[Malignant transformation of sacrococcygeal teratoma with voluminous mesentery cyst: a case study conducted in Bamako]. / Dégénérescence maligne d'un tératome sacro-coccygien avec volumineux kyste du mésentère: à propos d'un cas à Bamako.

Malignant sacrococcygeal teratoma is a rare congenital embryonal tumor at high risk of malignant transformation. We report the case of a 20-month old female infant. She was the couple's fourth child. Her mother was 29 years old, she had four pregnancies with vaginal deliveries. All the infants were born alive. The woman was not properly followed during pregnancy. She had vaginal delivery at term and had correctly attended expanded programme on immunization (EPI) with positive reaction to BCG vaccine. The child walked autonomously at 13 months. She had painful fluctuating inguinal and left labium major swelling (A), distended abdomen with oozing wound measuring 4cm/3cm on the right buttock (A). Frontal x-rays of abdomen without preparation showed distended flaccid abdomen with opacity in the periumbilical region as well as in the hypogastric region (B). Ultrasound objectified voluminous calcified sub-vescical tissue mass measuring 87*54 mm (C). Thoracoabdominal CT scan showed calcified sacrococcygeal tissue mass measuring 83*59 mm, with modest fissure in the left pubis and abdominal cyst without wall (D,E). Moreover, there were nodules of variable size in the lungs and the liver (F,G). The infant was treated by an oncopediatric team.

[Giant right post-traumatic retroauricular keloid]. / Chéloïde géante retro-auriculaire droite post-traumatique.

Keloid is a benign fibroblastic tumor which is most often secondary to a scar, but it can occur spontaneously in a subject with black skin. We report the case of a 19-year old patient, electrician, presenting with giant right retroauricular mass evolving over two years. For some time, the patient has experienced a feeling of heaviness on the pavilion of the right ear. The lesion had manifested as a hard, pruritic, non-painful patch gradually increasing in size. The patient had received several topical and antiseptics treatments without any effect. He had a history of traumatic injury in the right retroauricular sulcus. A month after, pruritic hypertrophic scar occurred. Physical examination showed voluminous hard, fixed, retroauricular tumor (10 × 6 cm) with normal skin color, non-painful on movement (A). Its base was sessile. The remainder of the physical examination was normal. Ultrasound showed little vascularized skin tumor of the right retroauricular sulcus with more or less sharp margins, measuring 9 x 5 cm. Two diagnoses were suspected: post-traumatic keloid (most likely) and Darier Ferrand dermatofibrosarcoma. Biopsy was performed and histological examination showed keloid. The patient underwent intramarginal excision (B). The surgical specimens weighed 75 grams (C). The postoperative course was simple with disappearance of the feeling of heaviness.

[Voluminous juvenile prostatic lithiasis complicated by perineal fistula: about a case reported at the regional hospital in Gao]. / Grosse lithiase prostatique juvénile compliquée de fistule périnéale: à propos d'un cas à l'hôpital régional de Gao.

Prostatic lithiases are characterized by the development of stones in the prostatic tissue (acini, channels). They rarely occur in children but they are frequent in men. We report the case of a 24-year old patient with a few month-history of micturation disorders including dysuria and pollakiuria followed by perineal urinary leakage during minction. Reno-vesico-prostatic ultrasound showed voluminous prostatic calcification. Standard radiographic evaluation of the urinary tract and fistulography of the perineal orifice showed a communication with the bladder and showed large calcification projecting over the pubis. The diagnosis of prostatic lithiasis was retained. The patient was treated with antibiotic therapy before, during and after surgical extraction of the voluminous lithiasis. Surgical outcomes were favorable.

[A case of rupture of voluminous spontaneous subcapsular hematoma of the liver in Bamako]. / Volumineux hématome spontané sous capsulaire hépatique rompu: à propos d'un cas à Bamako.

Rupture of spontaneous subcapsular hematoma of the liver is very rare and therefore it has been rarely described in the literature. It generally occurs among women with underlying liver disease or often, during pregnancy, in women with HELLP syndrome. We here report the case of a 60-year old man with no particular past medical history presenting with large subcapsular haematoma of the liver. He was admitted to the Emergency Department with moderate-intensity right hypochondre pain evolving over the last week, which was aggravated, two days before, by influenza-like illness associating cough, yellowish sputum and sweatings. Clinical examination showed abdominal tenderness on palpation of the right hypochondre and hypogastrium. The remainder of the clinic examination was normal. Laboratory tests showed hemoglobin level 7.8g/dl, MCV: 79.9, reticulocyte count 48.9. computed tomography (CT) scan showed voluminous subcapsular hematoma of the liver measuring 17cm in height, 14cm in cross-sectional diameter and 5cm in thickness and a hepatic nodule measuring 10mm (A) with hemoperitoine of great abundance without active bleeding (B). The patient underwent visceral surgery (laparotomy) with favorable postoperative outcome.

[Voluminous unilateral hydrocele with scrotal ulceration: about a case study conducted at the Regional Hospital of Gao]. / Volumineuse hydrocèle unilatérale avec ulcération scrotale: à propos d'un cas à l'hôpital Régional de Gao.

Hydrocele is an accumulation of fluid between the testis and its vaginal coat. It may be very abundant. It commonly affects people who live in tropical regions. We report the case of a 56-year old patient, Mr. YM, living in the sahelian zone with very abundant hydrocele and thickening of vaginal coat associated with bag ulcer. The patient presented with big bag associated with a feeling of heaviness as well as annoyance when walking, evolving for about one year with progressive increase in volume. Clinical examination showed voluminous left bag (A,B) with a plague measuring 3 cm (A). Two diagnosis were suspected: voluminous hydrocele (more probable) and severe scrotal tumor. Ultrasound of the bag showed very abundant effusion of in the vaginal coat (3000 ml) with thickening of the tunica vaginalis measuring 7 mm in diameter. The diagnosis of very abundant unilateral hydrocele associated with pachyvaginalitis was retained. The extractions of 2.8 L of stained fluid was performed during surgery (C). Postoperative course was favorable (D) under triple antibiotic therapy.

[Evolutive posterior forms of persistent fetal vasculature bilateral at Gao regional hospital]. / Formes évolutives postérieures de la persistance de la vascularisation fœtale bilatérale à l'hôpital régional de Gao.

The persistence of fetal vasculature (PFV) is an abnormal resorption in hyaloid vascular system. We report the case of a 2-year old child with evolutionary posterior form of bilateral vasculature presenting with leukocoria in the right eye. Clinical examination showed bilateral leukocoria, exotropia in the right eye and an exotropia in the left eye. Fundus examination of the right eye showed fibrovascular retinal band stretched to the ora serrata associated with total retinal detachment and peripheral pigment changes. Fundus examination of the left eye showed fibrovascular retinal band stretched from the papilla to the ora serrata, associated with partial inferior, anterior temporal detachment and peripheral pigment changes.