Solitary ovarian plasmacytoma: About a rare entity of extramedullary plasma cell tumor.

INTRODUCTION: Solitary ovarian plasmacytoma is a rare form of extramedullary plasmacytic tumor that develops outside the bone marrow. PRESENTATION OF CASE: We report the case of a 52-year-old female patient who consulted for pelvic pain and abdominal distension. Clinical examination revealed an abdominopelvic mass and a pelvic MRI confirmed a right ovarian mass. The diagnosis of ovarian plasmacytoma was made after exploratory laparotomy. DISCUSSION: Extramedullary plasmacytoma (EMP) is rare and most often found in the upper aerodigestive tract, ovarian localization is exceptional. Histological and immunohistochemical features of EMP highlights similarities with multiple myeloma. EMP treatment options are discussed, including radiotherapy, surgery, and chemotherapy. The prognosis of EMP depends on several factors, including tumor size and timing of treatment. CONCLUSION: Solitary ovarian plasmacytoma is a rare but important entity to consider in the diagnosis of abdominopelvic masses. Appropriate treatment, such as surgery combined with radiotherapy, can be effective, although regular monitoring is necessary due to the risk of relapse and transformation into multiple myeloma.

[Potential role of the angiogenic factor "EG-VEGF" in gestational trophoblastic diseases]. / Rôle potentiel du facteur angiogénique «EG-VEGF¼ dans les maladies gestationnelles trophoblastiques.

Gestational trophoblastic disease (MGT) includes a wide spectrum of pathologies of the placenta, ranging from benign precancerous lesions, with gestational trophoblastic tumors. Metastases are the leading causes of death as a result of this tumor. They represent a major problem for obstetrics and for the public health system. To date, there is no predictor of the progression of molar pregnancies to gestational trophoblastic tumor (GTT). Only an unfavorable plasma hCG monitoring after evacuation of hydatidiform mole is used to diagnose a TTG. The causes of the development of this cancer are still poorly understood. Increasing data in the literature suggests a close association between the development of this tumor and poor placental vascularization during the first trimester of pregnancy. The development of the human placenta depends on a coordination between the trophoblast and endothelial cells. A disruption in the expression of angiogenic factors could contribute to uterine or extra-uterine tissue invasion by extravillous trophoblast, contributing to the development of TTG. This review sheds lights on the phenomenon of angiogenesis during normal and abnormal placentation, especially during the MGT and reports preliminary finding concerning, the variability of expression of "Endocrine Gland-Derived Vascular Endothelial Growth Factor" (EG-VEGF), a specific placental angiogenic factor, in normal and molar placentas, and the potential role of differentiated expressions of the main placental angiogenic factors in the scalability of hydatidiform moles towards a recovery or towards the development of gestational trophoblastic tumor. Deciphering the mechanisms by which the angiogenic factor influences these processes will help understand the pathophysiology of MGT and to create opportunities for early diagnosis and treatment of the latter.

[Partial hydatidiform mole in Morocco: an epidemiological and clinical study]. / Les môles hydatiformes partielles au Maroc: étude épidémiologique et clinique.

This retrospective study reviewed cases of partial hydatidiform mole (PHM) diagnosed at the University Hospital in Casablanca from 2000 to 2010 in order to examine the epidemiological, clinical, therapeutic and progressive pathological factors associated with PHM. All PHM cases confirmed clinically and sonographically at pathological examination were included. We identified 24 cases of PHM among 60 748 births and 1704 abortions, giving a frequency of 0.4 per 1000 pregnancies and 1.4% of abortions. The mean age was 26 years (range: 16-55 years). The circumstances of discovery and clinical ultrasound varied: 79.2% of patients sought consultation for bleeding; clinical thyrotoxicosis syndrome was found in 1 patient (4.2%). Physical examination showed increased uterine size in 83.3% of cases associated with a latero-uterine mass in 25%. The diagnosis was supported by an ultrasound examination combined with measurement of plasma betaHCG. Histological confirmation was made in all cases and treatment was endo-uterine aspiration. Neoplastic drift was observed in 1 case (4.2%) which went into remission with chemotherapy.

[Pregnancy and extra-gastrointestinal stromal tumor: an exceptional association]. / Grossesse et tumeur stromale extra-digestive : une association exceptionnelle.

Extra-gastrointestinal stromal tumors (EGIST) are rare entities. The coexistence of a gastrointestinal stromal tumor and pregnancy is exceptional. We describe a case of this association, three years after the first diagnosis of EGIST made during exploratory laparotomy for abdominal-pelvic mass. We report the diagnostic difficulties and management of pregnancy on recurrence of EGIST tumor.

Partial hydatidiform mole in Morocco: an epidemiological and clinical study

This retrospective study reviewed cases of partial hydatidiform mole [PHM] diagnosed at the University Hospital in Casablanca from 2000 to 2010 in order to examine the epidemiological, clinical, therapeutic and progressive pathological factors associated with PHM. All PHM cases confirmed clinically and sonographically at pathological examination were included. We identified 24 cases of PHM among 60 748 births and 1704 abortions, giving a frequency of 0.4 per 1000 pregnancies and 1.4% of abortions. The mean age was 26 years [range: 16-55 years]. The circumstances of discovery and clinical ultrasound varied: 79.2% of patients sought consultation for bleeding; clinical thyrotoxicosis syndrome was found in 1 patient [4.2%]. Physical examination showed increased uterine size in 83.3% of cases associated with a latero-uterine mass in 25%. The diagnosis was supported by an ultrasound examination combined with measurement of plasma beta HCG. Histological confirmation was made in all cases and treatment was endo-uterine aspiration. Neoplastic drift was observed in 1 case [4.2%] which went into remission with chemotherapy

[Complete hydatiforme mole in Morocco: epidemiological and clinical study]. / Les môles hydatiformes complètes au Maroc : étude épidémiologique et clinique.

OBJECTIVE: Complete hydatidiform moles (CHM) are a real public health problem, especially in the "southern countries" and Asia, because of their impact on the female reproduction and the risk to progression to either invasive mole or choriocarcinoma. PATIENTS AND METHODS: We collected the cases of CHM referred to our department over a period of ten years (2000 to 2009). We will present our results, emphasize the modalities of diagnosis, treatment and evolution, with a review of literature. RESULTS: During this study, we identified 254 cases of CHM, and recorded 57,987 births and 1627 abortions. Their incidence was 0.43% of pregnancies. The mean age of our patients is 25 years old (16 to 55). Relative risk observed was much increased among women under 20 years old (×6.8) and those over 40 years old (×15). Both of nulliparous and primiparous patients represented 52.3% of the cohort. Eighty-five percent of patients belonged to an agricultural environment associated with a low socio-economic status. Uterine bleeding was the most common symptom accounting for 93.7%. Toxic syndrome was present in 18.5% of patients. Physical examination showed a highly increased uterine size in 85% of cases associated with lateral uterine mass in 25% of cases. The diagnosis was suspected using ultrasonography in all cases associated with an elevated level of plasmatic ß-human chorionic gonadotrophin (ßhCG). All cases were confirmed histologically. Treatment used was endo-uterine aspiration in all cases. Recurrence of CHM was documented in 25 patients or 9.4%. Neoplasic progression was observed for 6.3% of cases. All of them have evolved into remission with chemotherapy. DISCUSSION AND CONCLUSION: CHM continue to be a public health problem in Morocco, their incidence is among the highest ones. In fact, this studied population corresponds to the lowest socio-economic status and generally described as population at risk. It is subject to drastic weather's conditions causing loss of fresh products. Extreme ages and degree of parity are also risk factors described in the literature. Early diagnosis, appropriate treatment, and supervision of molar pregnancies are obligatory. Despite of the unfavourable initial conditions, our study shows that relevance and continuing care can significantly reduce the morbidity of moles.

[Idiopathic granulomatous mastitis with favorable outcome with medical treatment]. / Mastite granulomateuse idiopathique d'évolution favorable sous traitement médical.

Granulomatous mastitis is a rare inflammatory disorder. Its etiology remains unknown. We report a 42-year-old female who presented with an idiopathic granulomatous mastitis. Outcome was favourable with corticosteroids. The disease course of this entity is unpredictable and a consensual treatment is difficult.