Growing teratoma syndrome and peritoneal gliomatosis.

The growing teratoma syndrome (GTS) is defined as a detection of an enlarged mass during or after chemotherapy treatment for germ cell tumor. We report a case of an 18-year-old girl treated for growing teratoma syndrome after chemotherapy for malignant germ cell tumor of the ovary associated with peritoneal gliomatosis. Chemotherapy induced normalisation of alpha-fetoprotein rate whereas there was an enlargement of the mass. Subsequent complete resection was performed, and the patient remained in good control for 60 months. This clinical picture suggested the diagnosis of "GTS". This syndrome can lead to confusion with progression or relapse of a germ cell tumour because of increase in tumour volume during chemotherapy, so it is important to recognize it.

[Post-radiotherapy ureterovaginal fistula. 12 case reports]. / Fistules urétérovaginales post-radiques. A propos de 12 cas.

The authors report a series of 12 cases of ureterovaginal fistulas observed over 15 years period. Our patients had a mean age of 38 years (range 27 to 44 years old). Eighty four percent of ureterovaginal fistulas were due to radiotherapy and clopohysterectomy. Sixteen percent of ureterovaginal fistulas were due to brachy and radiotherapy. The clinical features were dominated by urine leak via the vagina with persistent micturition. Intravenous urography confirmed the diagnosis and revealed ureterohydronephrosis. Various therapeutic methods were used, in 7 patients treatment consisted of end-to-end anastomosis. We have used ureterovesical reimplantation in 3 cases and double J sent in 2 cases. The course was favourable in 84%.

[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.

[Kidney cancer: report of 47 cases]. / Cancer du rein: à propos de 47 cas.

The authors report a series of 47 cases observed over a 15-years period in the department of carcinological at the national oncological institute of Rabat. Patients consisted of 16 mean and 21 women (57%), with a mean age of 49 years old (range 29 to 70 years). The clinical features were polymorph, firstly loin pain (81%), hematuria is the next (25%). A lumbar mass (10%). The diagnosis was established by ultra-sonography and CT-scan in all the patients. The mean tumour diameter was 10 cm (5-17 cm), it were located in down pole in 53%. The surgical procedure consisted of radical nephrectomy and regional or hailer lymph node dissection in 46 patients. The post operative course was marked by one death due to pulmonary metastases. The mean follow-up was (2 to 15 years). Asynchronies metastases occurred in 6 patients after a mean interval (9 to 36 months). The overall 5 year survival was 100% PT1, 78% PT2, 34% PT3.

Male breast cancer. A report of 71 cases.

Male breast cancer is rare; it constitutes 0.2-1.5% of all malignant tumours in men and 1% of all breast cancers. The goal of this retrospective study is to analyse the epidemiologic, clinic, therapeutic and evolutive profiles of this disease in 71 cases collected at the National Institute of Oncology in Rabat, Morocco, between the years 1985 and 1998. The median age was 60 years. No significant risk factor was found. The average consultation's delay was 35 months. The main clinical complaint was a mass beneath the areola in 86% of the cases, associated with ulceration in 18% of the cases. For that, the disease was diagnosed at an advanced stage. Infiltrating ductal carcinoma was the most frequent pathologic type (91.5% of cases). Management consisted especially of radical mastectomy, followed by adjuvant radiotherapy and hormonal therapy with or without chemotherapy. It was possible to follow 58 of the patients. The median of follow-up was 30 months. The evolution has been characterized by local recurrence, after a median delay of 36 months, in five cases (8.5% of all patients). Metastasis occurred, after a median delay of 12 months, in 14 cases (24% of all patients). The site of metastasis was the bone in six cases, lung in five cases, liver in one case, liver and skin in one case and pleura and skin in one case. There were three cases of death. In one case, death was related to lung metastases. In the two remaining cases, death was due to comorbid disease. Progression was observed in one case.

[Association of ovarian juvenile granulosa cell tumor with Maffucci's syndrome]. / Association d'une tumeur ovarienne de la granulosa juvénile à un syndrome de Maffucci.

The authors report a rare case of the ovarian juvenile granulosa cell tumor associated with Maffucci's syndrome (enchondromathosis + hemangiomas), no heriditary mesodermal dysplasia. Sarcomatous changes of chondromas are encountered most frequently; however other various typed neoplasma have been reported: ovarian juvenile granulosa cell tumor may occur not infrequently in female patients with Maffucci's syndrome in the first or second decades. Sarcomatous changes of choromas established prognosis of the Maffucci's syndrome.

[A case report of testicular leiomyosarcoma]. / A propos d'un cas de leiomyosarcome testiculaire.

This report describes a case of primary leiomyosarcoma of the testis in a 70-year-old man. Treatment consisted in orchidectomy by the inguinal route with no adjuvant treatment. The patient developed pulmonary metastasis 14 months after surgical treatment. Few reports have been published on primary leiomyosarcoma of the testis. Most reported cases have been in small series in association with germ cell tumors. Surgical treatment is the most effective therapeutic modality. The standard surgical technique is orchidectomy by the inguinal route. Retroperitoneal lymph node dissection is not always performed. The prognosis of isolated testicular sarcoma is better than that of sarcoma associated with germ cell components.

[Reno-sigmoid fistula in a tuberculous pelvic ectopic kidney]. / Fistule réno-sigmoïdienne sur un rein ectopique pelvien tuberculeux.

Renocolic fistulas are rare lesions, generally involving the ascending and descending colon. The authors report a case of reno-sigmoid fistula occurring in a tuberculous pelvic ectopic kidney. Nephrectomy with segmental sigmoid resection was completed by antituberculous treatment for 9 months. The patient presents a good general condition with normal renal function and normal intestinal transit with a follow-up of 19 months.

[Leiomyosarcoma of the vagina: a rare case]. / Le léiomyosarcome du vagin: une observation rare.

Vaginal leiomyosarcoma is unfrequent. We report on a case in a 50-year-old multipara patient who had presented a posterior vaginal swelling since 6 months. The tumor was discovered at the occasion of pains and non hemorragic discharge. The histological pattern of the tumor was well-differentiated spindle cell sarcoma with pleiomorphic areas. The immunohistochemistry confirmed the smooth myogenic differentiation. The treatment consisted of posterior pelvic exenteration extended to the vagina. The patient is alive and free of disease at 20 months of fellow-up.

[Spermatocytic seminoma. Apropos of a case and review of the literature]. / Le séminome spermatocytaire. A propos d'un cas et revue de la littérature.

We report a case of sperm cell seminoma caused by trauma. The data in the literature indicate the frequency is less than 5% of all seminomas. This case was exclusively located in the gonads and was a pure form. Orchidectomy with high ligature of the cord and adjuvant radiotherapy at the dose of 25 Gy centered on the para-aortic and subdiaphragmatic chains is adequate treatment. When inguinoscrotal surgery is performed, this zone must be irradiated with 25 Gy. Prognosis is satisfactory: 5-year survival is 100% with this protocol.