Apport de la biopsie radioguidée dans le diagnostic histopathologique des tumeurs de l’enfant: expérience de l’Hôpital d’Enfant de Rabat

La biopsie radioguidée constitue une alternative à la biopsie chirurgicale invasive et à la cytologie pour le diagnostic des tumeurs pédiatriques. L'intérêt de notre étude est d'évaluer la valeur diagnostique des biopsies radioguidées examinées au laboratoire d'anatomopathologie de l'hôpital d'Enfants de Rabat (HER). L'étude a porté sur 78 biopsies radioguidées recueillies dans notre laboratoire entre janvier 2008 et décembre 2011. l'âge moyen des patients était de 5 ans et 10 mois avec une prédominance masculine  (65,4 %). La tumeur était abdominale dans 80 % des cas, thoracique dans 15 % cas, thoracique et abdominale dans 2,5% et sacrée dans 1,2%. Les biopsies étaient écho-guidées dans 90 % des cas et scannoguidées dans 10% des cas. Le diagnostic histopathologique était posé dans 89 % des cas.  L'immuno-histochimie a été indiquée dans 35 % des cas. Les diagnostics les plus fréquents étaient : tumeurs neuroblastiques (42 cas), lymphomes non hodgkiniens (10 cas), rhabdomyosarcomes (6 cas), autres (sarcome d'Ewing, néphroblastomes, tumeur  myofibroblastique inflammatoire, maladies de Hodgkin, leucémie aiguë, hépatoblastome et ostéosarcome). Dans notre série, la biopsie radioguidée a permis un diagnostic histopathologique certain dans 89 % des cas.Elle nécessite une étroite collaboration entre clinicien, radiologue et anatomopathologiste pour discuter son indication, afin de diminuer le nombre de biopsies peu ou non représentatives.Key words: Biopsie, radioguidée, tumeur, enfan

Intracardiac Teratoma in an Infant: Report of a New Case and Literature Review

Primitive intracardiac tumours are rare, especially in childhood, and are often discovered on autopsy. The intracardiac teratoma is the rarest intracardiac tumours of childhood. Herein, we report the case of an 11-month-old infant, which featured recurrent bronchoalveolitis since the age of 3 months, with a thoracic deformation. Physical examination did found discrete respiratory distress signs. Chest radiography showed large mediastinal enlargement. The computed tomography showed a solid cystic-cloisonned mass with fat and central calcification highly suggestive of an intracardiac teratoma. A radical surgical excision was made and the histological examination found a well circumscribed tumour containing elements of the three germ layers confirming the diagnosis of mature well-differentiated teratoma, with no need of immunohistochemical support

Unusual case of congenital/infantile fibrosarcoma in a new born

Congenital infantile fibrosarcoma (CIFS) is a rare mesenchymal tumor that is primarily developed in the soft tissue of distal extremities and occasionally in unusual locations such as the lung and retroperitoneum. It occurs mainly in children below the age of 5 years. About 200 cases have been reported in the literature so far, very few of them in new-borns. The prognosis of this tumor is relatively good compared to adult forms. We report an unusual case of CIFS occurring in new-born mimicking an hemangioma and causing hemorrhage in the neonatal period. The tumor is located in the left arm and axilla and associated with a hand malformation. A shoulder amputation is performed after chemotherapy failure. The infant is now two-years old with no recurrence

Solitary infantile myofibromatosis in the upper extremities: Case report

Infantile myofibromatosis (IM) is a mesenchymal tumor that may present in infants in a couple of major forms: solitary (myofibroma) and multicentric (myofibromatosis) which can be more subdivided into IM without or with visceral involvement. The tumors present as nodular lesions in the soft tissues, bones, and/or internal organs. Although the success of imaging in suggesting the correct diagnosis can't be denied, histopathology and Immunohistochemical examinations are necessary to confirm the diagnosis of IM as it might be misdiagnosed as a malignant tumor. We report a case of solitary infantile myofibromatosis in the upper extremities discovered in a 9-year-old girl. She had swelling and an enlargement on the posterior forearm on the ulnar side. The X-ray showed a lytic lesion with swollen soft tissue. The patient underwent an MRI which suggested the diagnosis of myofibroma. Then, solitary myofibroma was confirmed histologically. Infancy's most prevalent fibrous tumor is IM. Its prognosis depends on the visceral involvement. Imaging, especially MRI is the ideal tool to diagnose it

A rare case of renal tumor in children: Clear cell sarcoma with an unusual presentation

Clear cell sarcoma of the kidney is the most frequently misdiagnosed renal tumor in children. We report the case of a 6-year-old boy with clear cell sarcoma of the kidney with an unusual presentation, including a primary tumor of the left kidney with metastasis in the homolateral psoas muscle. The renal tumor was revealed by abdominal mass without hematuria. In a review of the literature. Clear cell sarcoma of the kidney is most commonly associated with bone and lung metastases. Muscular metastasis at initial diagnosis has not previously been reported. This case represents an unusual metastatic pattern of clear cell sarcoma of the kidney. This also illustrates clear cell sarcoma of the kidney's ability to metastasize to other sites including the muscular. These tumors present a diagnostic challenge for the radiologist who should be aware of this entity to differentiate it from other renal tumors which are more frequent at this age. We aim to report the clinical, radiological features, and pathological presentation of this entity

Application of Aleppo pine extract for skin burn treatment

Objective: To investigate the Pinus halepensis extracts and determine its healing and antibacterial effects, and to evaluate the treatment of skin burns. Methods: Aqueous and ethanolic extracts and topical based on Aleppo pine plant extracts were prepared. Thirty male and female Wistar rats were used to study the cutaneous toxicity of extracts from the bark of P. halepensis. The extracts' healing potential for burn wounds were also assessed by evaluating the clinical and macroscopic aspects of the wounds. The antibacterial activity of crude extracts of P. halepensis as well as its wound healing abilities was verified in this investigation. Results: In animals with acute dermal toxicity, there were no signs of treatment-related toxicity or death. The extracts of these plants could be transformed into phytomedicines for the treatment of infected wounds. The results demonstrated that formulated ointments are successful in treating second-degree burns in rats and may be suitable for the short-term therapeutic treatment of second-degree burns. Conclusion: This study successfully answered our problem, regarding the efficacy of our extract for treating second-degree burns in rats. Further studies are needed to confirm these results by identifying the molecules responsible for these activities and examining their mechanism of action