RESUMO
PURPOSE: The aims of this study were: determination of the CTV to PTV margins for prostate and pelvic lymph nodes. Investigation of the impact of registration modality (pelvic bones or prostate) on the CTV to PTV margins of pelvic lymph nodes. Investigation of the variations of bladder and rectum over the treatment course. Investigation of the impact of bladder and rectum variations on prostate position. PATIENTS AND METHODS: This study included 15 patients treated for prostate adenocarcinoma. Daily kilo voltage images and weekly CBCT scans were performed to assess prostate displacements and common and external iliac vessels motion. These data was used to calculate the CTV to PTV margins using Van Herk equation in the setting of a daily bone registration. We also compared the CTV to PTV margins of pelvic lymph nodes according to registration method; based on pelvic bone or prostate. We delineated bladder and rectum on all CBCT scans to assess their variations over treatment course at 4 anatomic levels [1.5cm above pubic bone (PB), superior edge, mid- and inferior edge of PB]. RESULTS: Using Van Herk equation, the prostate CTV to PTV margins (bone registration) were 8.03mm, 5.42mm and 8.73mm in AP, ML and SI direction with more than 97% of prostate displacements were less than 5mm. The CTV to PTV margins ranged from 3.12mm to 3.25mm for external iliac vessels and from 3.12mm to 4.18mm for common iliac vessels. Compared to registration based on prostate alignment, bone registration resulted in an important reduction of the CTV to PTV margins up to 54.3% for external iliac vessels and up to 39.6% for common iliac vessels. There was no significant variation of the mean bladder volume over the treatment course. There was a significant variation of the mean rectal volume before and after the third week of treatment. After the third week, the mean rectal volume seemed to be stable. The uni- and multivariate analysis identified the anterior wall of rectum as independent factor acting on prostate motion in AP direction at 2 levels (superior edge of, mid PB). The right rectal wall influenced the prostate motion in ML direction at inferior edge of PB. The bladder volume tends toward significance as factor acting on prostate motion in AP direction. CONCLUSIONS: We recommend CTV to PTV margins of 8mm, 6mm and 9mm in AP, ML and SI directions for prostate. And, we suggest 4mm and 5mm for external and common iliac vessels respectively. We also prefer registration based on bony landmarks to minimize bowel irradiation. More CBCT scans should be performed during the first 3weeks and especially the first week to check rectum volume.
Assuntos
Adenocarcinoma/radioterapia , Linfonodos/diagnóstico por imagem , Próstata/diagnóstico por imagem , Neoplasias da Próstata/radioterapia , Reto/diagnóstico por imagem , Bexiga Urinária/diagnóstico por imagem , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/patologia , Algoritmos , Análise de Variância , Antagonistas de Androgênios/uso terapêutico , Humanos , Artéria Ilíaca/diagnóstico por imagem , Veia Ilíaca/diagnóstico por imagem , Linfonodos/anatomia & histologia , Irradiação Linfática/métodos , Masculino , Movimentos dos Órgãos , Órgãos em Risco/anatomia & histologia , Órgãos em Risco/diagnóstico por imagem , Ossos Pélvicos/anatomia & histologia , Ossos Pélvicos/diagnóstico por imagem , Pelve , Estudos Prospectivos , Próstata/anatomia & histologia , Neoplasias da Próstata/diagnóstico por imagem , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/patologia , Planejamento da Radioterapia Assistida por Computador/métodos , Erros de Configuração em Radioterapia , Radioterapia Conformacional , Radioterapia Guiada por Imagem , Reto/anatomia & histologia , Estatísticas não Paramétricas , Tomografia Computadorizada por Raios X , Carga Tumoral , Bexiga Urinária/anatomia & histologiaRESUMO
Intramedullary spinal cord metastases (ISCM) is a rare, but devastating complication of malignant disease. Prognosis is poor, with an overall median survival (OS) of 4 months from the time of diagnosis. Yet, ISCMs are being increasingly diagnosed, related to advances and increased use of imaging and therapies that prolong survival in patients with cancer. Prompt and accurate diagnosis of ISCM is necessary for effective treatment, and magnetic resonance imaging (MRI) is the preferred imaging technique. The optimal management of these patients is controversial because of the multitude of clinical circumstances and the lack of controlled studies on the efficacy of the different therapeutic approaches. Increased awareness of this rare entity may lead to an earlier diagnosis at a stage when neurological deficits are reversible, and therefore, more effective palliation may be achieved. Therefore, we carried out this retrospective research of 3 observations of ISCM, associated with a detailed review of the literature describing the diagnostic, therapeutic and evolutionary characteristics of this special rare entity.
Assuntos
Adenocarcinoma/secundário , Carcinossarcoma/secundário , Doenças Raras/etiologia , Neoplasias da Medula Espinal/secundário , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/terapia , Adulto , Neoplasias da Mama/patologia , Carcinossarcoma/complicações , Carcinossarcoma/diagnóstico por imagem , Carcinossarcoma/terapia , Detecção Precoce de Câncer , Evolução Fatal , Feminino , Humanos , Vértebras Lombares , Neoplasias Pulmonares/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Doenças Raras/diagnóstico por imagem , Doenças Raras/terapia , Estudos Retrospectivos , Neoplasias da Medula Espinal/complicações , Neoplasias da Medula Espinal/diagnóstico por imagem , Neoplasias da Medula Espinal/terapia , Vértebras TorácicasRESUMO
INTRODUCTION: Tuberculosis miliary is a severe and rare form of tuberculosis. It is often due to a haematogenous spread of the bacillus of Koch and represents less than 2 % of tuberculosis. PATIENTS AND METHODS: We conducted a retrospective study of 81 cases of tuberculous miliary collected at the Department of respiratory diseases of the Ibn Rochd university hospital in Casablanca between September 2003 and November 2016. RESULTS: A female predominance was noted with 58 % of the cases. The average age was 36 years. The history of tuberculosis was found in eight cases and tuberculous tuberculosis in eleven cases, postpartum in five cases, diabetes in three cases and trisomy 21 in one case. The clinical picture was dominated by altered general status in all cases, and fever in 69 cases (86 %). Chest x-ray showed a miliary aspect in all cases, cardiomegaly in two cases, pyopneumothorax in three cases, and opacities excavated in five other cases. The intradermal tuberculin reaction, performed in all cases, was positive in 26 cases, and sputum oscillations were positive in 21 cases. The dissemination report found cerebromeningeal involvement in nine cases, with cerebral tuberculomas in five cases, pericarditis in four cases, mediastinal and peripheral adenopathies in nine cases each. Bouchut tubercles were found in nine cases. Antibacillary therapy was started as a matter of urgency, according to the national TB control program with the old regimen (2SHRZ/7RH) and the new regimen (2RHZEb/7RH) in all cases. The outcome was good in 55 cases (68.9 %), 17 patients were lost to follow-up, and 11 deaths were reported. CONCLUSION: We insist on this work on the severity of the tuberculous miliary and the need for early and urgent therapeutic management.
Assuntos
Antituberculosos/uso terapêutico , Tuberculose Miliar/epidemiologia , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Mycobacterium tuberculosis/isolamento & purificação , Estudos Retrospectivos , Tuberculose Miliar/diagnóstico , Tuberculose Miliar/tratamento farmacológico , Adulto JovemAssuntos
Neoplasias Pulmonares/diagnóstico , Linfoma de Zona Marginal Tipo Células B/diagnóstico , Antineoplásicos/uso terapêutico , Feminino , Humanos , Pulmão/patologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Linfoma de Zona Marginal Tipo Células B/tratamento farmacológico , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Tuberculosis is a major public health problem in Morocco. Tuberculosis of the lung bases is a rare and atypical form and raises real diagnostic problems. PATIENTS AND METHODS: We report a retrospective study of 21 cases of basal pulmonary tuberculosis, collected at the service of respiratory diseases in Ibn Rushd hospital in Casablanca between 2004 and 2015 (11 years). RESULTS: From a total of 21 patients having basal pulmonary tuberculosis, 13 (62%) were women versus eight men (48%), the average age was 33 years. The average time of diagnosis was 25 days. The disease was unilateral in 20 cases (95%). The right lower lobe was the most frequently affected (71%). Inhomogeneous opacities (66%) and consolidation (28%) were the main radiological findings. Associated comorbidities were dominated by diabetes in six cases (28%). Bronchoscopy had recovered thickening spurs in eight cases, endobronchial granules in seven cases and bronchial inflammation in six cases. Bronchial biopsies had found a necrotizing granulomatous inflammation tuberculoide in seven cases (33%). The smear was positive in sputum in three cases (14%), in the bronchial aspirate in four cases (19%), in induced sputum in one case (4.7%) and in post-bronchoscopic sputum in six cases (28%). The antituberculous treatment was started in all patients with good clinical and radiological evolution. CONCLUSION: The basal localization of the pulmonary tuberculosis is misleading; source of diagnostic delay, hence the need to think about it especially in patients with comorbidities.
Assuntos
Pulmão/patologia , Tuberculose Pulmonar/patologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Pulmão/diagnóstico por imagem , Pulmão/microbiologia , Masculino , Pessoa de Meia-Idade , Radiografia Torácica , Estudos Retrospectivos , Tuberculose Pulmonar/diagnóstico por imagem , Tuberculose Pulmonar/epidemiologia , Adulto JovemRESUMO
INTRODUCTION: The management of a first episode of spontaneous pneumothorax is controversial and the best technique to be used as an initial intervention, aspiration or intercostal drainage, is still debated. PATIENTS AND METHODS: We present a retrospective case series during two and a half consecutive years describing the immediate management of spontaneous pneumothoraces, comparing aspiration versus thoracic drainage. RESULTS: One hundred and thirty-three clinical files from patients with spontaneous pneumothoraces were analyzed (17 primary and 116 secondary). The pneumothoraces were of varying size and different etiologies. Patients were initially treated with simple aspiration in 68 cases, with an immediate success rate of 37.5%, intercostal drainage in 49 cases, and by rest alone in 16 cases. CONCLUSION: In case of secondary pneumothorax, aspiration appeared to offer advantages as an initial strategy over intercostal drainage in terms of hospital stay (11 versus 22 days), and with significant effectiveness (37.5%).
Assuntos
Pneumotórax/terapia , Adulto , Tubos Torácicos/estatística & dados numéricos , Drenagem/métodos , Drenagem/estatística & dados numéricos , Humanos , Tempo de Internação/estatística & dados numéricos , Pessoa de Meia-Idade , Marrocos/epidemiologia , Pneumotórax/diagnóstico , Pneumotórax/epidemiologia , Pneumotórax/patologia , Recidiva , Estudos Retrospectivos , Toracentese/estatística & dados numéricosRESUMO
OBJECTIVE: Tuberculosis is a serious and common complication of silicosis. The aim of this study is to describe the epidemiological, clinical, radiological and progressive aspects of this pathological entity. PATIENTS AND METHODS: The study concerns 23 cases of silicotuberculosis which were collected at the service of respiratory diseases at CHU Ibn Rochd of Casablanca, Morocco during 12years (2003-2015). RESULTS: All patients were men. They were 7 diggers, 5 rock crushers, 7 miners and 4 masons. The mean duration of silica exposure was 11years. The symptomatology was dominated by dyspnea and persistent bronchial syndrome. Imagery showed tumor-like opacities in all cases, associated with mediastinal calcified lymphadenopathy in 9 cases, with micronodules in 8 cases and an excavated opacity in 2 cases. The diagnosis of tuberculosis was confirmed by isolation of the Koch's bacillus in sputum in 13% of cases in the bronchial aspirate in 52% and culture in sputum post-bronchoscopy in 13%. The bronchial biopsies confirmed the diagnosis in 2 cases. Tuberculosis had complicated silicosis 9years on average after the cessation of exposure to silica in 65% of cases. The antituberculous treatment was started in all patients with good clinical outcome in 22 cases. We had deplored a case of death by acute respiratory failure. CONCLUSION: Silicosis increases the risk of tuberculosis, hence the importance of TB screening in all patients with silicosis.
Assuntos
Silicose/epidemiologia , Silicotuberculose/epidemiologia , Idoso , Progressão da Doença , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Radiografia Torácica , Estudos Retrospectivos , Fatores de Risco , Silicose/diagnóstico por imagem , Silicose/patologia , Silicotuberculose/diagnóstico por imagem , Silicotuberculose/etiologia , Silicotuberculose/patologiaRESUMO
BACKGROUND: Pelvic recurrences of cervical cancer after primary surgical treatment can be potentially cured with radical hysterectomy or chemoradiation therapy. Combined radio-chemotherapy is believed to improve results compared to other option. Currently, RapidArc radiotherapy is considered an excellent technological advance that shows great potential for producing highly conformal doses to treatment volumes. CASE PRESENTATION: We present a case of a 67-year-old woman with history of early cervical cancer initially treated by radical laparoscopic hysterectomy. More than 5 years later, the patient presented with a central pelvic vaginal cuff recurrence that is histologically confirmed. Salvage radiotherapy using RapidArc with concurrent cisplatin-based chemotherapy was indicated. A high dose of 70 Gy was delivered to the gross recurrent disease with simultaneous integrated boost (SIB) to the subclinical disease and good sparing of organs at risk especially the rectum and sigmoid. CONCLUSIONS: This case clearly demonstrates a large benefit for salvage RapidArc radiotherapy to central pelvic recurrences of gynecological cancers with an excellent rate of local control and less rate of toxicity.
Assuntos
Adenocarcinoma/cirurgia , Quimiorradioterapia , Histerectomia/efeitos adversos , Recidiva Local de Neoplasia/terapia , Complicações Pós-Operatórias , Neoplasias do Colo do Útero/cirurgia , Neoplasias Vaginais/terapia , Adenocarcinoma/patologia , Idoso , Feminino , Humanos , Incidência , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/etiologia , Estadiamento de Neoplasias , Prognóstico , Dosagem Radioterapêutica , Terapia de Salvação , Neoplasias do Colo do Útero/patologia , Neoplasias Vaginais/epidemiologia , Neoplasias Vaginais/etiologiaRESUMO
INTRODUCTION: Chronic pulmonary aspergillosis is a pulmonary fungal infection with various presentations that can occur on a pre-existing cavity, often a sequel of tuberculosis. The objective of our study was to report the diagnostic and therapeutic management of pulmonary aspergilloma in our structure. PATIENTS AND METHODS: We retrospectively studied 81 cases of pulmonary aspergilloma having occurred in the respiratory diseases unit of the Casablanca Ibn Rochd hospital, over 11 years. RESULTS: We included 48 male and 33 female non-immunocompromised patients, with an average age of 51 years (27-75). A history of tuberculosis was recorded in 78 cases. Hemoptysis was the revealing symptom in 73 cases. A characteristic "bell-like" image was observed in 25 cases. The serological results were positive for aspergillus in 54 cases. The treatment was surgical in 50 cases and medical in 24 cases. Five patients died. DISCUSSION: A significant number of pulmonary aspergilloma cases were recorded in our study, occurring most frequently on sequels of tuberculosis. This disease is currently common in countries highly endemic for tuberculosis; early and adequate management is required. CONCLUSION: Aspergillosis is a frequent and potentially severe disease occurring on pre-existing lesions, most often in our context sequels of tuberculosis. Surgical resection is the reference treatment but is the cause of a significant morbidity and mortality. Preventive measures are mandatory.
Assuntos
Aspergilose Pulmonar/epidemiologia , Adulto , Idoso , Antifúngicos/uso terapêutico , Doença Crônica , Terapia Combinada , Comorbidade , Feminino , Hemoptise/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/epidemiologia , Infecções Oportunistas/diagnóstico por imagem , Infecções Oportunistas/tratamento farmacológico , Infecções Oportunistas/epidemiologia , Infecções Oportunistas/cirurgia , Pneumonectomia , Aspergilose Pulmonar/diagnóstico por imagem , Aspergilose Pulmonar/tratamento farmacológico , Aspergilose Pulmonar/cirurgia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Radiografia , Estudos Retrospectivos , Fumar/epidemiologia , Tuberculose Pulmonar/epidemiologiaRESUMO
OBJECTIVE: Smoking is a major public health problem. The doctor should be at the forefront in the fight against tobacco. Our study aims to determine the prevalence of smoking among medical students and to evaluate their attitudes towards this problem. PATIENTS AND METHODS: A cross-sectional survey was conducted among 736 medical students enrolled in the faculty of medicine and pharmacy of Casablanca in the academic year 2009/2010. RESULTS: The prevalence of smoking was 7.9%. It was significantly higher in men (16% against 3% in women) and varied little from one age group to another (7-8%). The average number of cigarettes smoked per day was eight. More than half of the students (58%) had attempted to quit smoking. The main motivation was the occurrence of certain symptoms (66%). Ex-smokers accounted for 10% of the total. Moroccan anti-smoking law was poorly understood by more than half of our students (72%). The majority was in favor of prohibition of tobacco sales to children (92%) and the training of health professionals to help patients who want to quit smoking (86%). CONCLUSION: Compared with previous years this study shows a marked decrease in the prevalence of smoking among medical students in Casablanca as well as a better understanding of its ill effects. This is due not only to greater awareness of this problem among medical students but also to the introduction of the teaching of the pathologies related to tobacco.
Assuntos
Atitude Frente a Saúde , Fumar/psicologia , Estudantes de Medicina/psicologia , Adolescente , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Marrocos/epidemiologia , Prevalência , Abandono do Hábito de Fumar/legislação & jurisprudência , Abandono do Hábito de Fumar/psicologia , Abandono do Hábito de Fumar/estatística & dados numéricos , Inquéritos e Questionários , Indústria do Tabaco/legislação & jurisprudência , Tabagismo/complicações , Tabagismo/epidemiologia , Tabagismo/prevenção & controle , Tabagismo/psicologia , Adulto JovemRESUMO
Chickenpox is a viral infection usually benign and practically mandatory of the childhood. In the adult, it may know multivisceral complications as pneumonia in relationship with chickenpox which is the most frequent. One case of varicella pneumonia with a bilateral pleurisy has been noticed in a 38-year-old adult. The definite diagnosis has been based on clinical, biological and radiological arguments. Under an antiviral treatment, the evolution is favourable.
Assuntos
Varicela/complicações , Imunocompetência , Pleurisia/etiologia , Adulto , Varicela/diagnóstico por imagem , Humanos , Masculino , Pleurisia/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/etiologia , Radiografia TorácicaRESUMO
OBJECTIVE: Inhalation of foreign bodies is rare in adults. Inhalation of scarf pin is a phenomenon more frequent in the female population in Morocco. The aim of our study was to describe the characteristics of this particular foreign body and illustrate the circumstances and consequences of its inhalation. PATIENTS AND METHODS: Twenty-six young patients, all veiled, were hospitalized in the service of Respiratory Diseases University Hospital Ibn Rushd of Casablanca between January 2005 and July 2011 for inhaled scarf pin. RESULTS: The mean age was 16 years. Inhalation was accidental in all cases, whereas patients initiated to wear the veil. The penetration syndrome was found in all cases. Clinical examination was normal in all patients. The chest X-ray showed the foreign body as a linear opacity, located right in 18 cases and left in eight cases. Flexible bronchoscopy was able to extract the pin in 21 cases. The pin was released spontaneously in three cases and two patients were operated on. CONCLUSION: The scarf pin is a foreign body especially more common in women who wear the Islamic veil. Flexible bronchoscopy is an essential means of therapy, but the best preventive treatment is avoiding to put in the mouth sharp objects.
Assuntos
Corpos Estranhos/diagnóstico , Islamismo , Joias , Traqueia , Adolescente , Broncoscopia , Feminino , Corpos Estranhos/terapia , Hospitalização , Hospitais Universitários , Humanos , Marrocos , Aspiração RespiratóriaRESUMO
Intracardiac thrombosis is a rare complication of Behçet's disease. It may be isolated or associated with arterial disease. We report a case of a patient from northern Morocco, aged 23, without specific medical history. He consulted for recurrent hemoptysis of middle abundance, associated with bipolar aphthosis. Chest radiography showed a left basal opacity fuzzy and right paracardiac opacity. The thoracic CT objectified left segmental lower lobe embolism, an aneurysm of a segmental branch of the right lower lobe and right intraventricular thrombus. Echocardiography confirmed the intracardiac thrombus. The patient was treated by oral corticosteroids, azathioprine, colchicine, and anticoagulants. The outcome was favorable with complete resolution of intraventricular thrombus and the aneurysm.
Assuntos
Aneurisma/etiologia , Síndrome de Behçet/complicações , Cardiopatias/etiologia , Artéria Pulmonar , Embolia Pulmonar/etiologia , Trombose/etiologia , Aneurisma/diagnóstico , Aneurisma/diagnóstico por imagem , Síndrome de Behçet/diagnóstico , Síndrome de Behçet/diagnóstico por imagem , Diagnóstico Diferencial , Cardiopatias/diagnóstico , Cardiopatias/diagnóstico por imagem , Humanos , Masculino , Artéria Pulmonar/diagnóstico por imagem , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/diagnóstico por imagem , Radiografia Torácica , Trombose/diagnóstico , Trombose/diagnóstico por imagem , Adulto JovemRESUMO
BACKGROUND: There have been a very small number of reported cases of radiotherapy-induced autoimmune bullous disease. We describe a case of generalised autoimmune sub-epidermal bullous pemphigoid (BP) induced by radiotherapy in a female patient presenting squamous cell carcinoma of the vulva. CASE REPORT: In June 2008, a 48-year-old woman underwent vulvectomy with lymph node curettage for squamous cell carcinoma of the vulva. Following surgery, adjuvant radiotherapy was indicated. At the 16th session (dose of 32 Gy), erythema occurred on the irradiation field. At the 23rd session (46 Gy), the patient presented bullous lesions that became generalised after four days with involvement of the oral mucosa. Skin biopsy revealed sub-epidermal bullae and direct immunofluorescence showed continuous linear deposits of IgG and of C3 along the dermal-epidermal junction. Indirect immunofluorescence revealed the presence of antibodies directed against the basement membrane. A favourable outcome was achieved under systemic corticosteroids. No immunotransfer analysis of serum or any other immunological investigations were performed. DISCUSSION: The clinical and histological features of this autoimmune bullous disease were evocative of BP, despite the absence of any formal proof. Radio-induced BP is extremely rare, with only 28 cases being described to date in the literature. The trigger mechanism is poorly understood; radiotherapy appears to cause changes in the antigenic properties of proteins in the dermal-epidermal junction resulting in production of autoantibodies. The radio-induced nature of BP does not affect therapeutic response. The case we report is novel in terms of both generalisation of the eruption and mucosal involvement.
Assuntos
Carcinoma de Células Escamosas/radioterapia , Penfigoide Bolhoso/diagnóstico , Radiodermite/diagnóstico , Neoplasias Vulvares/radioterapia , Biópsia , Carcinoma de Células Escamosas/cirurgia , Complemento C3/metabolismo , Feminino , Técnica Direta de Fluorescência para Anticorpo , Técnica Indireta de Fluorescência para Anticorpo , Humanos , Imunoglobulina G/metabolismo , Excisão de Linfonodo , Pessoa de Meia-Idade , Penfigoide Bolhoso/patologia , Radiodermite/patologia , Dosagem Radioterapêutica , Radioterapia Adjuvante , Pele/patologia , Vulva/patologia , Vulva/efeitos da radiação , Vulva/cirurgia , Neoplasias Vulvares/cirurgiaRESUMO
Demons-Meigs syndrome is a benign tumor of the ovary. It is very rare and its physiopathology remains obscure. We report a case of Demons-Meigs syndrome in a woman aged 51 years. It was discovered following a right pleural effusion syndrome with ascites and an abdominopelvic mass. Rate of serum CA 125 was 412IU/mL. Surgical exploration revealed ascites of one litre with no suspicious peritoneal lesion and an ovarian fibrothecoma of 70 mm. There were no post-operative complications and three months later, the level of CA 125 was negative with a total drainage of effusions.