Solid pseudopapillary tumor of the pancreas with concomitant Bochdalek's hernia. The first reported case.

BACKGROUND: Solid pseudopapillary tumors of the pancreas are rare. The diagnosis is difficult because of its clinical and radiological polymorphism. It was described in the literature that this entity can be associated with congenital malformation. We report an exceptional case associating solid pseudopapillary tumor of the pancreas to Bochdalek's hernia. CASE REPORT: A 31 year-old woman presented with abdominal pain. Radiological findings (ultrasound, CT scan, MRI) showed a heterogeneous mass evoking a stromal tumor of duodenal origin associated to a hernia through the foramen of Bochdalek. The patient underwent tumorectomy without lymphadenectomy with a hernia repair. Pathology report confirmed the diagnosis of solid pseudopapillary tumor of the pancreas. The 3-years follow- up was uneventful. CONCLUSION: Solid pseudopapillary tumor of the pancreas is a rare benign tumor with a good prognosis after resection. Recognition of the association of congenital malformation with solid pseudopapillary tumor of the pancreas is useful as it could have implications on the diagnosis and treatment.

[What's new in rectal cancer?]. / Quoi de neuf dans le cancer du rectum?

BACKGROUND: In recent years, multidisciplinary therapeutic management of rectal cancer has evolved. This progress had interest radio and chemotherapy. AIM: To describe the main spots of the progress in the therapeutic strategies of the disease, surgical techniques and standardization of these techniques, particularly regarding locoregional extension in the mesorectum. METHOD: Literature review. RESULTS: Treatment of rectal cancer is multidisciplinary. On the surgical field, excision of the mesorectum (total mesorectal excision [TME]) has reduced local recurrence and the genitourinary sequelae. Meanwhile, chemoradiotherapy has become important. The standard now is to indicate to T3 T4 N+ tumors to decrease local recurrence without improving survival, however. CONCLUSION: Advances in the management of rectal cancer with both imaging progress and therapeutic modalities have improved the prognosis and survival of this cancer.

[Inflammatory fibroid polyp of the ileum presenting as intussusception: a case report in an adolescent]. / Polype fibro-inflammatoire de l'intestin grele revele par une invagination intestinale aigue: a propos d'un cas chez une adolescente.

Inflammatory fibroid polyp is an uncommon and benign submucosal lesion of the gastrointestinal tract. The maximal incidence is in the fifth and sixth decades. The main histological characteristics are diffuse inflammatory infiltrate with eosinophils and highly vascularized fibrocystic stroma. We report a case of 15-year-old patient who underwent emergency surgery because of acute intestinal obstruction as a result of an intussusception. The macroscopical study after segmental ileal resection showed a nodular lesion 3x2x2 cm, arising from the submucosa with an ulcerated surface. The pathologic diagnosis was ileal inflammatory fibroid polyp. Immunohistochemically, the cells reacted with vimentin and CD34. It has no malignant potential although extensive infiltration may occur. The etiology is unknown. We discuss the clinical, the pathological aspects and the possible etiological factors of the inflammatory fibroid polyp.

[Hepatic mesenchymal hamartoma in adulthood: a case report with literature review]. / Hamartome mesenchymateux du foie chez l'adulte: a propos d'un cas avec revue de la littérature.

Mesenchymal hamartoma is a rare and benign tumor.. Representing 5 to 8 % of children's hepatic tumors, it is rarely described in adults. Authors report a new case of hepatic mesenchymal hamartoma in a 21-year-old woman, diagnosed after a sudden onser of clinical and biological cholestasis. Abdominal US and CTscan exminations showed a medial liver tumor with cystic formations suggestive of a hydatid cyst. The diagnosis of hepatic mesenchymal hamartoma was based onn hitology of the resected liver specimen. Radiological findings can suggest the diagnosis but only histology can confirm it. Treatment is surgical involving in most of the cases; a wide hepatic resection because of the size of the tumor. Progosis is excellent when complete exeresis is possible.

[Intestinal T cell lymphoma in coeliac disease. A case report]. / Lymphome t du grêle sur maladie coeliaque. A propos d'un cas.

Primary intestinal T-cell lymphomas account for about 5% of all primary gastrointestinal lymphomas and are mostly associated with coeliac disease. Intestinal lymphomas are usually discovered during the 4th to 5th decade and constitute an exceptional complication of coeliac disease. This lymphoma is generally a high grade pleomorphic cell lymphoma with large cells. Our case concerned a 30 year old woman with a history of coeliac disease who developed a gastro-enteromesenteric lymphoma. Anatomopathological and immunohistochemical analysis showed an enteropathy associated T-cell lymphoma. We suggest that patients with coeliac disease unresponsive to a gluten free diet or with deteriorating clinical condition be investigated for complications such as enteropathy associated T-cell lymphoma. It is also important to avoid this complication by detecting asymptomatic form of coeliac disease that needs a gluten-free diet.