A challenging diagnosis and treatment of embryonal rhabdomyosarcoma in the cervix of an adult woman: A surgical case report.

INTRODUCTION AND IMPORTANCE: Embryonal Rhabdomyosarcoma is a rare form of sarcoma mainly seen in children and adolescents. In the specific case of the cervix, embryonal Rhabdomyosarcoma is an extremely rare mesenchymal tumor, accounting for <1 % of all cervical cancers. This highly malignant tumor mainly affects adolescents and young adults. CASE PRESENTATION: We describe the case of a 29-year-old woman with embryonal rhabdomyosarcoma of the cervix, which manifested as an exophytic cervical mass. Histopathological and immunohistochemical findings confirmed the presence of embryonal rhabdomyosarcoma of the cervix. This patient was successfully treated with a combination of neoadjuvant chemoradiotherapy, total abdominal hysterectomy with bilateral ovary transposition, and adjuvant chemoradiotherapy. CLINICAL DISCUSSION: Embryonal Rhabdomyosarcoma of the cervix may manifest by vaginal bleeding, a cervical mass and pelvic symptoms. The diagnosis is confirmed by histopathology and immunohistochemistry. With multimodal treatment including surgery, chemotherapy and radiotherapy, outcomes improve for patients. CONCLUSIONS: Uterine cervix embryonal RMS is an uncommon cancer in adult patients. While rare, it should be considered as a potential diagnosis in patients presenting with vaginal bleeding and a significant cervical polyp. Histopathology, complemented by relevant immunohistochemistry, is crucial for accurately detecting the tumor and guiding appropriate management strategies.

Idiopathic granulomatous mastitis: A challenging case report and comprehensive review of the literature.

INTRODUCTION AND IMPORTANCE: Idiopathic granulomatous mastitis is an uncommon, long-lasting inflammatory condition of the female breast. It is characterized by the development of a painful breast mass that gradually increases in size. This condition is benign and its cause is unknown. It primarily affects women of childbearing age who have a history of pregnancy and breastfeeding. The main feature of idiopathic granulomatous mastitis is the presence of chronic inflammation in the breast. CASE PRESENTATION: We report a 36-year-old woman with a history of pregnancy and breastfeeding presented with pain and swelling of the right breast. Physical examination revealed a mass with redness and retraction of the nipple. Imaging revealed localized density and hypoechoic areas with collection, suggesting granulomatous mastitis. A biopsy confirmed the diagnosis. The abscess was drained through a small incision performed under local anesthesia. Treatment with corticosteroids resulted in significant improvement, with complete resolution after one month. CLINICAL DISCUSSION: A comprehensive evaluation of potential causes is necessary to confirm the diagnosis of idiopathic granulomatous mastitis. Histologically, it is distinguished by the predominant presence of neutrophils and the absence of caseous necrosis. Treatment remains controversial, with recent literature supporting the efficacy of conservative management with steroid and immunosuppressive therapy, leaving surgical excision for complicated and refractory cases. CONCLUSIONS: Idiopathic granulomatous mastitis is an uncommon breast condition where the exact causes and recommended treatment approaches are not well-defined. It is important to consider this condition in women who are in their reproductive years.

Abortifacient power of potassium permanganate rebirth of an archaic myth: Case report.

INTRODUCTION AND IMPORTANCE: Potassium permanganate has been historically used as an abortifacient, but it is now considered an outdated practice. Despite the lack of scientific evidence supporting its effectiveness as an abortifacient, some communities still hold misguided beliefs about its abortifacient properties. CASE PRESENTATION: We report a case of a 38-year-old multiparous North African woman. Who experienced excessive vaginal bleeding after using potassium permanganate as an abortifacient. The examination revealed carbonized ulcerated lesions on the vaginal walls and cervix. Once the patient was stabilized, the medical team performed sutures on the vaginal lesions and inserted an intravaginal tampon to arrest the bleeding. The patient was discharged after 72 h. CLINICAL DISCUSSION: In the last century, potassium permanganate was utilized as a method of abortion, but this practice has gradually fallen out of use. Regrettably, due to misinformation and a lack of comprehensive documentation, certain underdeveloped regions persist in employing this unsafe approach. The aim of this report is to inform obstetricians about the harmful effects of potassium permanganate, and the injuries it can cause. Given the scarcity and age of published reports on the subject, this document highlights the crucial importance of proper management to prevent these practices and ensure the safety of the women concerned. CONCLUSIONS: The use of potassium permanganate in abortion presents serious risks, and despite its outdated nature, false beliefs about its abortifacient properties persist. Raising awareness among healthcare professionals and the general public is crucial in preventing the harmful effects of these erroneous beliefs.

Primary clear cell adenocarcinoma of the vagina not associated with diethylstilbestrol metastasizing to the lung: a case report.

Primary clear cell carcinoma of the vagina (PCCAV) is a rare form of vaginal cancer that typically affects young women with a history of prenatal exposure to DES. However, data on non-DES PCCAV cases are limited. This report describes a case of PCCAV in a 47-year-old patient who presented with post-coital bleeding and was diagnosed with clear cell adenocarcinoma via biopsy and MRI. The patient had no history of DES exposure and further testing showed no signs of metastasis, leading to surgery and chemotherapy. Four years later, the patient presented with dyspnea, and a chest CT scan revealed a lung nodule, later confirmed to be a metastasis of clear cell adenocarcinoma from the vaginal cancer. The patient passed away a month later due to complications from COVID-19.

Giant ovarian serous cyst and postmenopausal adnexal torsion: An unusual case report and literature review.

INTRODUCTION AND IMPORTANCE: Adnexal torsion is an uncommon but urgent surgical situation more frequently observed during the reproductive years and rarely in postmenopausal women. CASE PRESENTATION: This case report describes a postmenopausal woman with a large left ovarian cyst measuring 18 × 20 × 22 cm who experienced adnexal torsion, which is a rare occurrence in this age group. To avoid the potential requirement for additional surgical procedures in case of cyst recurrence in the remaining ovary or the development of uterine diseases a total abdominal hysterectomy and bilateral salpingo-oophorectomy with cystectomy were performed. Histopathological analysis of the cyst confirmed that it was a benign serous cystadenoma of the ovary. CLINICAL DISCUSSION: Adnexal torsion can happen at any age but is less likely to occur after menopause. Moreover, giant ovarian cysts (>10 cm) are uncommon, making adnexal torsion on these cysts a rare event. While laparotomy remains the gold standard surgical intervention, laparoscopy is beginning to play a role in management of giant cyst. CONCLUSIONS: This report documenting a rare case of adnexal torsion in a postmenopausal woman following a serous giant cystadenoma emphasizes that this surgical emergency can occur at any age. In addition, the report highlights that the presence of an ovarian mass or cyst increases the risk of adnexal torsion, regardless of age.

Spontaneous successful term delivery in a unicornuate uterus: A case report and literature review.

INTRODUCTION AND IMPORTANCE: Malformations of the uterus are generally rare and are due to defective fusion of Mullerian duct. These include the unicorn uterus, with or without a rudimentary horn. Pregnancy in a unicornuate uterus is a rare event and carries with it maternal-fetal risks. CASE PRESENTATION: In this report, we present an exceptional case of a pregnancy reaching full term in a unicornuate uterus without an accessory horn, which was serendipitously discovered during an emergency cesarean section. Intraoperatively, the uterus exhibited a distinct cylindrical shape with a flattened left wall, with the absence of both the left fallopian tube and left ovary. No additional abnormalities within the abdominopelvic cavity were noted. Notably, the postoperative recovery was uneventful for both the mother and newborn, without any notable complications. CLINICAL DISCUSSION: The presence of a unicornuate uterus is associated with adverse obstetric outcomes, including recurrent miscarriage, premature delivery, fetal malposition, intrauterine growth retardation, and uterine rupture. In addition, around 40 % of women with this malformation may experience infertility. Although the efficacy of preconception or early interventions, such as rudimentary uterine horn resection and prophylactic cervical cerclage has not been fully established in improving obstetric outcomes, their usefulness is suggested by current medical practice. CONCLUSION: Women with a unicornuate uterus are known to be at increased risk of obstetrical complications, such as spontaneous abortion, premature delivery, post-partum hemorrhage, abnormal fetal presentation and cesarean delivery. It is important to consider women with this anomaly as being at high obstetrical risk.

Breast metastasis 18 years after nephrectomy for renal cell carcinoma: a case report.

Metastasis of renal clear cell carcinoma (RCC) to the breast is exceptional. Breast metastases of extra-mammary tumors are rare and usually involve melanoma, lymphoma or leukemia. We report the case of a patient with breast metastasis of renal clear cell carcinoma occurring 18 years after nephrectomy. A history of RCC should always raise suspicion about breast metastasis, a situation that remains exceptional and whose diagnosis relies on anatomopathology.

[Huge ovarian tumor in a perimenopausal woman: a case report]. / Masse géante de l'ovaire en périménopause: à propos d'un cas.

Huge ovarian tumor is usually diagnosed at an advanced stage, in particular in developing countries. It can cause surgical complications. Anatomopathological examination is essential to establish the diagnosis. The role of tumor marker CA125 in a perimenopausal woman with pelvic mass has been widely debated.