Tumeur myofibroblastique inflammatoire de la vessie.

La tumeur myofibroblastique inflammatoire est une lésion classée par l'OMS parmi les néoplasies intermédiaires. Elle peut siéger dans différents organes : les poumons, le pancréas, le mésentère et l'utérus. La localisation vésicale est rare.Nous rapportons le cas d'un jeune homme de 38 ans qui a consulté pour hématurie. L'échographie a révélé la présence d'une structure tissulaire intravésicale de 3 cm de grand axe. L'examen anatomopathologique et l'étude immunohistochimique ont conclu à une tumeur myofibroblastique inflammatoire de la vessie. À partir de cette observation, nous présentons les diagnostics différentiels et les particularités anatomopathologiques de cette localisation rare.Myofibroblastic inflammatory tumor is considered as an intermediate neoplasm according to the WHO classification. It can occur in different organs: lung, pancreas, mesentery and uterus. The localization in the bladder is unusual. We report a case of a 38-year-old patient who presented with hematuria. Echography showed a 3 cm tissular structure of the bladder. Histological analysis and immunohistochemistry concluded to the diagnosis of myofibroblastic tumor of the bladder. The present work will give a general view of the myofibroblastic tumor, and will review its differential diagnosis.

Bilateral proliferating Brenner tumor of the ovary associated with recurrent urothelial carcinoma of the urinary bladder.

CONTEXT: Brenner tumors of ovary are relatively uncommon neoplasm. Most of them are benign and less than 5% are proliferating or borderline. The association between Brenner tumor of the ovary and papillary urothelial carcinoma of bladder is extremely rare. CASE REPORT: We describe an unusual case of proliferating bilateral Brenner tumor of the ovary with a highly recurrent low-grade papillary urothelial carcinoma of bladder. CONCLUSION: The immunohistopathological similarities of ovarian and bladder tumors and their association in the current case, may be coincidental but may reflect a common initiating event inducing similar pathogenesis changes in the epithelium of both organs. More cases are needed to be reported to better understand this association.

Squamous cell carcinoma arising from an epidermal inclusion cyst: A case report.

CONTEXT: Cutaneous epidermal cysts are common lesions, but fortunately, malignant transformation of their epithelium is rare. There are few case reports in the literature concerning malignant transformation of an epidermal cyst into squamous cell carcinoma. We present a case of squamous cell carcinoma arising from an epidermal inclusion cyst and describe the clinical and histopathologic findings. CASE REPORT: A tumour measuring 1.5cm was surgically excised. Based on the histopathologic findings of the tumour, this case was diagnosed as squamous cell carcinoma that arises in an epidermal cyst. Malignant change had not been suspected until histological examination revealed it. Nine months after tumour resection, the patient is free of disease. CONCLUSION: malignant transformation of an epidermal inclusion cyst is rare; this case illustrates the importance of routine histology in excision of epidermal cysts.

Extra ocular sebaceous carcinoma of the thigh: A case report.

CONTEXT: Sebaceous cell carcinoma is a malignant neoplasm, rarely recognized in extra ocular sites. His prognosis depends of the precocity of the diagnosis. This neoplasm is aggressive in 29%; lymph node and visceral metastasis aren't rare. CASE REPORT: An 80-year-old male had an ulcerated and infected nodule located on the left thigh. The lesion appeared after five months ago. It suspected a squamous cell carcinoma. The histologic findings revealed an extra ocular sebaceous carcinoma. The patient died one month later due to heart insufficiency. CONCLUSION: extra ocular sebaceous carcinoma is a rare neoplasm. It has more difficulties of diagnosis because it has diverse clinical presentations as well as a variety of histologic patterns. We will discuss the incidence, clinical, histological and the prognosis of this aggressive neoplasm.

Mucinous carcinoma with axillary lymph node metastasis in a male breast: A case report.

CONTEXT: Pure mucinous carcinoma of the male breast is an extremely rare neoplasm. It is characterized by a lower incidence of metastatic nodal involvement and a higher survival rate than invasive ductal carcinomas. CASE REPORT: We report the case of a 75-year-old male who presented with a retroareolar mass of the right breast. The patient underwent radical mastectomy including right axillary lymph node dissection. The tumor was well demarcated and had a friable consistency with a gelatinous appearance. Histologically, the diagnostic of pure mucinous carcinoma with lymph node metastasis was performed. After surgery, the patient received chemotherapy, radiotherapy, and hormonotherapy (Tamoxifen). The patient remained free of disease for 36 months after surgery. CONCLUSION: Pure mucinous carcinoma of the male breast is a very rare tumor; in which axillary nodal disease is exceptional.

Synovial Sarcoma: A Clinicopathological and Radiological Study of 12 Cases Seen Over 18 Years.

BACKGROUND: Synovial sarcoma is a rare malignant soft tissue tumor characterized by a poor outcome. We report herein our experience concerning synovial sarcoma and review its diagnosis, histology, treatment and prognosis. METHODS: This is a retrospective review, from 1990 to 2007, of cases of synovial sarcoma diagnosed at the Department of Pathology, Farhat Hached hospital, Sousse, Tunisia. The clinical, radiological and pathological features as well as treatment modalities and patient's outcome were recorded. RESULTS: From 1990 to 2007, 12 cases of synovial sarcoma have been diagnosed in our department. Patients' mean age at the time of diagnosis was 21 years. There was no sex predominance and the lower extremity was the most commonly involved. A painful tumefaction was the most common presenting symptom. The duration of symptoms ranged from 6 months to 6 years. Malignancy was suspected on radiological findings in only 2 cases. Ten patients underwent surgery, in association with adjuvant chemotherapy in 4 cases, one of whom underwent post-operative radiotherapy. Histological subtypes included monophasic synovial sarcoma in 8 cases, biphasic synovial sarcoma in 3 cases and poorly differentiated synovial sarcoma in one case. At the time of analysis, 6 patients were dead with an average follow-up of 18 months. CONCLUSIONS: Synovial sarcoma is a rare malignancy with a propensity for young adults and a poor prognosis. Its symptomatology is non-specific and it is characterized by histopathological diversity. Diagnosis can be suggested by radiology and definitive diagnosis is achieved after pathological analysis.

In Situ and Invasive Ductal Carcinoma Within a Borderline Phyllodes Tumor.

A rare case of a borderline phyllodes tumor with simultaneous intraductal and infiltrating duct carcinoma is reported. The patient was a 52-year-old woman with a breast tumor detected by physical examination. A simple mastectomy was performed. The excised tumor had a macroscopic appearance of a phyllodes tumor. After histological examination, the diagnosis of ductal carcinoma within a borderline phyllodes tumor was made. Immunohistochemical staining revealed that the epithelial component was positive for Epithelial Membrane Antigen and cytokeratin. No metastasis was detected in the axillary lymph nodes and the patient didn't receive any adjuvant therapy. No recurrence or metastasis has been observed 38 months after the surgery.

Synchronous Bilateral Benign Phyllodes Tumor of the Breast in a 32-year-old Woman.

Bilateral phyllodes tumors are distinctly uncommon. As some previous reports have described, most of them are malignant and asynchronous. We report a new case of bilateral synchronous phyllodes tumor in a 32-year-old women. Both tumors were classified as benign after large bilateral excision. No tumor recurrence was noted during the 10 months follow-up.

Primary Subcutaneous Ewing Sarcoma Presented as Pseudo Aneurysmal Subcutaneous Tumor.

BACKGROUND: Extraskeletal Ewing's sarcoma is a rare malignant tumor of mesenchymal origin, which is histologically similar to primary osseous Ewing's sarcoma. It has been well described in deep soft tissues. However, location in cutaneous or subcutaneous tissue has rarely been reported. Being seen principally in children, it can be seen, rarely, in old men. CASE REPORT: We present a case of subcutaneous Ewing sarcoma within the left shoulder of a 49-year-old man, without osseous involvement. Physical examination suggested a vascular tumor. Histologically, it was a small round cell tumor that marked strongly for CD99. The diagnosis of subcutaneous Ewing sarcoma was performed. CONCLUSION: Ewing sarcoma is a rare malignant small round cell tumor of the skin and subcutaneous tissue. It should be differentiated from other cutaneous neoplasms composed of small round cells.

Lymphoepithelial Carcinoma of the Nasal Cavity With EBV Infection in a North African Man.

We report the case of a 58-year-old Tunisian man who presented with a 2 months' history of left nasal obstruction and one episode of epistaxis. Nasal endoscopy revealed a polypoid mass of the left nasal septum. Magnetic resonance imaging showed a left nasal cavity tumor with erosion of the orbit. Diagnosis of nasal cavity lymphoepithelial carcinoma EBV positive was performed on biopsy. The patient was treated by chemotherapy and radiotherapy. No tumor recurrence has been reported with a follow-up of 12 months.

Primary lymphoepithelial carcinoma of the parotid gland in a North African woman.

Lymphoepithelial carcinoma of the salivary glands is a rare neoplasm that is characterized by a non-neoplastic lymphocytic infiltration associated with an epithelial proliferation. It involves mainly the parotid gland. Racial and geographical factors contribute to the pathogenesis of this tumor. We report a case of a 70-year old woman from a non-endemic area who presented with several months history of swelling in the parotid region. Magnetic resonance imaging showed a parotid mass suggestive of a pleomorphic adenoma. The diagnosis of lymphoepithelial carcinoma of the parotid gland was performed on the surgical specimen. A primitive nasopharyngeal carcinoma was ruled out by random biopsies of the nasopharynx mucosa. The Epstein-Barr virus (EBV) was absent in neoplastic cells. We insist that, even in non-endemic areas and when clinical and radiological characteristics are not suggestive of malignancy, intra-operative frozen section analysis should be used in order to ensure the appropriate treatment.

Solitary fibrous tumor with giant multinucleated cells in the retroperitoneum - a case report.

CONTEXT: Solitary fibrous tumor is a distinct neoplasm, rarely recognized in extrathoracic sites. CASE REPORT: The article reports a new case in the retroperitoneum in a 55 year-old man, who presented with urinary symptoms. Tumor was completely excised, and the solitary fibrous tumor was diagnosed after pathologic examination and immunohistochemistry. The patient has remained free of disease for five years since surgery. CONCLUSION: An uncommon variant of retroperitoneal solitary fibrous tumor with giant multinucleated cells was documented in the study.

Giant cell tumor of soft tissue of neck: a case report.

CONTEXT: Giant cell tumor of soft tissue is a rare primary soft tissue tumor with low malignant potential. It is clinically and pathologically similar to the giant cell tumor of the bone. CASE REPORT: We report a case of a 28-year-old man complaining of a painless solitary nodule arising in the spinal muscle of the neck. Computed tomography suggested a neurogenic tumor, but the diagnosis of giant cell tumor was confirmed after detailed pathological examination. The patient remains disease free five months after diagnosis. CONCLUSION: It is important to recognize this pathological entity in order to avoid misdiagnosis with other fibrous tumors associated with giant cells.

Gastrointestinal stromal tumor of the pancreas: A case report and review of the literature.

CONTEXT: Primary stromal tumors of the pancreas are extremely rare. Only four cases have been reported in the literature. We describe a new case and analyze, through a review of the literature, the clinical and pathological data, and the outcome of the previously reported cases. CASE REPORT: We report the case of a 52-year-old-woman who presented with epigastric pain. Preoperatively, abdominal pelvic computed tomography revealed a pancreatic head mass. The surgery confirmed the presence of a large tumor of the pancreatic head. Pathologic results revealed a malignant gastrointestinal stromal tumor of the pancreatic head, completely removed. There is no recurrence or metastases 10 months after surgery. CONCLUSION: The current case consolidates the possibility that this rare tumor can involve the pancreas as a primary site and that GIST of primary pancreatic localization are usually of high risk of malignancy.