Chromophobe renal cell carcinoma: A case report and literature review.

INTRODUCTION: Chromophobe renal cell carcinoma, a distinct subtype of renal cell carcinoma (RCC) with characteristic light microscopic, histochemical, and ultrastructural features, typically has a favorable clinical course. PRESENTATION OF CASE: A 45-year-old femele presented with abdominal pain. A physical examination found a palpable mass in the left upper quadrant of the abdomen. A CT scan of the abdomen showed a heterogeneously enhancing mass, with necrosis and calcifications contents betwen the liver and the right kidney. she underwent surgical resection. Partial nephrectomy was performed. Pathological diagnosis was Chromophobe renal cell carcinoma. DISCUSSION AND CONCLUSION: Chromophobe RCC is a rare variety of kidney neoplasm that has recently been better characterized from a molecular and genetic perspective. Overall, it is considered to have a better prognosis, and is associated with earlier stage tumors and longer overall survival compared with clear cell RCC.

Spontaneous splenic rupture: A rare complication of acute myeloid leukemia. Report of a case.

INTRODUCTION: Spontaneous rupture of the spleen (SPR) is a rare and severe affection, difficult to diagnose, with multiple causes such as: Infectious and hematologic affections which represent more than half of the cases. Among this subset of patients, acute myeloid leukemia is one of the causes. PRESENTATION OF CASE: A 48-year-old man undergoing chemotherapy for acute myeloid leukemia presented with acute intense abdominal pain. Computed tomography showed Abdominal CT scan showed a splenic rupture with abundant hemoperitoneum and bilateral pleural effusion. The patient presented hemodynamic instability and was immediately operated, splenectomy were performed. DISCUSSION: Spontaneous rupture of the spleen usually presents as a severe abdominal syndrome, which may accompany non-specific symptoms.Two signs are suggestive of splenic rupture: Kehr's sign (left diaphragmatic irritation resulting in referred pain to the left shoulder) and Balance's sign (palpable tender mass in the left upper quadrant. Diagnostic methods of choice are computed tomography andultrasound. The prognosis is depending on the quality of care and the nature of the etiology. Splenectomy remains the cornerstone of the treatment of splenic rupture. It is important to include splenic rupture as a differential diagnosis for acute abdominal pain, especially in patients with hematologic malignancy, since early recognition and treatment increase patient survival and improve the prognosis. CONCLUSION: Even if spontaneous splenic rupture is rare, every clinician should have in mind the reflex to think of it, especially in patients with hematologic malignancies.

Retrorectal cystic hamartoma: A case report.

INTRODUCTION: and importance: Retrorectal cystic hamartoma (RCH) is a rare congenital lesion of the presacral space, which is part of the vestigial cystic tumors often benign and predominantly in women. Generally asymptomatic, the appearance of symptoms such as pain or neurological disorders should raise suspicion of degeneration. CASE PRESENTATION: We report an unusual observation of a 62-year-old patient admitted for perineal pain evolving for 2 months associated with tenesma and chronic constipation. The digital rectal examination found a posterior bulge at 4 cm from the anal margin, without intraluminal lesion. Rectosigmoidoscopy had noted posterior extrinsic compression but no rectal tumor. Pelvic CT and MRI had shown a solidocystic formation of the retro-rectal and presacral spaces, related to an enteric cyst. The operation was performed by abdominal approach and the surgical exploration had found a bilobed cystic formation. The cystic mass was removed and the anatomopathological examination concluded that it was a cystic hamartoma with no sign of malignancy. CLINICAL DISCUSSION: Retrorectal tumors develop in the space bounded anteriorly by the propria fascia of the rectum and posteriorly by the presacral fascia overlying the sacrum. Common in children and then often malignant, inversely, in adults, they are rare and most often benign tumors. They are generally asymptomatic with a predominance of females, unlike our observation where the patient was male with a symptomatology dominated by perineal pain and constipation. The discovery is incidental in the majority of cases, however, in some cases, these cysts may be revealed by complications. The lesion can be explored by transrectal or suprapubic ultrasound, MRI and CT scan. Rectoscopy and fistulography may complete the exploration in case of diagnostic doubt. The resection must be thorough and in monobloc because of the risk of recurrence and the approach depends on the location and the size of the lesion. CONCLUSION: RCH is a rare benign lesion whose morphological characteristics seem quite stereotyped. A detailed postoperative anatomopathological examination allows the diagnosis to be made and, above all, to look for a site of malignant transformation. This is why a complete surgical removal is necessary to prevent recurrence.

Non-functional retroperitoneal paraganglioma: A report of case with literature review.

INTRODUCTION: Retroperitoneal paragangliomas are rare tumors, they arise from ganglia along the sympathetic and parasympathetic chain. We report a rare case of a non functional paraganglioma in whom surgical resection was performed. PRESENTATION OF CASE: A 35 years-old female presented with chronic abdominal pain, A contrast magnetic resonance imaging (MRI) of abdomen showed a well-defined Left latero-aortic cystic retro-peritoneal surgical resection using laparotomy was performed, The patiente recovered well and was discharged three days after surgery. Histological examination and immunohistochemical revealed a retroperitoneal paraganglioma. DISCUSSION AND CONCLUSION: Non-functioning retroperitoneal paragangliomas are rare and are most often Isolated. Radiological techniques including, Contrast-enhanced computed tomography (CT) and Magnetic resonance imaging (MRI) are useful for identifying and locating retroperitoneal paragangliomas. surgical excision is still the most effective treatment when it possible.

A gastrointestinal stromal tumor of stomach presenting with an intratumoral abscess: A case report.

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal tract, GISTs of the stomach presenting as an intratumoral abscess are extremely rare, which necessitates emergency surgery, we report a case of a stomach GIST developing an intratumoral abscess, in whom emergency surgery was performed. PRESENTATION OF CASE: A 68-year-old man presented with severe abdominal pain and a fever. Laboratory data showed an elevated white blood cell count and C-reactive protein level. Computed to mography scan showed a 15 × 10 cm cystic mass adjacent to greater curvature of the stomach, which contained air. Emergency laparotomy revealed A giant cystic gastric mass was observed. Sleeve gastrectomy were performed. Immunohistochemically, the tumor was diagnosed as a Gastric high risk GIST,and imatinib mesylate was initiated, The patient had an uneventful postoperative course and remains well. DISCUSSION AND CONCLUSION: Such rare cases can be diagnosed and treated properly with careful clinical evaluation, surgical resection and adjuvant chemotherapy with imatinib mesylate is still the mainstay and most effective treatment for GISTs to date.