[Management of a case of unilateral exophthalmos due to an intraorbital lipofibroma at Kara teaching hospital in Togo]. / Prise en charge d'un cas d'exophtalmie unilatérale due à un lipofibrome intra-orbitaire au CHU de Kara au Togo.

In childhood, benign tumors are uncommon causes of exophtalmos. We report a case of intraorbital lipofibroma in an 11-year-old girl who presented with painless, progressive proptosis of the right eye over the preceding 6 months. Ultrasound had shown an extraconal intraorbital mass. Complete excision and pathologic examination were performed, revealing a lipofibroma with no signs of malignancy This case report is notable due to the rarity of the condition.

[Bilateral simultaneous central retinal artery occlusion revealing giant cell arteritis]. / Occlusion bilaterale et simultanee de l'artere centrale de la retine revelatrice d'une maladie de Horton.

AIM: To point out the importance of the early diagnosis of giant cell arteritis (GCA) (Horton's disease). MATERIALS AND METHODS: a case report of a sudden bilateral blindness that had revealed GCA. CASE REPORT: A 68-year old female patient with a history of elevated blood pressure and diabetes mellitus type 2, was examined in emergency for a right painful headache developed one week previously. In ophthalmological examination, her BCVA was 0.9 and P2 in both eyes. Diagnosis of Horton's disease was not initially done in spite of elevated erythrocytes sedimentation rate (ESR) at 30 mm, protein C reactive (CRP) at 19 mg/l. The patient consulted seven weeks later in emergency for a sudden bilateral blindness associated with severe headache, recent asthenia, and limping of the lower jaw. At that time, visual acuity was reduced to light perception in both eyes whereas ophthalmoscopy revealed a bilateral central retinal artery occlusion (CRAO). ESR was 74 mm and CRP 233 mg/I. Temporal artery biopsy confirmed the diagnosis of GCA. The patient was treated with systemic steroids without visual recovery. CONCLUSION: This case outlines the importance of the early diagnosis of GCA in order to make possible to start treatment before the occurrence of irreversible complications.

Ossifying fibroma of the maxillary sinus at the Kara (Togo) Teaching Hospital.

INTRODUCTION: Ossifying fibroma of the jaw is a benign tumorous disease, somewhat rare and aggressive. It frequently targets the mandible, but seldom the maxillary. CASE STUDY: The present study reports the first case of left maxillary sinus fibroma treated at the Kara Teaching Hospital in North Togo. It occurred in a 29-year-old patient who experienced slow-growing tumefaction of the left maxillary sinus, resulting in deformation of the left side of the face in the maxillary region and ipsilateral nasal obstruction. Orthopantomography showed a displacement of teeth 21, 22, and 23 with an abnormal degree of opacity at the dental roots. The CT scan of the nose and sinuses revealed a tumorous lesion of expanding bony density increasing in volume at the outer wall of the left maxillary sinus, of regular shape that contained microscopic calcifications, extending into the ipsilateral orbital floor and pushing the surrounding soft tissues forward without invading them. The histopathological examination of the tumor confirmed the diagnosis of ossifying fibroma. DISCUSSION: Ossifying fibroma or fibrous osteoma is a rare and benign lesion developing insidiously with a polymorphous aspect. Of unknown etiology, most frequently located in the mandible, it is differentiated from other types of fibroma in its clinical, radiological, and histological aspects. However, only examination of the gross specimen can provide the final diagnosis. Treatment requires surgery. CONCLUSION: Surgical treatment entailed the complete macroscopic enucleoresection. Recovery has been favorable at 2 years of follow-up.

[Imflammatory myofibroblastic tumour of nose and paranasal sinuses in a little girl of 7-year-old]. / Tumeur myofibroblastique inflammatoire endonasale chez une fillette de 7 ans.

Inflammatory myofibroblastic tumours (IMTs) are clinical and pathological distinct entities with controversial biological entities. IMTs have been described in the lungs, abdomen, retroperitoneum and extremities but rarely in the head and neck region. This case report corresponds to an IMT of the nose and the paranasal sinuses in a little girl of 7 years of age. The computed tomography scan showed an expanding tumoral process without skull destruction. First case report in the west African region, this observation describes the treatment instituted according to the possible care in our medical area, and the treatment when the patient was referred to a centre with efficient technical platform. This case underlines the aggressiveness of this type of tumour: an invasive tumour with local-regional extension and high recurrence potential. Currently, after 2 years, the tumoral process is considered cured after several radical surgical excisions.