain why this cannabis-addicted patient lost control and self-mutilated. To the best of our knowledge, this is the first case report which presents an association between self-castration and cannabis abuse.</p

L’apport de la laparoscopie dans la prise en charge des abdomens urgents.

Résumé Introduction : La laparoscopie est de plus en plus utilisée dans la prise en charge des urgences en chirurgie viscérale, tant au niveau du diagnostic que thérapeutique. C e t r a vail a pour but d e d é montrer l’intérêt de cette tendance en présentant l’expérience personnelle d’un opérateur de chirurgie viscérale en laparoscopie urgente, su r une période de deux ans et demi. Matériels et méthodes : il s’agit d’une étude rétrospective portant sur 88 patients opérés en urgence par laparoscopie pour un abdomen aigu, entre le mois de mai 2005 et le mois de janvier 2008, à l ’ h ô p i t a l u n i v e r s i t a i r e C h e i k h Zayed de Rabat. Les malades sont répartis en 46 femmes et 42 hommes, soit un sexe ratio de 0,92. Leur âge varie entre 6 ans et 88 ans pour une médiane à 48 ans. R é s u l t a t s : Ces 88 patients se répartissent comme suit : 22 Appendicites aigües ( 2 5 % ) ; 42 Cholécystites aigües (47,7); un Pseudo-Anévrisme de l'artère cystique ; 2 Occlusions digestives ; 1 Tumeur hépatique ; 4 cas d’Infarcissement mésentérique ; 8 Péritonites ( 9 , 1 % ) ; 1 Kyste mésentérique ; 5 douleurs du bas ventre chez la femme ; 2 cas d’exploration laparoscopique de contrôle en u r g e nce suite à une laparotomie. Le diagnostic a été donné par la laparoscopie dans 99,6% des cas e t c e t t e m ê m e technique a permis le traitement de 87,5% de nos cas. Le taux de conversion est de 12,5%. La mortalité opératoire fut de 0% et la morbidité de 3 , 4 % pour les patients ayant été trait é s . Il est à noter un seul décès en post opératoire suite à une laparoscopie diagnostique chez une patiente en choc septique pour infarcissement entéro- mésentérique étendu. Conclusion : La laparosopie est un très bon complément des différ e n t s m o y e n s d’investigations cliniques et paracliniques en urgence. Il s’agit d’un atout diagnostique suplémentaire pour le chirurgien confronté à un abdomen aigu. Elle permet de poser un diagnostic et de traiter la pathologie causale dans le m ê m e t e m p s opératoire. Nos résultats démontrent la faisabilité de la laparoscopie pour les urgences abdominales en insistant sur le service rendu pour le diagnostic et éventuellement pour le traitement chirurgical de l’étiologie de l’urgence. 1 2

Case Report Renal Metastases of a Femur Osteosarcoma: A Case Report and a Review of the Literature

This paper discusses a rare case of renal metastatic osteosarcoma. A 25-year-old man with a history of metastatic osteosarcoma involving his right kidney was referred to our institution for treatment. He was managed with chemotherapy. An exhaustive review of the English literature pertaining to this disease was performed. To our knowledge, this case represents only the sixteenth. The literature suggests that the incidence of renal involvement in osteosarcoma is significant and that the treatment should be multidisciplinary in such patients