Hydatid cyst at unusual locations: Report of three cases.

INTRODUCTION: Hydatidosis is an anthropozoonosis due to the development in humans of the larval form of Echinococcus granulosus and is endemic in many countries of the Mediterranean region such as Morocco. CASES PRESENTATION: We report three cases of hydatid cyst at unusual locations such as the peritoneum, and the retroperitoneum. DISCUSSION: Hydatid disease usually involves the liver (75 %), the lungs (15.4 %), and the spleen (5.1 %). Almost any anatomic location can be the host site of the parasitic cysts. CONCLUSION: Multiple locations of hydatid cyst often pose a problem of differential diagnosis. Surgery is the mainstay of treatment.

A Pigmented Lesion of the Vulva Revealing Aggressive Melanoma: A Case Report.

Vulvar melanoma (VM) is a rare and aggressive malignancy presenting unique challenges in diagnosis and management. This report presents the case of a 61-year-old female patient and explores the clinical characteristics, diagnostic modalities, treatment strategies, and prognosis associated with VM. The patient presented with a painless mass on the labia majora, which turned out to be an undifferentiated malignant tumor process consistent with melanoma on examination. Immunohistochemical analysis confirmed the diagnosis and subsequent imaging revealed metastatic disease necessitating palliative chemotherapy following radiotherapy. VM is a rare and aggressive form of melanoma. While surgery is the standard of care for early stages, advanced stages require a combination of immunotherapy and targeted treatments. Clinical trials are vital to improve our understanding of this condition and the various aspects of its care. Collaboration among experts is essential to achieve progress in managing these patients.

Spleen-preserving surgery for splenic hydatid cyst: a case report.

Hydatidosis is a zoonosis due to the development of the larval form of Echinococcus granulosus in humans. This disease is very frequent in many countries of North Africa such as Morocco. The most frequent locations of hydatid cysts are the liver (75%) and the lungs (15.4%). Splenic hydatid cyst occurs in only 5.1% of cases. The diagnosis remains challenging and is made upon a hundle of clinical, radiological, biological, and histological arguments. In this paper, we report a case of spleen-preserving surgery for a splenic hydatid cyst to suggest the best management of these hydatid cysts and avoid recurrences.

Pleomorphic Carcinoma of the Breast: A Report of Three Cases.

Pleomorphic carcinoma (PC) is an uncommon and high-grade form of breast carcinoma characterized by the presence of distinctive pleomorphic giant tumor cells exhibiting bizarre nuclei and atypical mitosis. In this study, we report three patients who presented with lesions composed of a proliferation of large pleomorphic cells with a predominance of multinucleated giant cells on a microscope. Immunohistochemical analysis revealed distinct immunologic profiles within the respective malignant components. Notably, this report aims to contribute valuable insights, adding to the understanding of this uncommon tumor, accompanied by a literature review. Despite its rarity, PC in the breast remains clinically relevant due to its distinctive morphological and pathological features. These unique attributes require specific considerations in both clinical presentation and management.

Gastric Volvulus: A Rare Cause of Intestinal Occlusion.

Gastric volvulus (GV) is a rare condition characterized by the rotation of all or part of the stomach around its transversal or longitudinal axis. We report the case of a 76-year-old woman with the acute form of GV, likely exacerbated by hiatal hernia and age-related ligamentous relaxation, evolving for a week before her admission. She underwent a midline laparotomy with fundoplication at 270° and anterior gastropexy. GV poses life-threatening risks in its acute presentation. Surgical management entails restoring the hemodynamic stability, surgical detorsion of the volvulus, and addressing the etiology (hiatal hernia).

Pseudoaneurysm of the Gastroduodenal Artery: A Rare Complication of Bile Duct Surgery.

Pseudoaneurysm of the gastroduodenal artery (GDA) is an exceptional complication of common bile duct (CBD) resection. We present the case of a 60-year-old woman with a history of cholecystectomy. The patient was admitted to our hospital for surgical management of the cystic dilatation of the CBD. The patient presented on postoperative day 21 with hemodynamic instability related to a pseudoaneurysm of the GDA. An urgent open surgery was performed with dissection and ligation of the GDA.

A Report of Two Rare Cases of Buschke-Löwenstein Tumor.

The Buschke-Löwenstein tumor is a rare clinical entity. Its severity is related to the local invasion and the risk of recurrence and malignant transformation. It is caused by a viral infection due to the human papillomavirus. The transmission is primarily sexual and often affects the penile region. The perineal location is relatively rare. We report two rare cases of neglected Buschke-Löwenstein tumor due to the late diagnosis treated with large surgical resection. This study aimed to emphasize the contribution of clinical examination in the early diagnosis and the management of our patients.

Early Small Bowel Obstruction Caused by Surgical Drain Following Rectal Cancer Surgery: A Case Report.

The abdominal drains are commonly used and could be a source of several complications, including infection and small bowel obstruction. We report the case of a 70-year-old male patient with intestinal obstruction related to abdominal drainage after rectal surgery. Acute bowel obstruction remains a rare complication of abdominal drains. Surgeons should be aware of this situation and use drains with caution. The treatment options include conservative treatment or surgery either a laparoscopic approach or laparotomy.

Gastric schwannoma: The gastrointestinal tumor simulator - case report and review of the literature.

INTRODUCTION AND IMPORTANCE: Gastric schwannoma is a rare and benign tumor originating from the peripheral nerves of the stomach. Despite its benign nature, this tumor typically remains asymptomatic for an extended period, and its radiological and endoscopic presentation poses challenges in distinguishing it from other gastric mesenchymal tumors. CASE PRESENTATION: Here, we present a rare case of a patient experiencing gastric pain and melena secondary to a gastric mass. The initial preoperative diagnosis indicated a gastrointestinal stromal tumor, but subsequent pathological and immunohistochemical staining of the surgical specimen confirmed the presence of gastric schwannoma. DISCUSSION: To gain insights into this uncommon condition, we conducted an electronic search on PubMed using the keywords "gastric schwannoma" and "gastric neurinoma." Our focus centered on case series containing more than five cases of gastric localization, resulting in the analysis of 14 case series involving a total of 321 patients. Our review aims to comprehensively discuss the clinical, radiological, and therapeutic aspects associated with this rare disease. CONCLUSION: In the absence of a definitive preoperative diagnosis, the surgical approach is considered the primary treatment for resectable gastric schwannoma, given its excellent long-term outcomes. However, further studies are imperative to better define the role of endoscopic resection in managing this condition.

Extrahepatic bile duct metastasis from rectal adenocarcinoma: case report and literature review.

INTRODUCTION AND IMPORTANCE: Extrahepatic metastasis is an exceptional site for rectal adenocarcinoma. Its clinical and radiological presentations are similar to those of cholangiocarcinoma, and its management requires collaboration between surgeons, endoscopists, and oncologists. CASE PRESENTATION: We present a unique case of a 58-year-old woman previously treated two and a half years ago for middle rectal adenocarcinoma with liver metastasis. In the immediate postoperative period, following restoring digestive continuity, she presented cholestatic jaundice from malignant obstruction of the extrahepatic bile duct. A midline laparotomy revealed a tumor of the common bile duct invading the hepatic pedicle. Therefore, external bile drainage, biopsy and hepatic lymph node dissection were performed. Immunohistochemical staining confirmed the diagnosis of extrahepatic bile duct metastasis from rectal adenocarcinoma. CLINICAL DISCUSSION: Extrahepatic bile duct metastasis from rectal adenocarcinoma manifests as bile duct stenosis or intraluminal lesions, and only pathological examination with immunochemical staining confirms the diagnosis. Radical treatment is possible when general conditions allow it. CONCLUSION: Our case is the twelfth to describe a solitary metastasis of the bile duct metastasis from colorectal adenocarcinoma. The rarity of published cases in the literature means that their development mechanism and management are not well-codified.

Radiation-induced angiosarcoma of the breast: a case report.

Introduction: Breast angiosarcoma is a rare, aggressive tumour affecting adult women. It can occur in two forms, primary form and secondary forms or radiation-induced breast angiosarcoma affecting patients with history of breast or chest radiotherapy. Case presentation: The authors report a new case of breast angiosarcoma in 52-year-old women, with history of invasive ductal carcinoma, and reporting a discoloration of her breast skin. The patient did undergo a mastectomy of right breast and adjuvant chemotherapy. Conclusion/discussion: Surgery with total excision associated or not to adjuvant chemotherapy remains the treatment of choice in breast angiosarcoma.

Biliptysis Revealing a Bilio-Bronchial Fistula.

The presence of a bilio-bronchial fistula (BBF) of hydatid origin is considered a serious complication as it can lead to significant injuries at the abdominal, diaphragmatic, and thoracic levels. Here, we report the case of a 70-year-old patient presenting with biliptysis as a symptom and whose thoracic and abdominal CT scan confirmed the presence of a right BBF. The management consisted of an initial endoscopic sphincterotomy, followed by an exclusive left thoracotomy surgery to treat lung, liver, and diaphragmatic injuries. Fortunately, the evolution was favorable with the disappearance of the biliptysis. To diagnose a BBF, it is crucial to conduct a precise assessment, focusing mainly on imaging to accurately locate the injury before any surgical intervention.

Ovarian plasmacytoma: a case report.

Plasmacytomas are a rare spectrum of plasma cell neoplasms that are single localized tumours, lacking the clinical features of plasma cell myeloma with no radiographical evidence of additional plasma cell tumours. Two clinical variants of plasmacytomas can be distinguished: solitary plasmacytoma of bone and extramedullary (or extraosseous) plasmacytoma. The latter is rare, representing 1% of all plasma cell neoplasms, occurring most frequently in the upper airways. Ovarian localization is exceptional, with only a few cases being reported in the literature. We herein report a case of an ovarian extramedullary plasmacytoma occurring in a 56-year-old woman who consulted for abdominal pain and abdominal mass, while highlighting the main histological and immunohistochemical features of this rare malignancy, along with a thorough review of literature gathering all cases of ovarian plasmacytomas reported to date.

An unusual presentation of ovarian carcinoma with supraclavicular lymph node and colorectal metastases leading to spontaneous rectovaginal fistula.

INTRODUCTION AND IMPORTANCE: Secondary metastases to the rectum from primary ovarian cancer are a rare entity and their diagnosis and management are challenging. In this report, we discuss the findings of the case of metastatic ovarian cancer to supraclavicular lymph nodes and the rectum complicated with rectovaginal fistula. CASE PRESENTATION: A 68-year-old woman was admitted for abdominal pain with rectal bleeding. Pelvic examination revealed a left latero-uterine mass. Abdominal-pelvic CT scan showed a tumor mass on the left ovary. A cytoreductive surgery and resection of a non-imaged rectal nodule identified during surgery were performed. The tumor specimens including the rectal metastasis were immunohistochemically confirming a metastatic ovarian cancer using CK7, WT1 and CK20. The patient received chemotherapy and had complete remission. However, she had a recto-vaginal fistula confirmed by imaging and had developed right supraclavicular lymphadenopathy from ovarian cancer later. CLINICAL DISCUSSION: The dissemination of ovarian cancer in the digestive tract can be frequently, through direct invasion, abdominal implantation and lymphatic system. Unusually, ovarian cancer cells may spread to supra-clavicular nodes, because of the connection of the two diaphragmatic stages allowing the lymph flows through the lymphatic vessels. Moreover, rectovaginal fistula is an uncommon complication which can be seen spontaneously or due to certain patient's features. CONCLUSION: In advanced ovarian carcinoma, it is required to properly assess the digestive tract during surgery because imaging can miss metastatic lesions such as our case. The use of immunohistochemistry is recommended to differentiate between primary ovarian carcinoma and secondary metastasis.

A giant primary vaginal sarcoma: A report case and literature review.

Primary vaginal sarcoma is a rare disease entity, reported in less than 3% of cases of vaginal cancers. We report the observation of a patient treated at the regional oncology center of Oujda in Morocco who is presented with a non-metastatic primary vaginal leiomyosarcoma of 20 cm. The treatment consisted of neoadjuvant chemotherapy, followed by hemostatic surgery with tumor resection limits, reinforced by radiotherapy and then a surgical resection with a tumor resection taking away the infiltrated part of the anterior face of the lower rectum and the realization of a left iliac colostomy whose resected tumor part limits were healthy. At present, the patient is 4 years of follow-up without locoregional or distant recurrence.

Hydatid cyst of the psoas: case report and review of literature.

Hydatid disease (HD) is a parasitic pathology that remains endemic in Morocco and poses a public health problem. Its location in the psoas muscle is a rare entity. We report this case highlighting the diagnostic challenges, therapeutic modalities as well as prognosis. Case Presentation: We report the case of a 40-year-old male patient without a notable pathological history, referred to our department for management of a paravertebral hydatid cyst mass with fluid density and scalloping on the verteral body on thoraco-abdomino-pelvic computed tomography scan. After a pretherapeutic assessment, the patient underwent an exploratory laparotomy which objective a deep right laterovertebral mass. The patient underwent a resection of the protruding dome, lavage using hydrogen peroxide and drainage of the residual cavity. The patient recovered well and was discharged 5 days later on albendazole 10 mg/kg/d. The anatomopathological analysis of the specimen confirmed the diagnosis of hydatid cyst. The evolution was satisfactory for the patient with a recall of 6 months. Discussion: Hydatidosis is an anthropozonosis caused by the larval form of Echinococcus granulosus. It can reach the psoas muscle by great circulation. The diagnosis of HD in the psoas is often difficult. Biology and imaging confirm the diagnosis and the standard treatment remains surgery. Conclusion: HD of the psoas is a rare entity. The diagnosis is based on biology and imaging, and radical treatment is surgery.

A Rare Case Report of Trichilemmal Carcinoma.

Trichilemmal carcinoma (TC) is a rare skin malignant tumor with pillar differentiation. TC presents along with other malignant hair follicle tumors and accounts for only 1% of all adnexal carcinomas. TC usually occurs on sun-exposed skin in elderly people, nevertheless, it can occur at any age. We report a case of trichilemmal cyst carcinoma in a 54-year-old woman presenting with an increasing occipital cyst. A histological examination confirmed the diagnosis and a large excision was performed. Despite the absence of a well-defined consensus on the management of TC, surgical excision with adequate margins seems to be safe in the absence of metastatic lesions. However, in the case of second localization, chemotherapy could be initiated, but again, in this case, no consensus on the appropriate protocols exists.

Peritoneal melanosis associated with serous carcinoma of the ovary: A case report and literature review.

Introduction: Melanosis peritonei is an exceptionally benign condition of uncertain origin marked by the deposition of dark pigments on the peritoneal cavity. It's usually associated with other abnormalities and must be differentiated from metastatic melanoma. Case presentation: We report this case of a 67-year-old female presented for abdominal distension for 16 months. Abdomino-pelvic CT scan showed a right pelvic ovarian mass locally developed with the presence of peritoneal ascites. We performed initially an exploratory laparotomy confirmed the radiological constatations with biopsies of the peritoneal carcinosis. Histologic analysis showed a poorly differentiated carcinomatous cell. The patient benefited from neoadjuvant chemotherapy then an abdomino-pelvic CT scan of control was performed showing the reduction in size of the ovarian mass and dispersion of the abdominal effusion. A second laparotomy was carried out and the exploration showed the appearance of dark nodules on the peritoneum. Hysterectomy associated with appendectomy and omentectomy with biopsy of the dark nodules was performed. Pathological study and immunohistochemical staining confirmed the diagnosis of benign peritoneal melanosis associated with serous carcinoma of the ovary. Discussion: Peritoneal melanosis is a rare condition with only 18 cases reported on the English literature. It is often associated with other conditions. The origin of this lesion still unclear although some hypotheses were reported. The main differential diagnosis is metastatic melanoma with very poor prognosis. Conclusion: benign peritoneal melanosis is a rare condition. Its management depends essentially on the associated disease.

Surgical management of ancient retroperitoneal schwannoma.

Schwannomas are benign and rare entities of peripheral nerve sheath origin. The clinical presentation depends the size of tumor, and they may cause symptoms of abdominal pain, urinary difficulties, anemia, hematuria, and abdominal mass as a result of the pressure of the tumor to the adjacent structures. The diagnosis can only be established by immunohistochemical study. Complete surgical clearance remains the mainstay of treatment. We report the case of a 35-year-old female patient consulted for chronic abdominal pain. Abdominal ultrasound and abdomino-pelvic CT scan identified a well-delineated, heterogenous retroperitoneal mass developed in anteraortocaval region measuring 55 × 65 × 88 mm. The lesion seemed to repress the inferior vena cava, and enhanced with contrast administration. The histopathological panel confirmed the diagnosis of retroperitoneal schwannoma.

Gastrointestinal stromal tumor in the fourth portion of the duodenum does not express the CD117: A case report.

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive tract. Presentation of case: 54-year-old woman with a history of phyllodes tumor of the left breast he patient was admitted to our hospital for management of retroperitoneal soft tissue tumor, attached to the fourth portion of the duodenum, opposite the head of the pancreas. The patient underwent a large excision of the tumor, the duodenojejunal flexure, and the third and fourth portions of the duodenum along with the head of the pancreas. The histopathological examination confirmed the presence of a spindlecell mesenchymal proliferation. These cells do not express CD117, but they express DOG1. A PDGFRA mutation was identified later. The final diagnosis was duodenal GIST. Discussion: few cases of GIST in the fourth portion of the duodenum had been reported in the literature. PDGFRA mutation is identified as GISTs tumorigenesis to 15% of cases, and the diagnosis of GISTs is not based solely on the expression of the protein Kit. Conclusion: the molecular biology examinations are very helpful in the direction of the correct diagnosis in case of negative staining for CD117.