Tumeur de Frantz: deux nouveaux cas

A travers cet article, nous détaillons les caractéristiques clinico-pathologiques et discutons l'histogenèse de la tumeur de Frantz. Deux patients opérés pour tumeur de Frantz. Ils ont eu un traitement chirurgical seul. L'étude morphologique était couplée à un examen immuno-histochimique (IHC) utilisant les anticorps anti CD10, anti- vimentine, anti-énolase neuronale spécifique (NSE), anti-synaptophysine, anti-chromogranine A et anti-cytokératine. Un immuno-marquage à l'anti-oestrogène et l'anti-progestérone a été réalisé dans un cas. Il s'agissait d'une femme âgée de 45ans et d'un garçon de 12 ans. Les aspects échographiques et scannographiques étaient non spécifiques. Une exérèse chirurgicale complète a été réalisée dans les deux cas. L'analyse histologique évoquait une tumeur de Frantz. Le diagnostic a été retenu après étude immuno-histohimique. L'évolution était favorable sans récidive avec respectivement un recul de 18 et 16 mois. La tumeur de Frantz est une entité rare. Son diagnostic repose sur l'examen anatomopathologique complété par l'étude immuno-histochimique. Son pronostic est excellent après résection chirurgicale.Pan African Medical Journal 2013; 14:

Intranodal palisaded myofibroblastoma: a case report from an unusual site

Intranodal palisaded myofibroblastoma is a rare lymph node benign tumor, of unknown pathogenesis. Although benign, this lesion is frequently confused with metastatic lesions, especially in atypical sites. We report a  39-year-old man with a history of testicular malignant mixed germ cell tumor, presented with abdominal  painless mass. The computed tomography of the abdomen confirmed the presence of 180 × 140 mm2 mass in the retroperitoneum with  lympadenopathy on the right measuring 20 x 15 mm. The patient underwent  exploratory laparotomy, and a surgical exerese of the retroperitoneeum lymph node  was made. Histological and immunohistochemical examination confirmed the diagnosis of intranodal palissaded myofibroblastoma. This entity has been previously, only once, in retroperitoneal region. Despite to the rarity of this  neoplasm, we discuss clinicopathologic features and differential diagnosis.Key words: Intranodal palisaded myofibroblastoma, retroperitoneum, lymph nod

Lymphadenopathic kaposi sarcoma in an immunocompetent young patient: a case report

Kaposi's sarcoma (KS) is a vascular lesion that usually originates from several sites in the mid-dermis extending into the dermis. Infection from human herpes virus type 8 (HHV-8) is the mostly associated cause. Several articles reported cases of KS, first in Africa, then worldwide because of its close association with HIV / AIDS. KS may also be due to iatrogenic immunosuppression of chronic steroid use, high level of expression of many cytokines and angiogenic growth factors. It can involve skin, mucous  membranes, lymph nodes and viscera. We report a case of a 24-year-old immunocompetent, HIV negative male who presented with indolent lymphadenopathy, after adenectomy and histological and immunohistochemical examination revealed a KS. The patient did not have skin lesions. Refusing any other therapy, our patient still lives healthy.This very rare case shows that KS does not always equal immunodeficiency. Key words: Lymphadenopathic, Kaposi sarcoma, immunocompeten

Unusual case of cavitary lung metastasis from squamous cell carcinoma of the uterine cervix

Spontaneous excavation of primary lung cancer is common; however cavitation of metastatic lung lesions is rare and usually confused with benign lesions. In Moroccan context tuberculosis is the first suspected diagnosis of lung excavations. We report a rare case of cavitary lung metastasis of a uterine cervix cancer, treated initially as tuberculosis. A 40-year old non-smoking woman with a known history of squamous cell carcinoma of the uterine cervix since August 2005; presented on September 2008 with right chest pain without fever, hemoptysis or weight loss. CT scan showed a thin walled cavity. Empirical Antibiotic therapy was conducted 15 days with poor outcome. Then antibacillary treatment was started with no proof of mycobacterial infection. A month later, the patient presented with gynecological bleeding and a pneumothorax. Bronchoscopy with transbronchial biopsy of the cavitary mass was performed. Pathology demonstrated a metastatic squamous cell carcinoma. Pelvic examination and MRI showed a subsequent local cervix recurrence. Patient underwent 3 courses of systemic chemotherapy. She died on June 2009 due to progressive disease. Even cavitary lung metastases are rare and benign differential diagnosis are more common, clinician should be careful in neoplastic context and investigation should be done to eliminate a recurrence.Pan African Medical Journal 2013; 14:3

Small bowel volvulus with intussusception: an unusual revelation of neuroendocrine tumor

The primary malignant tumors of the small bowel are rare, representing 1 to 1.4% of all gastrointestinal tumors. We report a case of a 33 year-old women, admitted to our emergency department of visceral  surgery for acute abdomen. The clinical examination revealed diffuse abdominal distension, defenseless, the hernia orifices were free and the rectal examination was normal. The biological test showed no hydro electrolytic disorders with normal hemoglobin and normal renal function. The abdominal CT-Scan showed signs of bowel obstruction due to a volvulus with intussusception without ischemia. The patient was operated urgently; the exploration has revealed a small bowel obstruction in the ileum with volvulus, an intussusceptum associated with a retractile mesenteritis, and the hepatic exploration found no   metastases. The patient underwent a bowel resection taking away the intussusceptum with the  infiltrated mesentery. The postoperative course was uneventful. The pathological result has proved a  well-differentiated neuroendocrine tumor with five free nodes. Through this observation, we aim to  highlight that an obstruction of small bowel with volvulus and intussusception could be exceptionally due  to a neuroendocrine tumor, this complication has enabled a relatively early diagnosis in the absence of metastases and a 6-month follow-up without recurrence is a  demonstration.Key words: Intestines, small, volvulus, intussusception, neuroendocrine tumor

Liposarcome dédifférencie du cordon spermatique: difficultés thérapeutiques des grosses tumeurs

Le liposarcome du cordon spermatique est une entité rare : environ 100 cas ont été rapportés dans la littérature. Nous rapportons l’observation d’un homme âgé de 42 ans, chez qui a été décelée une masse tumorale développée aux dépens du cordon spermatique droit. Une orchidectomie droite avec exérèse large de la tumeur a été difficilement réalisée en raison de la taille importante de la masse. En post opératoire, le patient a présenté une progression locale et métastatique pulmonaire. Une mono chimiothérapie a été administrée à base d’anthracycline mais le patient a décédé suite à une progression rapide de la maladie. À travers cette observation, nous rapportons brièvement les données de la littérature de cette entité rare. Une exérèse large avec des marges saines, tant que possible, est indispensable pour le contrôle local de la maladie. Néanmoins, en cas de taille tumoral importante, comme le cas de notre patient, une exérèse complète est souvent difficile. Vu le taux élevé de rechute locale, une stratégie combinée associant chirurgie et radiothérapie adjuvante peut être envisagée. Le rôle de la chimiothérapie, bien qu’incertain, garde son indication dans les cas métastatiques, surtout dans les sous types dédifférenciés

Calcified multilocular thymic cyst associated with thymoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>There are few case reports of thymoma with a thymic cyst. Such an association renders it difficult for any pathologist to differentiate from other neoplasms, such as a cystic thymoma.</p> <p>Case presentation</p> <p>A 50-year-old Berber woman from Morocco was admitted with a chronic cough of more than 10 years duration. Her medical history and physical examination were normal. Anterior chest radiography demonstrated a calcified opacity in her right anterior mediastinum. A chest-computed tomogram revealed a round cystic tumor, with significant calcification in her right anterior mediastinum. A surgical exploration was performed. The tumor seemed to be a well-encapsulated and totally calcified lesion, arising from the right lobe of her thymus. It was removed by partial resection of her thymus. Through histology, the calcified tumor exhibited some areas of multilocular fibrous-wall cysts. These cysts were partially lined by small cuboidal cells with severe chronic inflammation and an AB thymoma that arose from the wall of the cyst.</p> <p>Conclusion</p> <p>Greater attention should be given to multilocular thymic cysts, to exclude the possibility of neoplasm, especially when the cyst wall is thickened.</p