[Temporomandibular joint primitive tumors and pseudo tumors]. / Pseudotumeurs et tumeurs primitives de l'articulation temporomandibulaire.

The temporomandibular joint (TMJ) can be the site of bone, cartilaginous, or synovial tumors. There is no well-defined histological classification. We listed all benign tumors, malignant primitive tumors, and rare pseudo tumors of the TMJ. We provide a list to help for the diagnosis and the differential diagnosis of non-tumoral lesions by far the most frequent.

[Invasive aspergillosis of the maxillary sinus in an immunocompetent patient]. / Aspergillose invasive du sinus maxillaire chez un patient immunocompétent.

INTRODUCTION: Invasive aspergillosis of the maxillary sinus is a severe infection most commonly observed in immunocompromised patients. We report a pseudo-tumoral presentation of invasive aspergillosis of the maxillary sinus, in immunocompetent adult. CASE REPORT: A 70-year-old female patient consulted for chronic rhino-sinusitis resistant to medical treatment. Computed tomography scan revealed a hyperdense mass filling the left maxillary antrum, with erosion of sinus walls. The ethmoidal and right frontal sinuses were involved. The histological and mycological examination of the surgical resection confirmed the diagnosis of invasive aspergillosis. The patient was given voriconazole as first line treatment. The outcome was good at 18 months. DISCUSSION: Invasive aspergillosis of the maxillary sinus is a rare disease, usually observed in immunodepressed patients. It is very rarely observed in immunocompetent patients.

[Childhood sarcoidosis: ophthalmological manifestations and diagnostic difficulties in two cases]. / La sarcoïdose chez l'enfant : manifestations ophtalmologiques et difficultés diagnostiques à propos de deux cas.

Sarcoidosis is a systemic expression of granuloma found in young adults, but which remains rare in children. Its incidence is underestimated because of the asymptomatic forms. Ocular involvement is present in 25% of the cases. The diagnosis is sometimes difficult and is based on clinical, radiological, and biological arguments and is confirmed by histopathological examination. The authors report the observations of two children, aged 5 and 10 years, discussing the diagnostic difficulty and most particularly, the differential diagnosis with tuberculosis, thereby illustrating the two forms of pediatric sarcoidosis.

[Heterotopic ossification on a midline laparotomy scar after digestive surgery: etiopathogenic discussion about two cases]. / Ossification heterotopique sur cicatrice mediane abdominale apres chirurgie digestive: discussion etiopathogenique a propos de deux cas.

Heterotopic ossification (HO) is rarely seen after abdominal surgery and usually occurs after orthopedic surgery. It is a benign affection with an unknown mechanism and an unpredictable occurrence rate; but some etiopathogenic hypotheses have been put forward. Therapeutic attitudes were not assessed in this study. We report two observations of heterotopic ossification on mid-line laparotomy scar which could support the etiopathogenic hypothesis of osteoblastic cells migration in granulation tissue from the neighbouring bone tissue, particularly from the sternum or pubian structures. The etiopathogenic mechanism and treatment of this affection are discussed with regards to previously published literature.

L'ossification hétérotopique (OH) est rare au cours de la chirurgie abdominale et intéresse surtout la pathologie orthopédique. C'est une affection bénigne, de survenue imprévisible, de mécanisme encore discuté et des hypothèses étiopathogéniques sont proposées. L'attitude thérapeutique n'est pas codifiée. Nous rapportons deux observations d'ossification hétérotopique sur cicatrice médiane sus ombilicale qui pourraient supporter l'hypothèse étiopathogénique d'une greffe de cellules ostéoblastiques au sein du tissu de granulation à la faveur d'un tissu osseux de voisinage notamment les structures osseuses xiphoïdiennes ou pubiennes. L'étiopathogénie et le traitement de cette affection sont discutés à la lumière des données de la littérature.

[Rosai-Dorfman disease mimicking meningiomatosis: a case report]. / Maladie de Rosai-Dorfman mimant une méningiomatose: à propos d'un cas.

Rosai-Dorfman disease (RDD), also known as sinus histocytosis with massive lymphadenopathy, is a rare idiopathic histioproliferative disease affecting the lymph nodes. Although extranodal involvement has been reported in diverse sites, central nervous system manifestations, particularly in the absence of nodal disease with clinical and radiological findings suggestive of meningioma, are extremely rare. Histopathology and immunohistochemistry are essential for a positive diagnosis. We report a case of RDD in a patient presenting multiple meningeal nodules with a review of the literature and discussion of differential diagnosis.

[Erysipelas of the face revealing a mucormycosis]. / Érysipèle de la face révélant une mucormycose.

BACKGROUND: Mucormycosis is an opportunistic fungal infection, typically affecting immunocompromised patients. Rhino-orbital location is the most frequent form with cerebral blood vessels invasion and a fatal outcome. CASE REPORT: An immunocompetent 38-year-old woman, with previous history of primary cutaneous mucormycosis, was admitted for a febrile erythemato-oedematous lesion of the face with well-demarcated edge evoking erysipelas. No cutaneous portal of entry was identified. Oral cavity examination found an ulceronecrotic lesion of the hard palate. Diagnosis of mucormycosis was retained after nasal endoscopy and histological findings. The patient was first treated for erysipelas, then by ascending dose of intravenous amphotericin B. A good outcome was observed despite the occurrence of nephrotoxicity which normalized by alkaline hyperhydratation. Healing was obtained after 1month of effective dose leaving cleft palate sequelae. DISCUSSION: Mucormycosis occurs rarely in immunocompetent, even more if it is a second episode. Affecting the face, it may simulate or be revealed by superficial skin infection. Within that, a meticulous otorhinolaryngeal examination is required when the portal of entry is not obvious.

[Myopericytoma: an uncommon chest wall tumor]. / Le myopéricytome : une tumeur exceptionnelle de la paroi thoracique.

Myopericytoma is, according to the World Health Organisation classification of soft tissue tumours, a recently proposed term describing a group of tumours showing a perivascular myoid differentiation. It is a rare tumour with a predilection for the distal extremities and is often misdiagnosed. We report a new case of myopericytoma located exceptionally in the chest wall together with a review of literature.

Acral myxoinflammatory fibroblastic sarcoma.

Acral myxoinflammatory fibroblastic sarcoma is a rare low-grade malignant soft tissue tumor, usually observed in the extremities of middle-aged patients. We report a case involving the third finger of the left hand of a middle-aged man. The tumor showed a nodular architecture, with cellular areas, occasional foci of hyalinized fibrosis, and hypocellular areas with a myxoid background. Various neoplastic cells were identified including spindled or rounded epithelioid cells and occasional bizarre giant cells, morphologically mimicking ganglion cells. Tumor cells were strongly immunoreactive for vimentin and variably positive for CD68 and CD34. The tumor was completely removed, without further treatment.

[Nasoethmoidal psammomatoid cemento-ossifiying fibroma with intraorbital extension]. / Fibrome cémento-ossifiant psammomateux nasoéthmoïdal à extension orbitaire.

INTRODUCTION: Psammomatoid cemento-ossifying fibroma (PCOF) is a rare benign fibro-osseous lesion. It affects the maxilla, the nasal cavity, paranasal sinuses, and the ethmoid. It is slow-growing, progressive, and benign but it can be locally extended and mimic a malignant tumor. OBSERVATION: We report the unusual case of a 36-year-old woman with a nasal and ethmoid PCOF with orbital and endocranial extension. The tumor was revealed by exophthalmia and nasal obstruction. The diagnosis was proven histologicaly on biopsies. The treatment was transfacial surgery. There was no recurrence 1 year later. DISCUSSION: Intraorbital and endocranial extension of PCOF are rare aggressive behaviours. Histologically, the differential diagnosis is difficult between fibrous dysplasia or psammomatoid meningioma. Complete surgical excision is necessary to prevent recurrence.

[Papillary carcinoma in a thyroglossal duct cyst, a case report: Which management]. / Carcinome papillaire sur kyste du tractus thyréoglosse à propos d'un cas : quelle prise en charge ?

Cysts of the thyroglossal duct are common but malignant degeneration is rare, occurring only in 1% of the cases. The most frequent histological type is papillary carcinoma. The clinical presentation of these cancers is generally nonspecific, diagnosis being established postoperatively using the Sistrunk method. Debate remains open concerning appropriate management strategies and post-therapeutic follow-up for this type of neoplasia. We report the case of a 45-year-old patient who underwent surgery for an anterior neck mass that had developed over three years. Histology favored multifocal papillary carcinoma in a thyroglossal duct remant. Total thyroidectomy was performed. The postoperative protocol, established empirically due to the absence of consensus, included radioactive iodine and hormone suppression even though the thyroid was intact. After one year of follow-up, outcome has remained favorable.

[Cutaneous blastomycosis revealing intravascular B-cell lymphoma: a case in Morocco]. / Blastomycose cutanée révélant un lymphome B intravasculaire: une observation marocaine.

Blastomycosis is a systemic fungal infection caused by a thermally dimorphic fungus, Blastomyces dermatitidis. The incidence in immunocompromised patients has increased in the last two decades. A 55-year-old man consulted for inflammatory nodules on the forearm. Biopsy of one nodules showed a pseudoepitheliomatous hyperplastic epidermis overlaying a dense agranulomatous inflammatory infiltrate containing free-formed ovoid bodies enclosing giant macrophageous cells. These findings were consistent with blastomycosis. After a month of treatment cutaneous lesions regressed partially but the patient's general status continued to deteriorate with the appearance of an edematous-ascitic syndrome and icterus. Laboratory blood testing demonstrated cholestasia and abdominal ultrasound showed hepatosplenomegaly. Needle liver biopsy revealed giant B-cell lymphomatous infiltration of the hepatic ducts. The patient's condition worsened rapidly and he died five months after diagnosis despite four rounds of chemotherapy. Blastomycosis is rare in Morocco. Primary infection is usually a pneumonic process. Isolated cutaneous infection is possible but uncommon. To our knowledge the association of blastomycosis and intravascular lymphoma has not been previously reported. In immunocompromised patients, clinical findings can be alarming and the outcome can be rapidly fatal.

[Ganglioneuroma of the zygoma]. / Le ganglioneurome de l'os zygomatique.

INTRODUCTION: Ganglioneuroma is an uncommon benign tumor that arises from the sympathetic nervous system accounting for less than 1% of all soft-tissue neoplasms. CASE REPORT: We report the case of a 22 year-old man who presented a ganglioneuroma localized in the zygoma. DISCUSSION: Ganglioneuroma generally develop in the abdomen or thorax soft tissue. The occurrence of ganglioneuroma in the bone is exceptional. To date less than ten cases have been reported, six of which involved the mandible. We discuss the possible causes of tumor development at this site.

Cavernous hemangioma of the parietal bone. A case report.

Intraosseous cavernous hemangiomas are a rare finding in the calvarium. It is a benign tumors arising from the intrinsic vasculature of the bone. We report one case observed in a 31 year-old female, presented with a progressive left parietal mass. A plain X-ray of the skull and cranial CT-scan showed a osteolytic lesion in the left parietal bone. Surgery consisted of total resection of the lesion and cranioplasty. The postoperative course was uneventful. Histological study revealed a cavernous hemangioma of the diploe. In view of this observation and the literature review, clinical; radiological and therapeutic aspect of this rare entity are discussed.

[Uterine carcinosarcoma in a teenager: report of a case macroscopically mimicking rhabdomyosarcoma]. / Le cas clinique du mois. Carcinosarcome utérin chez une adolescente: a propos d'un cas simulant macroscopiquement un rhabdomyosarcome.

Uterine carcinosarcoma (malignant mixed mullerian tumor) is uncommon. We report the case of a 17-year-old patient who complained of pelvic pain and abnormal genital bleeding, and had a voluminous hemorrhagic tumor protruding through the vaginal os. Hysterectomy was performed. The histopathologic and immunohistochemical evaluation led to the diagnosis of uterine carcinosarcoma. Adjuvant chemotherapy was given. In spite of the surgical treatment, the evolution was fatal with widespread metastases. From data of the literature, we discuss the diagnosis, histogenesis and treatment of this rare tumor.