Hepatic epithelioid hemangioendothelioma simulating liver metastasis: A case report.

INTRODUCTION: Hepatic epithelioid hemangioendothelioma (HEHE) is a rare tumor of vascular origin. Liver involvement is often multinodular simulating metastases. Herein, we report a rare case of HEHE mimicking liver metastases in a female patient. CASE PRESENTATION: A 43-years-old female patient, presented with complaints of pain in the right upper quadrant. Laboratory tests were all within the normal range. Abdominal ultrasound revealed multiple heterogeneous hypoechoic liver lesions. A thoracic and abdominopelvic computed tomography showed bilateral pulmonary micronodules with multiple hypodense hepatic nodules involving both lobes. Percutaneous ultrasound-guided biopsy with pathological study and immunohistochemistry staining revealed the diagnosis of hepatic epithelioid hemangioendothelioma. DISCUSSION: HEHE usually involves both liver lobes with three radiological presentations: single nodular, multiple nodular, or diffuse types, the diffuse type reflects an advanced stage. 3/4 of the cases are initially misdiagnosed as liver metastases or primary liver tumors. The pathological study with the immunochemistry stainings confirms the diagnosis. There is no standard treatment for HEHE due to its rarity and lack of prospective randomized studies. CONCLUSION: HEHE is a rare tumor of vascular origin of unknown etiology with malignant potential and unpredictable course. The therapeutic management of this rare condition is not codified and is discussed on a case-by-case basis. Surgical treatment remains the best option with an excellent outcome.

Imaging appearance of isolated diffuse neurofibroma of nipple areolar area: a case report.

Sporadic neurofibromas of the nipple-areolar complexes are exceptional even in patients with neurofibromatosis. Diffuse neurofibroma is an uncommon subtype of neurofibroma that has received little attention in the imaging literature. As are most superficial lesions, it is often evaluated clinically and if biopsy is needed, it is usually performed without imaging. However the imaging data is quite characteristic with the aim of evaluating the extension in depth and detecting an underlying cancer. We report a case of women without a history of neurofibromatosis presenting a skin thickening disfiguring her left breast, related to diffuse neurofibroma of the nipple-areolar complexes confirmed histologically. We study echo-mammography and breast magnetic resonance imaging (MRI) findings in order to highlight its radiographics features.

Diffuse Capillary Spleen Hemangiomatosis: A Rare Cause of Hepatic Dysmorphia.

Spleen hemangiomatosis is the most common type of benign vascular tumor, and it is usually associated with other visceral localizations such as the liver, lymph nodes, skin, and bone marrow. The diffuse form of this condition is defined by the number of locations in one organ. We report the case of a 48-year-old female who sought consultation for left hypochondrium chronic pain. Physical examination subsequently revealed splenomegaly. Imaging showed a diffuse capillary spleen hemangiomatosis, hepatic dysmorphia, and several signs of portal hypertension.

[Carotid bulbe diaphragm]. / Diaphragme du bulbe carotidien.

Objets de santé et dispositifs médicaux connectés.L'expansion des objets connectés impose de distinguer ceux qui modifient la prise en charge d'un malade, à finalité médicale et ceux destinés à améliorer son bien-être. Les dispositifs connectés ayant une finalité médicale doivent obtenir un marquage CE pour évaluer la fiabilité technique de l'objet physique et du logiciel associé mais aussi pour garantir le contrôle de l'hébergement des données. Ceux qui démontrent une amélioration indivi¬duelle ou collective du diagnostic ou du traitement d'une maladie peuvent être pris en charge par la collectivité. Ce soutien financier représente en France le principal outil pour limiter la fracture numérique.

Giant Gallbladder Revealed by Chronic Cholecystitis Gallstone: A Case Report and Review of the Literature.

We report here an extremely rare case of giant gallbladder and discuss diagnostic circumstances and different ethiopathogenic theories. A 53-year-old woman presented acute right hypochondrium pain. Ultrasonography showed a huge cystic mass with gallstones and a CT scan confirmed the diagnosis of giant gallbladder. Cholecystectomy was performed. Outcomes were uneventful and histopathological examination of the specimen confirmed the presence of chronic cholecystitis. Enlargement of the gallbladder is related to biliary retention. This enlargement is favored by the slow evolution of malignant pathologies. However, some benign situations have been reported in the literature, and giant gallbladder can occur in a benign situation even if its ethiopathogeny is not so clear.

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.

Liver injury secondary to chest tube placement: a case report of conservative management and review of literature.

Chest tube placement is a routine procedure performed in different medical departments. Liver injury is a very rare complication that can occur but can be life-threatening. Conservative management can be proposed in stable patient. Following guidelines and training physicians should decrease the incidence of such complications.