Fibrothecoma a rare ovarian tumor: A case report.

INTRODUCTION AND IMPORTANCE: Fibroma, thecoma, and fibrothecoma collectively denote a range of non-cancerous sex cord-stromal tumors distinguished by the presence of fibroblastic stromal cells and/or cells resembling luteinized theca cells. CASE PRESENTATION: In this report, we present a case study of a 52-year-old patient in whom this uncommon tumor was identified via MRI, highlighting the distinctive diagnostic and treatment considerations associated with it. CLINICAL DISCUSSION: Ovarian fibrothecoma tumors are infrequent, constituting less than 4 % of all ovarian tumors. Although they may manifest at any age, they are more commonly observed in elderly and post-menopausal individuals. Diagnosis hinges on clinical and paraclinical data, yet definitive confirmation is predominantly achieved through anatomopathological examination. For younger patients, conservative surgery is usually favored, whereas peri- or post-menopausal individuals may undergo radical treatment. CONCLUSION: Ovarian Fibrothecoma, though rare, are typically benign tumors frequently found in older patients. Diagnosis primarily relies on histological examination. Fortunately, the prognosis for these tumors is generally favorable.

Mesenteric cystic lymphangioma misdiagnosed as ovarian cyst in a 63-year-old female: A case report and review of literature.

INTRODUCTION: Cystic lymphangioma is rare benign tumor that results from a lymphatic system malformation. The mesenteric location is even more uncommon. CASE REPORT: We report the case of a menopausal 63-year-old woman who presented with a persistent painful well-defined mass of the pelvis. On ultrasound and computed tomography, the mass appeared as thick-walled unilocular homogenous cyst in favor of an ovarian cystadenoma. During laparotomy, the misdiagnosis was confirmed as the tumor was found to be embedded in the mesentery of the ileum. Subsequent histopathological examination confirmed the benign cystic lymphangioma diagnosis. DISCUSSION: Mesenteric cystic lymphangioma is rare peritoneal tumor of the adult. Clinically, it often masquerades as other abdominopelvic masses like ovarian cysts. Differential diagnosis is often challenging because of the overlapping clinical abdominal presentation and radiological features. Histopathological is the gold standard in diagnosing mesenteric cystic lymphangioma. Surgery is the mainstay treatment, and the recurrence rate is low if negative surgical margins are achieved. CONCLUSION: Mesenteric cystic lymphangioma often mimics more frequent and potentially malignant lesions. It is essential for surgeons to remain vigilant for the possibility of this diagnosis when evaluating abdominopelvic cystic masses.

Parietal endometriosis: An uncommon cause of c-section scar pain - A case report.

INTRODUCTION: Parietal endometriosis is the most common form of extra-pelvic endometriosis. It develops on the surgical scar of c-section or hysterectomy. It is one of the causes of scar pain. CASE PRESENTATION: A 26 years old patient presents with recurring pain and swelling of a Pfannenstiel scar 6 years after a caesarean section. Physical examination revealed a firm tender subcutaneous nodule that appeared at MRI as a heterogenous parietal mass infiltrating the rectus abdominis muscles. The patient underwent a wide excision of the nodule. DISCUSSION: Parietal endometriosis can be the cause of debilitating scar pain even in patients with no history of deep endometriosis. It presents as firm parietal nodule that can become large and infiltrative if left untreated. Diagnosis is purely histological. Surgery remains the treatment of choice and requires a wide excision. CONCLUSION: Parietal endometriosis, potentially more common due to rising number of caesarean sections, should be considered with persistent scar pain. Surgery is the preferred treatment, offering a conclusive diagnosis.

Ovarian vein and inferior vena cava thrombosis after vaginal delivery: A case report.

Ovarian vein thrombosis (OVT) is a rare but serious complication, most commonly occurring in the postpartum period. This article reports the case of a 40-year-old woman who presented 12 days after a normal vaginal delivery with fever and pelvic pain. An initial diagnosis of endometritis was made, and empiric antibiotic therapy was administered, but the fever persisted. An ultrasound scan was then done to rule out appendicitis, which revealed a thrombosis of the right ovarian vein extended to the inferior vena cava. Appropriate anticoagulant therapy was immediately started with spectacular clinical improvement. Ovarian vein thrombosis is difficult to diagnose as the signs are nonspecific, like fever and pelvic pain; radiological exploration, typically doppler ultrasound and computerized tomography, are therefore required. Early treatment is crucial to prevent severe complications, especially pulmonary embolism. This case emphasizes the need for heightened clinical awareness and a multidisciplinary approach to achieve optimal outcomes in managing ovarian vein thrombosis.

Endoscopic treatement by vaginoscopy of a Herlyn-Werner-Wunderlich syndrome: A case report.

INTRODUCTION: Herlyn-Werner-Wunderlich syndrome is a rare complex congenital disorder, presenting with obstructed vagina, uterus didelphys and ipsilateral renal agenesis. Hemivaginal obstruction firstly asymptomatic, leads to symptoms after menarche such as dysmenorrhea, pelvic pain or infertility. CASE PRESENTATION: A 15-year-old patient presenting with few symptoms, transvaginal ultrasound reveals an hematocolpos, we report also typical findings of this disorder on magnetic resonance imaging. DISCUSSION: The pelvic pain caused by the hematocolpos is the main symptom that leads patients to consult often urgently, the MRI is the gold standard exam to confirm diagnosis, the treatment consists on incision the septum vaginal and leads to avoid complications. CONCLUSION: Early diagnosis of this syndrome usually leads to initiate surgical treatment in order to avoid complications.

Management of congenital cervical atresia with vaginal aplasia: A case report and review of the literature.

INTRODUCTION: Vaginal agenesis is a rare congenital condition, with an incidence of 1 in 4500 female births. CASE REPORT: We present a clinical case of vaginal aplasia with cervical atresia in a 31-year-old woman with primary amenorrhea. We aim to report the diagnostic process and provide a comprehensive outline of different possible treatments. DISCUSSION: The most common etiology of these agenesis cases is Mayer-Rokitansky-Küster-Hauser syndrome associated with uterine aplasia. However, vaginal aplasia can occur in 9 % of cases where the uterus is present. During embryogenesis, the Müllerian ducts give rise to the fallopian tubes, uterus, and upper two-thirds of the vagina, while the lower portion of the vagina develops from the urogenital sinus. Vaginal aplasia arises from a failure in the development of the terminal portion of the paramesonephric ducts. Abdominal pain, especially periodic pain, is the most common symptom, followed by primary amenorrhea. MRI is considered the gold standard for the diagnosis and precise description of female genital tract anomalies. CONCLUSION: Total hysterectomy remains a preferred option for cases of complete vaginal atresia to mitigate the risk of cervical or vaginal stenosis, adhesions, and pelvic inflammation resulting from poor menstrual blood drainage.

A Sertoli-Leydig ovarian tumor presenting as ovarian torsion: A case report.

Torsion occurs as a complication in 10% of cases of ovarian tumors. It predominantly occurs in benign ones, while malignant tumors are less prone to torsion. Sertoli-Leydig cell tumors are highly unusual sex cord-stromal tumors of the ovary, accounting for less than 0.2% of all ovarian cancers. A 39-year-old patient presented to the emergency department with a Sertoli-Leydig cell tumor diagnosed due to ovarian torsion. The clinical presentation was characterized by abdominal pain. Ultrasound indicated signs of torsion, and torsion of the right ovary was subsequently confirmed during laparotomy. A salpingo-oophorectomy was performed, and histological examination revealed a moderately differentiated Sertoli-Leydig cell tumor. Sertoli-Leydig cell tumors often present with hormone-related or non-hormonal symptoms. Surgery plays a crucial role in both diagnosis and treatment. Postoperative treatment is not necessary for well-differentiated Sertoli-Leydig cell tumors in stage IA-IB. However, patients with grade 2-3 disease, advanced stage, or heterologous elements may consider adjuvant treatment. As these tumors are rare, this case contributes to the documentation of Sertoli-Leydig cell tumors, with a case diagnosed due to ovarian torsion. The case highlights the importance of establishing international registries of Sertoli-Leydig cell tumor cases for standardized management.

Massive cellular angiofibroma of the vulva: a case report.

Cellular angiofibroma is a rare benign mesenchymal tumor, typically occurring in the vulvar region of middle-aged women. This report highlights the importance of histological analysis in diagnosing this uncommon condition and emphasizes its benign nature and straightforward management. We present a case of a 58-year-old North African woman who had a large, well-defined mass in the left labia majora, which had been evolving over 2 years. MRI confirmed the resectability of the tumor by delineating its boundaries. The tumor, despite its slow growth leading to delayed diagnosis, was effectively treated with wide surgical excision. Diagnosis was confirmed through histological and immunohistochemical evaluations, revealing spindle cell proliferation with thick-walled vessels. Cellular angiofibroma, although initially alarming due to its size, is generally managed successfully with surgery and prognosis is favorable with a low risk of recurrence.

Ruptured interstitial ectopic pregnancy: A case report and review of the literature.

Introduction: Interstitial pregnancy is a rare type of ectopic pregnancy. The aim of our publication is to describe the diagnosis and treatment of this entity. Case report: We report the case of a ruptured interstitial pregnancy diagnosed in a 32 years old patient admitted for acute abdominal pain. Discussion: The main symptom was severe pelvic pain in a context of amenorrhea. The ultrasound found the ectopic pregnancy in the form of an eccentric gestational sac with an empty uterine cavity as well as intraperitoneal effusion. A ruptured ectopic pregnancy was suspected and the patient was admitted immediately for emergency laparotomy with cornusotomy and salpingectomy. Conclusion: Interstitial ectopic pregnancy is associated with high morbidity. Its diagnosis and management should be early and adequate in order to avoid complications and preserve fertility.