Serous endometrial intraepithelial carcinoma: a case report.

Serous endometrial intraepithelial carcinoma (SEIC) is a rare but highly aggressive form of uterine endometrial cancer. We report two cases of post-menopausal, 58-year-old patients with abundant vaginal bleeding and pelvic pain. The first patient had a history of surgical hysteroscopy in 2019 for an endocervical polyp. The second patient had a history of breast resection, axillary lymph node dissection, chemotherapy, radiation therapy, and tamoxifen therapy for breast carcinoma 6 years ago. An abdominal hysterectomy was performed in both patients. The pathological assessment showed serous endometrial intraepithelial carcinoma. Diagnosis of a serous proliferation of the uterus implies the exploration of other genital tract organs as well as distant locations in search of metastatic disease.

A Rare Case of Clear Cell Sarcoma of the Tongue: A Case Report.

Clear cell sarcoma (CCS), previously known as soft tissue melanoma due to similarities with melanoma, is a rare and aggressive neoplasm. This tumor predominantly occurs in the lower limbs and rarely affects the tongue, as well as other head and neck locations. To our knowledge, only five cases have been reported in the English literature. CCS presents many similar morphological and immunohistochemical features to those of melanomas, sarcomatoid cell carcinoma, angiomatoid histiocytoma, and Ewing sarcoma, which makes the diagnosis difficult, especially in cases of uncommon locations. The treatment is based on oncological surgery and adjuvant radiation therapy as these tumors show low sensitivity to chemotherapy. This study aimed to report a case of an 88-year-old male patient who presented a large, rapidly growing nodular lesion on the right border of the mobile tongue diagnosed with CCS of the tongue.

Fibroblastic variant of low-grade endometrial stromal sarcoma mimicking an inflammatory pseudotumor: a case report.

The World Health Organization currently divides endometrial stromal sarcomas into 4 different entities, based on their clinical and pathological features: endometrial stromal nodule, low-grade endometrial stromal sarcomas (LG-ESS), High-grade endometrial stromal sarcomas, and undifferentiated uterine sarcoma. The fibroblastic variant of LG-ESS is rare and is usually made of small tumoral cells of oval to fusiform shape, demonstrating low cytologic atypia and low mitotic activity, which can lead to confusion with a benign myofibroblastic proliferation. We hereby report a rare case of a fibroblastic variant of LG-ESS in a 37-year-old woman presenting abundant metrorrhagia, which was initially misdiagnosed as an inflammatory pseudotumor before proofreading in our laboratory, along with a review of a histological and immunohistochemical findings, aiming to help pathologists avoid this diagnosis pitfall.

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.

Gallbladder carcinosarcoma with two heterologous components: a case report.

Carcinosarcoma of the gallbladder is a rare cancer characterized by presence of a carcinomatous and a sarcomatous component. In our work, we report the case of a 66-year-old male patient, presenting with isolated abdominal pain evolving for more than 6 months. contrast-enhanced computed tomography enabled identification of a gallbladder mass, invading liver, duodenum and abdominal wall. A cholecystectomy, extended to liver, duodenum and abdominal wall was performed. The final diagnosis of gallbladder carcinosarcoma was obtained by pathological assessment. Gallbladder carcinosarcoma has a poor prognosis. Since it is rare, no established chemotherapy or radiation protocols exist. Further studies about case series are needed to establish better therapeutic protocols. Gallbladder carcinosarcoma is a rare cancer with a rapid progression making therapeutic decisions difficult. All these factors contribute to the poor prognosis of this cancer.

Evaluation of Acute and Subacute Toxicity and LC-MS/MS Compositional Alkaloid Determination of the Hydroethanolic Extract of Dysphania ambrosioides (L.) Mosyakin and Clemants Flowers.

Dysphania ambrosioides (L.) Mosyakin and Clemants is a medicinal plant that has traditionally been used to cure a range of diseases. There has been no thorough investigation of the potential toxicity of this plant. The objective of this study is to assess the acute and subacute toxicity of D. ambrosioides hydroethanolic extract (DAHE), as well as it alkaloids composition, utilizing LC-MS/MS analysis. An in silico approach was applied to determine pharmacokinetic parameters and to predict the toxicity of D. ambrosioides identified alkaloids. A 14-day treatment with a single oral dose of 1-7 g/kg was carried out to investigate acute toxicity. DAHE was given orally at dosages of 5, 50, and 500 mg/kg for 15 days in the subacute toxicity investigation, and body weight and biochemical parameters were evaluated. Livers, kidneys, lungs, and heart were examined histologically. Chromatographic investigation revealed the existence of nine alkaloids, with N-formylnorgalanthamine being the most prevalent. The oral LD50 value of DAHE was found to be 5000 mg/kg in an acute toxicity study. No variations were observed with respect to food intake, water consumption, mortality, or body and organ weight in the subacute toxicity study. On the other hand, DAHE (500 mg/kg) significantly enhanced alanineaminotransferase, aspartate aminotransferase, and urea. Liver and kidney histological examinations revealed modest infiltration of hepatocyte trabeculae by inflammatory cells in the liver and slight alteration in the kidney histoarchitecture. According to our findings, DAHE exhibits low to moderate toxicity.

Nasosinusal chondrosarcoma with orbito-cerebral extension.

Chondrosarcoma is a highly aggressive malignant tumor originating from cartilaginous and mesenchymal tissues. The aim of this report is to describe a rare case of nasosinusal chondrosarcoma with orbito-cerebral extension. Our patient was a 55-year-old with a right cheek swelling evolving over a year, with unilateral right nasal obstruction gradually becoming bilateral associated with hyposmia, bilateral exophthalmos, reduced bilateral deep visual acuity and permanent headaches. The clinical examination found a tumor obstructing the two nasal cavities. Imaging showed a lobulated heterogeneous tissue process occupying the paranasal sinuses, with calcifications and enhancement at its periphery, extending to the orbito-cerebral area. The histopathological analysis was in favor of chondrosarcoma. The patient was first treated with an incomplete surgical resection by an endonasal route due to the extension to the orbit and the brain and received adjuvant radiotherapy. Surgical excision is a prognostic factor in this type of sarcomas and reduces recurrence rates.

[Recurrent Darier-Ferrand dermatofibrosarcoma in the abdominal wall: the role of preoperative radiotherapy (case report)]. / Dermatofibrosarcome de Darier et Ferrand récidivant de la paroi abdominale: apport de la radiothérapie pré-opératoire (à propos d'un cas).

Dermatofibrosarcoma is a rare cancer, accounting for 0.01% of all cancers. We here report the case of a 44-year-old female patient presenting with the 5th recurrence of locally advanced Darier-Ferrand dermatofibrosarcoma, that progressed on many cycles of neoadjuvant therapy and required emergency radiotherapy with good response. This allowed to perform wide excision of the tumor with healthy limits. The patient had remission after 1 year of follow-up. Prognosis for patients with Darier-Ferrand dermatofibrosarcoma is generally excellent. Wide surgery and the advent of Mohs surgery have improved local control. The role of radiotherapy is limited for non-resectable tumors or positive margins.

Angiofibroma of the external auditory canal: a rare case with literature review.

Angiofibromas represent <1% of all head and neck tumors and occur primarily in the nasopharynx. Extra-nasopharyngeal angiofibromas are rarer. Remarkably, only a case of external auditory canal location has been reported. We present a case of an angiofibroma in this unique location in a female who presented with fullness of right ear and hypoacusis for 6 months. The clinical examination found a mass in the right external auditory canal attached to the posterosuperior wall. Preoperative audiometry revealed average right conductive hearing loss of 37.5 dB. A computed tomography scan revealed a mass on the right external auditory canal. Surgical resection of the mass was performed and the histopathological assessment confirmed the diagnosis. Post-operative audiometry showed an improvement in hearing function. There was no recurrence after 5 years. The prognosis of these tumors is good after total bloc resection.

Primary adrenal mature teratoma: A rare case report and review of literature.

Introduction: Teratoma is a germ cell tumor, deriving from totipotent cells. Teratomas usually occur in gonads and are rarely extra-gonadal. The adrenal location is exceptional. Only few cases of primary adrenal teratomas have been reported in literature, mainly in young patients. Case report: We report the case of a 56-year-old female patient who presented with pyrosis, dyspepsia and abdominal pain that was evolving for 5 months. The abdominal computed tomography revealed a voluminous mass of the right adrenal gland and the hormonal evaluation was normal. The patient underwent an open transperitoneal adrenalectomy and the histopathological examination of the specimen confirmed the diagnosis of mature teratoma. Discussion: Adrenal teratomas are commonly asymptomatic and their diagnosis depends mostly on radiologic findings. Malignant transformation is very rare. Surgical excision is the mainstay of treatment with a good prognosis. Conclusion: Open surgery should always be considered in large and adhering teratoma tumors of the adrenal gland. Some pathologic features and tumorigenesis of adrenal teratomas are not entirely elucidated, thus the importance of larger studies in order to comprehend this pathological entity.

[Case study focusing on a rare case of squamous cell carcinoma of the tongue: a clear cell variant]. / Un cas rare de carcinome épidermoïde de la langue, variante à cellules claires: à propos d'un cas.

Clear cell squamous cell carcinoma is a poorly known, very rare, and poorly described variant of squamous cell carcinoma, with only 10 cases reported in the literature. It usually occurs in the oral cavity, with predominance of the female sex. We report the case of a 47-year-old man presenting with a rapidly growing budding mass in the base of the tongue. The diagnosis of clear cell squamous cell carcinoma was retained based on histological and immunohistochemical results.

Giant parathyroid carcinoma: Diagnostic, difficulties and therapeutic strategies: A case report.

INTRODUCTION: Parathyroid carcinoma is a very aggressive malignant tumor. It is mostly revealed by clinical primary hyperparathyroidism. CASE PRESENTATION: We report a rare case of parathyroid carcinoma in a 61-year-old-male patient who presented with a painless right-sided cervical tumefaction of hard consistency associated with cervical lymphadenopathy. Cervical ultrasonography showed a right parathyroid mass with intimate contact with the homolateral thyroid lobe. A parathyroidectomy enlarged to the adjacent thyroid parenchyma with a selective neck dissection level VI was performed. CLINICAL DISCUSSION: The clinical presentation is most often manifested with clinical features of primary hyperparathyroidism associating bone disorders. Surgery remains the treatment of choice. The benefit of adjuvant treatments is controversial and remains to be evaluated. CONCLUSION: Parathyroid carcinoma is a rare tumor. This rare entity is often presented with clinicobiological features of severe primary hyperparathyroidism.

[Squamous cell carcinoma of the gallbladder complicating a cystic dilation of the cystic duct and common bile duct: a case report]. / Carcinome épidermoïde de la vésicule biliaire compliquant une dilatation kystique de la voie biliaire principale (VBP) et du canal cystique: à propos d´un cas.

Congenital cystic disease of the biliary tree is a known risk factor for gallbladder cancer. We here report a case of squamous cell carcinoma of the bile duct (BD) complicating a cystic dilatation of the bile ducts in a 54-year-old woman hospitalized for biliary pancreatitis. Abdominal scanner showed nodular thickening of the fundus of the gallbladder and fusiform dilation of the cystic duct and the main bile duct (VBP) with lesion of the tail of the pancreas, initially suggesting mucinous cystadenoma. Extended cholecystectomy involving the gallbladder fossa with resection of the distal biliary tract, choledocoduodenal anastomosis with caudal splenopancreatectomy + drainage were performed. Histopathological examination of the gallbladder mass revealed moderately differentiated invasive squamous cell carcinoma without infiltration of the hepatic parenchyma. The patient underwent adjuvant chemotherapy. The patient did not have the common symptoms of gallbladder cancer. Then radiology was necessary to make a diagnosis. Surgery is the best therapeutic option for early-stage gallbladder cancer, but adjuvant chemo-radiation may also be useful in treating these patients. Cholecystectomy with resection of cystic dilatation of the bile duct in high-risk patients are the most effective means of prevention.

Evaluation of the acute toxicity of the extracts of Anacyclus pyrethrum var. pyrethrum (L.) and Anacyclus pyrethrum var. depressus Maire in Swiss mice.

BACKGROUND AND AIM: Anacyclus pyrethrum (L.) has been used in traditional North African and Indian medicine for the treatment of several diseases such as cancer, rheumatism, epilepsy, diabetes, and Alzheimer's disease. Despite its medical benefits, few studies have examined its toxicity. The present study evaluated the acute toxicity of hydroethanolic extracts of different parts (roots, seeds, leaves, and capitula) of two varieties of A. pyrethrum (L.), namely, A. pyrethrum var. pyrethrum (L) and A. pyrethrum var. depressus (Ball) Maire, in mice. MATERIALS AND METHODS: Acute toxicity was evaluated after the oral administration of different extracts at doses of 300, 500, and 2000 mg/kg. Mortality, body weight, general behavior, and adverse effects were observed daily for 14 days. At the end of the experiment, mice were sacrificed, and biochemical parameters and histopathology of the liver, kidneys, and spleen were analyzed. RESULTS: The extracts of different parts of both plants induced no signs of toxicity or mortality during the observation period, excluding capitulum and seed extracts, which induced slight sedation at a dose of 2000 mg/kg. The LD50 of the extracts was estimated to exceed 2000 mg/kg. The administration of A. pyrethrum var. pyrethrum roots at a dose of 300 mg/kg resulted in significantly increased AST levels. However, the A. pyrethrum var. depressus root extract induced significant increases in the levels of both transaminases (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]). The remaining extracts of both plants at a dose of 500 mg/kg significantly increased AST levels. Moreover, all plant extracts excluding the A. pyrethrum var. pyrethrum capitulum extract at 2000 mg/kg provoked significant increases in AST levels, and A. pyrethrum var. depressus roots provoked a significant increase of ALT levels. Meanwhile, mice treated with high doses of extracts (2000 mg/kg) displayed histopathological changes in the liver, kidneys, and spleen characterized by hepatic distress, inflammatory infiltration, focal tubular necrosis, vascular congestion, and lymphoid hyperplasia. CONCLUSION: The results of the present study indicate that the hydroethanolic extracts of different parts of two varieties of A. pyrethrum (L.) were not toxic in mice at low concentrations, whereas some toxic effects were detected in mice treated at 2000 mg/kg.

A Giant Solitary Adrenal Plasmacytoma in a Patient with HIV: A Rare Case Report and Review of the Literature.

Solitary extramedullary plasmacytoma (EMP) involving the adrenal gland is an extremely rare malignancy. We report a case of a solitary adrenal plasmacytoma in an HIV-positive 50-year-old woman on antiretroviral therapy who presented with a rapidly progressing lumbar left masse. A CT scan objectified a locally advanced left adrenal mass measuring 135mm long axis. A biopsy was taken, and the histopathology with the immunohistochemical study objectified an adrenal gland plasmacytoma. The skeletal survey and the sternal suction biopsy did not show any abnormalities. The diagnosis of a solitary EMP of the adrenal gland was made. There are only 10 cases of solitary adrenal plasmacytoma with only one case associated with an HIV-positive patient reported in the literature. Therefore, this paper is aimed at presenting the second case of an HIV-positive patient diagnosed with solitary adrenal plasmacytoma.

Diagnosis of a 09 cm pheochromocytoma mistaken to be an intramesenteric pancreatic tumor: Case report complying with the scare guidelines.

INTRODUCTION: Pheochromocytoma is an adrenal medullary tumor of the chromaffin cells first described in 1886, remains an entity not fully discovered that case reports keep showing its diversity in clinical presentation, diagnosis methods treatment and follow up challenges. CASE PRESENTATION: We report the case of a 47 year old woman with complaining from abdominal pain and major weightless with a 09 cm tumor of the body of the pancreas viewed in imaging with no hormonal secretion but high levels of chromogranine A open surgery conducted that revealed the tumor to be located between the adrenal medulla and the Aorta misleading the team between an adrenal tumor or a zuckerkandl body tumor. The hemodynamic changes after manipulation of the tumor and the histopathology confirming the diagnosis of pheochromocytoma. Our main surprise was the aspect of the tumor bombing in the peritoneal cavity firstly thought to be mesenteric tumor; and the stability of the patient with no premedication until the tumor had been manipulated, enlarging the hypothesis about catecholamine secretion of these tumor. DISCUSSION: The diagnosis is basically simple when the tumor expresses its catecholamines by biomarkers testing, an imaging. Functional imaging should be used to locate the tumor or its metastasis, the sequence of testing or imaging can vary either it's a symptomatic tumor or an incidentaloma. Preoperative measures should be taken so no major preoperative complications and the main treatment is the tumor complete resection CONCLUSION: The malignancy of the pheochromocytoma is no near to be reliably identified which imposes a lifetime follow up of these patients as for metastasis were described even after 40 years after diagnosis.

Neurofibromatosis type 1 associated multiple and cystic gastrointestinal tumors: 02 case reports.

INTRODUCTION: GIST's are the most common mesenchymal tumor of the gastrointestinal tract, clinically and radiologically heterogeneous, only a histological study can confirm the diagnosis. The link between NF1 and GISTs have been established but not fully elucidated. CASE PRESENTATION: we report 02 cases of NF1 associated GIST, a 60 years old woman with multiples GISTs in the duodenum, proximal jejunum and in the colon presenting an iron deficiency anemia due to chronic bleeding, operated with R0 resection and a low risk of recurrences and a 41 year old male patient with acute abdominal pain with a giant abdominal mass mimicking a hydatid cyst with no relevant medical history, diagnosed at the same time for typical clinical NF1, CT scan showed the cystic mass but did not confirmed its origin, a complete resection of the mass with no capsule fraction was tricky but successful and the histopathology found a high risk of recurrences. The 2 patients received adjuvant imatinib therapy with recurrence free survival at 12 months follow up. Our cases represents a rare entity (multiples GISTs and cystic GIST) within a rarest population (NF1 associated GIST). DISCUSSION: the diagnosis of NF1 is based on typical clinical criterias but the GISTs are known to be the variable, symptomatic or silent, small size or giant. Imaging is based on CT scan with intravenous contrast studying the vascular pattern, the extra intestinal and metastasis localizations. MRI is no superior, but useful in the study of pelvic GISTs and liver metastasis. Histopathology is the only way to confirm the diagnosis with marker staining with CD117 and DOG-1. The emerging imatinib, sunitinib and regorafinib are used as neoadjuvant or adjuvant therapies in GISTs with high or moderate risk of recurrences. No consensual guidelines are yet established for the follow up as the recurrences are more frequent. CONCLUSION: GIST's association to NF1 is established, but the different aspects of the physiopathological, clinical and the treatment haven't been established yet with no larger population to study. We believe that the understanding of the development of this type of tumors within the NF type 1 group would allow a better treatment and follow up and may be can lead to screening.

Malignant transformation of hepatocellular adenoma: report of a case.

Hepatocellular adenomas are benign liver tumours that occur mainly but not exclusively in young women taking contraceptives. Their malignant transformation into hepatocellular carcinoma is a rare complication that has been rarely reported in women taking contraceptives. The purpose of our work is to remind the epidemiological and diagnostic features of malignant transformation of hepatic adenomas by reporting the case of a hepatocellular carcinoma developed from a hepatocellular adenoma diagnosed within the Pathology Department of the Mohammed VI university hospital of Oujda.