Paratesticular leiomyoma: A case report of a rare entity.

Paratesticular leiomyoma is an extremely rare benign tumour. It is often asymptomatic. It is sometimes difficult to distinguish leiomyomas from malignant testicular tumours, which leads to radical orchidectomy, despite its benign nature. Magnetic resonance imaging can be helpful to make conservative management of this lesion.

Prostate adenocarcinoma metastasis to the testis: A new case report.

Prostate cancer (PCa) in the second most common cancer in men worldwide. It commonly metastasizes to the bone, lymph nodes, liver and lungs. Synchronous or metachronous testicular metastasis is a rare finding, generally diagnosed incidentally after bilateral orchidectomy for hormonal management in patients with advanced PCa, or at autopsy. We report a case of a 55-year-old male, presenting a PCa and who developed a single testicular metastasis treated by radical orchidectomy, while he was under hormonotherapy.

[Gastric cryptosporidiosis revealing a small cell lung carcinoma (Tunisia)]. / Cryptosporidiose gastrique révélant un carcinome a petites cellules bronchique (Tunisie).

Cryptosporidium, agent of cryptosporidiosis, is an ubiquitous protozoan organism causing diarrhoea especially in severe immunosuppressed patients. Cryptosporidium has been detected with increasing frequency in the gastrointestinal tract, but involvement of the stomach is rarely reported and discloses an underlying immunodeficiency state. We report the case of 67-year-old man, a heavy smoker, who presented with a history of epigastric pain with an altered general condition. Upper gastrointestinal endoscopy showed no significant mucosal abnormalities. The biopsy revealed a chronic active gastritis with Cryptosporidium parasites lining cryptic epithelium. Systematic chest X ray showed a right suspect parenchymatous opacity. Bronchoscopy with multiple biopsies concluded to a small cell lung carcinoma. Through this rare initial manifestation of immunocompromised state related to cancer we will discuss the role of gastrointestinal endoscopy with biopsies in the diagnosis of cryptosporidiosis.

[Prognostic value of morphologic subdivision of papillary renal cell carcinoma and MUC1 expression]. / Intérêt pronostique du sous-typage morphologique des tumeurs tubulopapillaires du rein et expression de MUC1.

OBJECTIVE: The purpose of our study was to demonstrate the prognostic value of morphologic subdivision of papillary renal cell carcinoma and compare MUC1 expression in two types. MATERIALS AND METHODS: The present retrospective study included 30 cases of papillary renal cell carcinoma based on review of histology slides. The histologic type, Führman grade and stage pTNM were specified. Immunohistochemistry was performed in 22 cases using antibody MUC1. RESULTS: Patients were 23 men and seven women with a mean age of 59.6 years. Eleven tumors were type 1 and 19 were type 2. Type 2 tumors were significantly associated with a higher Führman grade (p = 0.0002). We showed a differential expression of MUC1, which is frequently expressed in the type 1. A local recurrence occurred in one case, lung metastasis in the second one and both tumors were type 2. The survival rate without recurrence and metastasis was 100 % in the type 1. It was 79 % at 12 months and 59 % at 24 months in the type 2. MUC1 expression was correlated with the outcome. CONCLUSION: Type 2 tumors are associated with a higher Führman grade than type 1 and MUC1 expression is more frequent in type 1 and correlated with outcome.

Assessment of EGFR mutation status in Tunisian patients with pulmonary adenocarcinoma.

BACKGROUND: Despite recent advances, non-small cell lung cancer carries a grim prognosis. For appropriate treatment selection, the updated guidelines recommend broad molecular profiling for all patients with pulmonary adenocarcinoma. Precise histological subtyping and targeted epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) testing are mandatory. METHODS: Herein, we assessed the EGFR mutation status of 26 formalin fixed-paraffin embedded (FFPE) samples of lung adenocarcinoma. Mutational analysis concerned exons 18-21 of EGFR by real-time polymerase chain reaction (Real time-PCR) using the Therascreen EGFR RGQ PCR mutation kit. ALK status was established on 22 among 26 patients using D5F3 antibody with a fully automated Ventana CDx technique. RESULTS: Activating EGFR mutations were found in 3 men among 26 patients (11.5%). Positive ALK expression was found in 2 cases among 22 patients (9.09%). CONCLUSION: Frequency of EGFR mutations in pulmonary adenocarcinomas of our series is similar to that found in the European ones with some particularities. The mutations detected are uncommon. Whereas, we found a high frequency of positive ALK expression in our series compared to frequency reported in literature. Further studies with larger Tunisian series are required to obtain more conclusive results.

Clear Cell Adenocarcinoma of the Female Urethra, Mimicking Cystocele.

Clear cell adenocarcinoma of the urethra is an extremely rare neoplasm mainly described in women. Anterior pelvic exenteration was the treatment performed in most reported cases. It seems to have poorer prognosis than urothelial carcinomas.

Urothelial carcinoma with plasmocytoid component.

Plasmocytoid urothelial carcinoma is a rare subtype of tumour of the urinary bladder. Its clinical and histopathological features have not been well characterized. There are few reports of this type of tumour. We report a case of 65-year-old man who was operated in our department for bladder tumour. The pathological diagnosis was high-grade urothelial carcinoma with plasmocytoid component. The patient died shortly thereafter from liver and bone metastasis.

Undifferentiated pleomorphic sarcoma of the broad ligament.

AIMS: Sarcomas of the broad ligament are exceptionally rare. To our knowledge, the present case is the first description of undifferentiated pleomorphic sarcoma (UPS) occurring in the broad ligament. Herein, we report this unusual case, and discuss differential diagnoses and treatment. RESULTS: A 55-year-old postmenopausal woman was admitted for lower abdominal pain and vaginal spotting. Radiological examination revealed a latero-uterine mass that was independent of the surrounding organs. Treatment consisted in a total resection of the mass in addition to total abdominal hysterectomy and bilateral salpingo-oophorectomy. Based on histological examination, immunohistochemical study and quantitative PCR, a diagnosis of undifferentiated pleomorphic sarcoma (UPS) was made. The patient was lost to follow-up for 6 months, and then presented with a local recurrence of the tumour in addition to secondary pulmonary and vertebral localizations. The patient died less than one year after the first diagnosis. CONCLUSIONS: Diagnosis of UPS of the broad ligament is based on exclusion using a large panel of antibodies. There is no consensus for treatment. The prognosis of this disease cannot be assessed due to its rarity, but it can be hypothesized that early recurrence is indicative of poor prognosis.

Paratesticular angiomyofibroblastoma: case report and review of the literature.

Angiomyofibroblastoma is a rare, benign, mesenchymal tumour occurring mainly in the female genital tract, and more rarely, in males. We present a new case of angiomyofibroblastoma arising in the left inguinal region of an 83-year-old man. The tumour was well circumscribed and measured 60 mm in maximum dimension. On microscopic examination, the tumour was composed of small spindle cells without atypia within a fibrous and myxoid stroma where scattered mononuclear inflammatory cells were found around the capillaries of the stroma. Immunohistochemical studies showed positive staining of tumour cells for vimentin, desmin, smooth muscle actin and CD34, and negative staining for PS100 and oestrogen and progesterone receptors. These histological findings are consistent with angiomyofibroblastoma. The patient was followed up for 4 years without recurrence.