Solitary ovarian plasmacytoma: About a rare entity of extramedullary plasma cell tumor.

INTRODUCTION: Solitary ovarian plasmacytoma is a rare form of extramedullary plasmacytic tumor that develops outside the bone marrow. PRESENTATION OF CASE: We report the case of a 52-year-old female patient who consulted for pelvic pain and abdominal distension. Clinical examination revealed an abdominopelvic mass and a pelvic MRI confirmed a right ovarian mass. The diagnosis of ovarian plasmacytoma was made after exploratory laparotomy. DISCUSSION: Extramedullary plasmacytoma (EMP) is rare and most often found in the upper aerodigestive tract, ovarian localization is exceptional. Histological and immunohistochemical features of EMP highlights similarities with multiple myeloma. EMP treatment options are discussed, including radiotherapy, surgery, and chemotherapy. The prognosis of EMP depends on several factors, including tumor size and timing of treatment. CONCLUSION: Solitary ovarian plasmacytoma is a rare but important entity to consider in the diagnosis of abdominopelvic masses. Appropriate treatment, such as surgery combined with radiotherapy, can be effective, although regular monitoring is necessary due to the risk of relapse and transformation into multiple myeloma.

Radiological characteristics of the posterior fossa of the fetal skull and presentation of a rare case of antenatal screening for Dandy-Walker malformation using antenatal fetal ultrasound and MRI.

INTRODUCTION AND IMPORTANCE: Dandy-Walker malformation is a rare congenital anomaly of the brain that mainly affects the cerebellum region. It is characterised by abnormal dilatation of the fourth ventricle of the brain and partial or total absence of the cerebellar vermis. This malformation may also be accompanied by other anomalies of the brain. Ante-natal diagnosis is becoming increasingly frequent given the performance of medical imaging, in particular ante-natal ultrasound and MRI. The object of this article is to clarify the possible causes of rare cystic malformations of the posterior cerebral fossa, which are very rare congenital malformations. CASE PRESENTATION: a 30 year old patient, second gesture, mother of a live child by caesarean section, referred to us at 32 weeks of amenorrhoea at the university hospital centre for management of a cystic malformation of the posterior cerebral malformation detected on 2nd trimester ultrasound and confirmed as a Dandy Walker malformation on 3rd trimester fetal MRI. CLINICAL DISCUSSION: The Dandy-Walker malformation can be described on prenatal MRI as vermian hypoplasia and can be detected as early as the 1st trimester of pregnancy using ultrasound, This cystic malformation poses a problem of differential diagnosis with other pathologies which also result in a cystic image of the posterior cerebral fossa, in particular Black's pouch cyst, arachnoid cyst and mega magna cistern, which requires careful interpretation of cerebral MRI of the foetus. CONCLUSION: Imaging techniques play a fundamental role in diagnosis. Prenatal ultrasound and MRI can reveal a Dandy-Walker malformation as early as the 2nd month of pregnancy. MRI is ideal for differentiating differential diagnoses.

Rare case of radiotherapy-induced angiosarcoma (RIAS) after conservative and radical treatment of breast cancer: About two cases and review of the literature.

INTRODUCTION AND IMPORTANCE: Angiosarcoma of the breast is a rare malignant tumour of endothelial origin. It is characterised by a high degree of malignancy and a polymorphous clinical and radiological presentation, a source of diagnostic error and delay. It has a very poor prognosis. Mammary angiosarcoma is a rare but formidable complication of radiotherapy. The specificity of this observation is that we are presenting two clinical cases of different surgical management of breast cancer who suffered the same complication from radiotherapy. CASE PRESENTATION: We report two cases of Radiotherapy-induced angiosarcoma (RIAS) in two patients with a history of breast cancer one treated by conservative surgery and radiotherapy and the other by radical surgery and radiotherapy both patients were operated. CLINICAL DISCUSSION: Radiotherapy-induced angiosarcoma (RIAS) is a rare complication of radiotherapy. The increasing use of conservative treatment of breast cancer, which combines surgery with radiotherapy and chemotherapy, can rarely be complicated by breast sarcoma. CONCLUSION: The natural history of radiation-induced angiosarcoma is more or less rapid, with death occurring in the setting of metastatic spread after a median survival of 24 months. The quality of the surgical procedure is a prognostic factor.

Paget disease of de Vulva: About a rare case and a literature review.

INTRODUCTION: Paget disease of de Vulva (PDV) is a rare neoplastic intraepithelial pathology. In the majority of cases, neoplastic proliferation remains intraepithelial and the prognosis is favorable. The standard treatment for Paget disease is surgical excision. We report the observation of a patient with extensive and recurrent vulvar Paget's disease which we treated with surgery. PRESENTATION OF CASE: A 39-year-old single woman presented with itchy heterogeneous erythematous vulvar lesions suggestive of Paget disease. A biopsy confirmed the diagnosis of non-invasive Paget disease. Surgical excision of the lesions was realized, with the anatomopathological examination confirming the diagnosis. DISCUSSION: MPV is often diagnosed late due to the absence of specific symptoms in its initial phase. Clinically, it manifests as an erythematous lesion or eczema. Immunohistochemistry plays a crucial role in the diagnosis of VPM, helping to distinguish the disease from other vulvar conditions. Vulvar MPV has recently been subdivided into two subtypes: type 1, which concerns primary vulvar lesions, and type 2, which concerns associated primary non-cutaneous adenocarcinomatous proliferations or pagetoid intraepithelial urothelial carcinomas. Surgery is considered the gold standard treatment for MPV. CONCLUSION: PDV is a complex disease requiring appropriate diagnosis and management, with surgery as the main treatment, but other less invasive therapeutic options may be considered on a case-by-case basis. Prognostic factors play an important role in the choice of treatment and disease progression.

Torsion of paratubal cyst mimicking ovarian torsion: A rare case of difficult diagnosis.

INTRODUCTION: Paratubal cysts are frequent lesions, and may be responsible for complications such as adnexal torsion, which is rare and difficult to diagnose. Management requires emergency surgery in an attempt to preserve the adnexa. PRESENTATION OF CASE: We report a rare case of a young patient admitted with a Torsion of paratubal cyst mimicking ovarian torsion, the positive diagnosis was difficult. DISCUSSION: Paratubal cysts are lesions that constitute around 10 % of adnexal masses, and may have their embryological origin in Wolfian remnants. Morgagni's hydatid is by far the most common form. Torsion of a para-tubal cyst may manifest as sudden, continuous, or rapidly worsening pain in the iliac fossa. Ultrasound should systematically seek to identify the ovaries outside the lesion. Isolated tubal torsion can only be treated surgically. Laparoscopy is the gold standard. CONCLUSION: Paratubal cyst torsion is rare and very difficult to diagnose, but should be systematically considered in the case of an adolescent presenting with acute pelvic pain.

Neuroendocrine carcinoma of the cervix: About a rare case and literature review.

INTRODUCTION: Neuroendocrine carcinomas of the uterine cervix are rare carcinomas, accounting for only 0.9-1.5 % of cervical tumors. Given their rarity and the absence of randomized trials, the diagnostic and therapeutic management of these tumors is complicated and is essentially modeled on that of pulmonary neuroendocrine tumors. PRESENTATION OF CASE: We report a new case of large-cell neuroendocrine carcinoma of the uterine cervix, and review the various aspects of this rare entity. DISCUSSION: Neuroendocrine carcinoma is a rare and aggressive malignant tumor, It differs from squamous cell carcinoma in its higher recurrence rate and delayed diagnosis. On the other hand, association with human papillomavirus (HPV) 16 and 18 is a common risk factor for both carcinomas. CONCLUSION: To improve the survival of patients with large-cell neuroendocrine carcinomas of the uterine cervix, it is imperative to conduct multicenter clinical trials aimed at defining an effective, standardized treatment.

Primary pelvic hydatidosis: About two cases.

INTRODUCTION AND IMPORTANCE: Primary pelvic hydatidosis in women is a rare or even exceptional entity; its diagnosis is often late. CASE PRESENTATION: We report two cases of pelvic hydatid cyst with a clinical picture simulating an ovarian tumor, dignosticated at the Mohamed VI Center for the treatment of gynecomammary cancers in Casablanca. CLINICAL DISCUSSION: Pelvic hydatidosis is rare; its incidence is between 0.30 and 5.27% of hydatid localizations. Its diagnosis is exceptionally made preoperatively; the patient is most often consulted for pelvic pain, which reveals the presence of an abdominopelvic mass. Pelvic ultrasound is the first-line examination. Serology is necessary only in doubtful cases. Treatment is essentially surgical and must take into consideration the desire for pregnancy in women of childbearing age. CONCLUSION: The vital and gynaecological prognosis is at stake and early diagnosis is necessary. This diagnosis should always be evoked when there are signs of pelvic damage, despite the rarity of hydatid cysts in this location. However, prevention remains the best solution to this scourge, especially in endemic areas.

Twin pregnancy combining complete hydatidiform mole and healthy fetus: Case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Twin pregnancy combining a complete mole and a normal fetal pregnancy with its own healthy trophoblast is a rare entity. A partial molar pregnancy almost always ends in miscarriage due to a triploid fetus. CASE PRESENTATION: We report the case of a 43-year-old female patient admitted for bleeding during the 20th week of pregnancy. Pelvic ultrasound showed the combination of a complete hydatidiform mole and a normal fetal pregnancy. The decision to medically terminate the pregnancy was taken after consultation with the family. Examination of the placenta and histological study confirmed the diagnosis of complete hydatidiform mole associated with a normal fetus. The evolution was uneventful. CLINICAL DISCUSSION: Twin pregnancy combining a complete mole and a normal fetal pregnancy with its own healthy trophoblast is a rare entity that should not be misdiagnosed. There is still no consensus in terms of therapeutic attitude, the dilemma remains and the decision should always include the couple after a thorough explanation of all the risks. CONCLUSION: Our case reaffirms that to successfully manage this rare yet life-threatening condition, heterotopic pregnancy should be included in the differential diagnosis for any gravid women presenting with persistent abdominal pain, abnormal bleeding and/or extrauterine mass.