[A giant chondroblastic osteosarcoma of the mandible. A case report]. / Ostéosarcome chondroblastique géant de la mandibule. À propos d'un cas.

INTRODUCTION: Osteosarcoma of the craniofacial bones location is less common, usually with low grade of malignancy; it has better prognosis when surgical excision is complete. REPORT CASE: We report a case of a 35-year-old male diagnosed with a low-grade chondroblastic osteosarcoma of the mandible. The patient was treated with surgery alone and recovered with pectoralis major myocutaneous flap. After 48 months, the oncology's and aesthetics results are good. DISCUSSION: We will discuss the treatment of chondroblastic osteosarcoma of the mandible.

[Carcinosarcoma of the skin]. / Carcinosarcome de la peau.

BACKGROUND: Carcinosarcoma of skin is a biphasic tumor composed of intimately admixed malignant epithelial and mesenchymal components. Various terms have been used to designate these tumors (metaplastic carcinoma, pseudosarcoma, spindle cell carcinoma, etc.). However, the histogenetic conception has changed and carcinosarcoma is currently regarded as authentic sarcomatoid carcinoma. CASE REPORT: The authors report the case of a 32-year-old women initially presenting with a budding and ulcerating tumor at the site of an old cutaneous scar on the right leg. Histopathological and immunohistochemical evaluation led to a diagnosis of cutaneous carcinosarcoma. One month after treatment, the patient developed inguinal lymph node metastasis. DISCUSSION: Our case and a review of other cases in the literature confirm the dual epithelial and sarcomatous phenotype of sarcomatoid carcinoma. Progressive transition between the cells of the two components on microscopic analysis and their positive immunostaining for anti-p53 antibody suggest a clonal origin of the tumor. The carcinomatous component seems to influence the course of the disease with the development of metastases, particularly at the lymph nodes. It thus seems advisable to combine lymphadenectomy with surgical tumor excision.

[Uterine carcinosarcoma in a teenager: report of a case macroscopically mimicking rhabdomyosarcoma]. / Le cas clinique du mois. Carcinosarcome utérin chez une adolescente: a propos d'un cas simulant macroscopiquement un rhabdomyosarcome.

Uterine carcinosarcoma (malignant mixed mullerian tumor) is uncommon. We report the case of a 17-year-old patient who complained of pelvic pain and abnormal genital bleeding, and had a voluminous hemorrhagic tumor protruding through the vaginal os. Hysterectomy was performed. The histopathologic and immunohistochemical evaluation led to the diagnosis of uterine carcinosarcoma. Adjuvant chemotherapy was given. In spite of the surgical treatment, the evolution was fatal with widespread metastases. From data of the literature, we discuss the diagnosis, histogenesis and treatment of this rare tumor.

[Giant pelvic epidermoid cyst: a rare observation]. / Le kyste épidermique géant pelvien: une observation rare.

Epidermoid cyst is a frequent benign tumor. It gives rise to destruction of adjoining tissues, chiefly in the skull. The pelvic epidermoid cyst is rare. We report the second case of giant pelvic epidermoid cyst with a 25-year-old girl. Ultrasound exploration and computed tomography evoked an ovarian origin. The surgery discovers an epidermoid cyst under the peritoneum. Ovaries and uterus were undamaged. We realized an evacuation of cyst, which contained lamellas of keratin. Histology allowed confirmation of diagnosis. The patient is always observed after 18 months.

[Toxoplasma gondii: level of carriage in sheep of Marrakech region (Mnabha)]. / Toxoplasma gondii: taux de portage chez les ovins de la région de Marrakech (Mnabha).

Toxoplasma gondii is an ubiquitous parasite with a prevalence variable from country to country. In Morocco very few studies were devoted to this prevalence. To fill this gap we were interested to study the epidemiology of this parasite and to know the level of carriage by the different vectors which are the sources of contamination in humans. The study was done by directly detecting the cysts in the cerebral tissue of the 50 sheep killed and destined for consumption. The results of this preliminary study show that 30% of the cases carry the cysts of T. gondii. To confirm this result and verify the virulence, cerebral specimens were inoculated into mice. These findings are encouraging to complete this study with serological tests and to look for the parasite in cows and goats of this region.

[Accuracy of intraoperative diagnosis in central nervous system tumors: report of 1315 cases]. / Place de l'examen extemporané dans les tumeurs du système nerveux central. A propos de 1315 observations.

Clinicians order neurosurgery frozen sections in order to answer three questions: is the specimen tumor tissue? is it benign or malignant? what is its histological type? We studied the diagnostic accuracy of 1 315 frozen sections of central nervous system tumors, performed between 1988 and 1999, and compared it with data in the literature. Agreement between intraoperative and paraffin-section diagnosis was 96.6% (rate of error: 3.4% for the question tumor tissue or not). The answer was concordant in 92.6% with a 7.4% rate of error for tumor malignancy or benignity. Exact histological concordance was 87.6%. The most frequent errors in histological typing concerned gliomas, hemangioblastomas and metastasis. Our results emphazise the reliability of intraoperative frozen sections in Neurosurgery and the importance of close collaboration between clinicians, radiologists and pathologists.

[Pelvic actinomycosis simulating adnexal malignant tumor]. / Actinomycose pelvienne simulant une tumeur maligne annexielle.

The purpose of this report is to describe the case of a 35-year-old patient admitted to the National Oncology Institute in Rabat, Morocco for pelvic pain and deteriorating general status ongoing for 8 months. Clinical and ultrasonographic examination showed a heterogenous mass measuring 7 cm in maximum width located inferior and lateral to the inferior aspect of the right side of the uterus. These findings were suggestive of a malignant tumor of the right ovary. Ovariectomy and omentectomy were performed. Histological examination of surgical specimens demonstrated right tubo-ovarian actinomycosis associated with peritonitis. Genital tract actinomycosis is an uncommon finding in women of childbearing age. It is due to colonization by a pyogenic bacteria (Actinomyces) usually secondary to a gastrointestinal infection, e.g. ileocecum, and sometimes in association with the presence of an intrauterine device or foreign body. Based on this case report, the authors discuss abdominopelvic actinomyocosis with emphasis on tumor-like findings that can lead to misdiagnosis by clinicians and radiologists.

[Pleuropulmonary blastoma: possible interest of neoadjuvant chemotherapy. A case report]. / Blastome pleuropulmonaire: intérêt possible d'une chimiothérapie néoadjuvante. A propos d'un cas.

Pleuropulmonary blastoma is a very exceptional anatomoclinical and histological entity recently distinguished from adult pneumoblastoma. This tumor, observed in children aged less than 15, can involve the lung, the pleura, or the mediastinum and is characterized by a very poor prognosis. We report the case of a 4-year-old girl who developed pleuropulmonary blastoma which was discovered in a context of respiratory distress. Standard chest x-ray revealed an opacity covering the entire left lung. Histology and immunohistology led to the diagnosis of pleuropulmonary blastoma with several components: blastematous, malignant mesenchymatous with pluridirectional differentiation, and benign epithelial tissue. Treatment consisted in preoperative chemotherapy and radiotherapy to reduce tumor volume. This neoadjuvant treatment is not widely reported and its relatively favorable result allowed tumor resection. This approach might be useful in similar cases.

[Vascular epulis or lobular capillary hemangioma]. / L'épulis vasculaire ou l'hémangiome capillaire lobulaire.

Vascular epulide or Lobular capillary hemangioma is a form of epulide which is marked by an inflammatory infiltrate rich of blood vessels. Angiogenic factors seem to be responsible of the important vascular proliferation. Therapeutic implications include cautions toward hemorrhagic risk. Complete ablation is also required to avoid the risk of high recurrence.