A rare case of eosinophilic jejunitis: diagnosis and management strategies.

Eosinophilic gastroenteritis is a rare disease with an unknown cause, which can manifest independently or as part of a hyper-eosinophilic syndrome. The severity of the condition depends on the extent of eosinophilic infiltration and damage to the digestive tract. Diagnosis relies on histological examination, which reveals a significant presence of eosinophilic polymorphonuclear leukocytes in the digestive wall. The authors present a new case of eosinophilic gastroenteritis in a 28-year-old patient who exhibited obstructive symptoms but lacked peripheral eosinophilia. Esophagogastroduodenoscopy showed no abnormalities, but barium transit imaging revealed gastro-duodeno-jejunal dilation upstream of a tight jejunal stenosis. Surgical examination of the affected area confirmed a diffuse and transparietal eosinophilic infiltrate, with no evidence of parasitic or granulomatous lesions. Fortunately, the patient had a swift recovery following surgery. Biopsies conducted at other locations, including the gastric, hepatic, and medullary levels, produced negative results, indicating the localized nature of the condition.

[Breast cancer in young patient in Morocco]. / Cancer du sein chez la femme jeune dans le Nord-Est du Maroc.

OBJECTIVE: Breast cancer occurring in young women is rare with epidemiological, diagnostic and prognostic characteristics of their own. It is more often linked to genetic predisposition and especially correlated with a lower survival and higher rates of recidivism. The aim of the study was to analyze epidemiological, clinicopathological, biological and evolutionary characteristics. PATIENTS AND METHODS: It is a retrospective study concerning 74 patients aged 35 and younger, in whom a diagnosis of invasive breast cancer was made between September 2004 and December 2009. RESULTS: Incidence of breast cancer in women aged under 35 in our series was 18.6%, mean age was 30.62years and five patients (6.75%) had a family history of breast cancer. The mean tumor size was 3.9±2.6cm; 45.4% of tumors were locally advanced. It was an infiltrating ductal carcinoma of grade III of Scarff-Bloom and Richardson (SBR) in 45.7% cases and half the time it was accompanied by an axillary lymph node involvement. Negative hormone receptor (HR-) was found in only 28.7% of cases and 13 cases overexpressed Her2. Eighteen percent of the tumors were classified as triple negative. The overall survival at 3years was 87.8%. DISCUSSION AND CONCLUSION: The incidence of breast cancer in young Moroccan patients is high. In our context, it is distinguished by a delayed diagnosis explaining the advanced stage at diagnosis. Biological characteristics are often more aggressive, including high histological grade, lack of hormone receptors and the higher rate of triple negative tumours significantly reducing treatment options.

[Trichoblastic carcinoma]. / Un carcinome trichoblastique.

INTRODUCTION: Trichoblastic carcinoma is a rare malignant adnexal tumor. Its presentation is non-specific and the diagnosis is always histological. CASE REPORT: A 56-year-old patient presented with a trichoblastic carcinoma of the eyelid and eyebrow. It was located on the lower end of the scar, 7 years after the incomplete excision of a tumor. There was a large subcutaneous extension of the tumor, well beyond the visible margins of the skin lesion. The treatment was a broad surgical excision followed by radiotherapy. There was neither local recurrence nor metastasis 20 months later. DISCUSSION: This clinical presentation was atypical and had never been reported. We discuss the therapeutic management of this rare tumor.

[Buschke-Lowenstein tumor associated with scrotal melanoma. A case report]. / Tumeur de Buschke-lowenstein associé à un mélanome scrotal. À propos d'un cas.

Buschke-Lowenstein tumour (BLT) is a giant condyloma acumina, which is rare entity and represents only 1% of all populace. It is a rare viral disease, essentially transmitted by sexual intercourse, characterized by a potential for malignant transformation, invasion and recurrence after treatment. We report a case of BLT associated with perinea-scrotal melanoma. This association was never described in the literature. The purpose of our case report is to discuss the clinical and pathological appearances of these two entities and to outline the recent studies of molecular biology, which can explain this association.

[Desmoid tumor of mediastinum revealed by superior vena cava syndrome and tamponade]. / Syndrome cave supérieur et tamponnade révélant une tumeur desmoïde du médiastin.

Desmoid tumors are rare forms of low grade malignancies. They are characterized by a strong potential of local invasion. Although they are considered histologically benign they behave aggressive locally. They typically occur in the abdominal wall or within the abdomen. Mediastinal localisation is very rare. The only curative treatment is wide surgical excision but the surgery is difficult and the risk of local recurrence is high.

[Tripe palms and a hypertrophic osteoarthropathy syndrome revealing a neuroendocrine carcinoma of the lung]. / Pachydermatoglyphie associée à une ostéoarthropathie hypertrophique révélant un carcinome neuroendocrine du poumon.

BACKGROUND: Tripe palms is a rare cutaneous paraneoplastic syndrome, primarily evocative of lung and gastric neoplasia. Association of many paraneoplastic diseases has also been reported. PATIENTS AND METHODS: A 49-year-old man with a history of alcoholism and smoking addiction reported haemoptysis and thoracic pains present for one year. The physical examination showed left lung condensation. The skin examination revealed a thickened yellowish keratoderma with exaggerated skin ridges and digital clubbing. A diagnosis of paraneoplastic tripe palms was made, prompting repetition of the biopsy which ultimately revealed a neuroendocrine carcinoma. Skeletal scintigraphy showed periosteal proliferation with hypertrophic osteoarthropathy. COMMENTS: "Tripe palms" or "osteoarthritic acanthosis" is a paraneoplastic syndrome. It involves an acquired keratoderma taking on a yellow velvety appearance with accentuation of dermatoglyphic lines. Malignancy is discovered in over 90% of individuals with tripe palms. If malignancy is isolated, it mostly involves the lung (53%). Gastric cancer is associated in 77% of cases if the condition is associated with acanthosis nigricans. In approximately one third of cases, the keratoderma may resolve, generally after treatment of the tumour. The association of many paraneoplastic syndromes has also been reported, in particular digital clubbing and hypertrophic osteoarthropathy. At least 90% of cases of hypertrophic osteoarthropathy in adults occur in patients who have or will eventually develop a malignancy. It is characterized by periostosis of long bones, joint pain, and clubbing, and it is often seen on bone scintigraphy during staging of lung carcinoma.

[Mucoepidermoid carcinoma of the parotid gland in young children]. / Carcinome mucoépidermoïde de la glande parotide chez le petit enfant.

INTRODUCTION: Mucoepidermoid carcinoma of the parotid gland is a rare malignant tumor mostly affecting adults. It accounts for 1 to 3 % of head and neck malignant tumors. It is very rarely observed in children under 10 years of age. OBSERVATION: A four-and-half-year-old boy was brought to consultation in our department, in June 2006, for a left cervical swelling having progressively increased over the previous two years. Cervical US confirmed the presence of a 2.3cm long tumor of the left parotid area, hyperechogenic and heterogenic, associated to a homolateral lymphadenopathy in the jugular and carotid region (zone II), 2cm in diameter. A total parotidectomy preserving the facial nerve was performed. The biopsy extemporaneous histological examination suggested a low-grade mucoepidermoid carcinoma. Surgery was completed by functional neck dissection. DISCUSSION: Our four-and-half-year-old patient was one of the youngest cases ever reported. Malignant parotid gland tumors are very rarely observed in children: less than 19 cases have been published worldwide. Its occurrence in a young child under ten years of age is very rare. Mucoepidermoid carcinoma accounts for one third of all malignant parotid gland tumors.

[Rare bone tumour of the hand: capillary haemangioma of the second finger: case report]. / Tumeur osseuse rare de la main : hémangiome capillaire du deuxième doigt, à propos d'un cas.

Primary vascular tumours of bone are rare. Haemangiomas occur as incidental findings in the skull or in the spine. A solitary haemangioma of the hand skeleton is rare and difficult in radiological and histological differential diagnosis. We report a case of a 23 year-old patient presenting with a capillary hemangioma of the left second finger of few months duration for which he underwent amputation. Postoperative evolution was good and showed no recurrence. We discuss this through observation and a review of the literature including the different clinical, radiological and pathological diagnostic problems associated with an unusual site for vascular proliferation.

[Bile duct dilatation associated with pancreatic heterotopia: a case report]. / Hétérotopie pancréatique associée a une dilatation kystique du cholédoque. À propos d'un cas.

Pancreatic heterotopia or aberrant pancreas is a rare congenital anomaly, usually asymptomatic. Its diagnosis is difficult. We report an original observation in an 8-month-old infant, operated in the neonatal period for esophageal atresia type III in the context of VACTERL syndrome, cystic dilatation of the bile duct, and pancreatic heterotopia.