[Paratesticular mesothelioma: A rare case report]. / Mésothéliome paratesticulaire : à propos d'un cas rare.

Paratesticular mesothelioma is a very rare tumour, accounting for 0.3 to 1.4% of all mesotheliomas. Mesothelioma arising from the spermatic cord is extremely rare with only a few cases reported in the literature. We report a case of spermatic cord mesothelioma in a 70-year-old man who presented with a right inguinal mass and pain.

Large retroperitoneal ganglioneuroma revealed by a left ovarian endometrioma: A case report.

Uncommon in nature, retroperitoneal ganglioneuroma represents a neuroblastic benign tumor, predominantly manifesting in young adults, with a notable predilection for females. Often asymptomatic, the condition is frequently diagnosed incidentally due to delayed growth. Clinical manifestations arise primarily from the compression exerted on neighboring organs and vessels. The exclusive curative recourse lies in surgical intervention, underscoring the challenging task of achieving complete tumor excision, particularly when the ganglioneuroma attains considerable development and encapsulates significant retroperitoneal vessels. In this instance, we elucidate a case involving a 33-year-old woman, who had previously undergone a triple valve replacement due to rheumatic valvular disease, presenting persistent pelvic pain, unearthing a substantial asymptomatic retroperitoneal ganglioneuroma concomitant with an ovarian endometrioma. A laparotomy procedure was conducted, and to achieve a comprehensive excision of the mass, a meticulous intratumoral circular dissection of the prominent vessels, notably the superior mesenteric artery and celiac trunk, was undertaken. No local recurrence has been reported, 6 months after surgery. The significance of an experienced and well-trained surgical staff is underscored in addressing the complexities associated with this condition.

Buschke-Lowenstein tumor in the penis and anorectal region: case report.

The Buschke-Lowenstein Tumor is a giant condyloma acuminatum caused by human papillomavirus, most commonly types 6 or 11. It is a rare condition with an estimated frequency of 0.1% in the general population. Transmission primarily occurs through sexual contact. It particularly affects men, predominantly appearing on the penis, characterized by its deep-seated growth, potential for degeneration, and tendency to recur after treatment. Surgery is the preferred treatment. We present the case of a50-year-old patient with a history of recurrent urethritis and multiple sexual partners. The patient sought medical attention for a swelling on the penis that had been progressively developing over the past 10 years. An MRI was performed for a locoregional study, revealing a perineal and penile mass with polylobed contours resembling a cauliflower, along with a sizable perineal mass Histological examination of a biopsy sample from the penis confirmed the diagnosis. Unfortunately, due to the tumor's characteristics and the patient's condition, surgery was contraindicated.

Pseudomyogenic Hemangioendothelioma Arising in the Maxillary Sinus, an Uncommon and Misdiagnosed Tumor: A Case Report.

Pseudomyogenic hemangioendothelioma (PMHE) is a rare vascular neoplasm with an intermediate to low-grade malignant potential. Only 5% of PMHEs occur in the head and neck. This tumor exhibits different histological patterns and mimics other vascular tumors, myoid tumors, or carcinomas. The distinction between these tumors can be a very challenging situation for pathologists. In this article, we report the first case, to our knowledge, of PMHE arising in the maxillary sinus, to highlight this uncommon entity and discuss differential diagnoses.

Pseudotumor inflammatory of the spleen: A rare entity with diagnostic and therapeutic challenges: A case report.

INTRODUCTION AND IMPORTANCE: Inflammatory pseudotumor (IPT) of the spleen is a rare entity that can be difficult distinguishing it from malignancies, both in clinical presentation and radiological imaging. CASE PRESENTATION: We present the case of a 43-year-old female presented with 15-cm left hypochondrial mass, Initial imaging studies raised concerns of malignancy, leading to a splenectomy. However, the final pathological examination determined that the patient had IPT of the spleen with focal expression of Smooth Muscle Antibody (SMA). CLINICAL DISCUSSION: This case highlights the importance of considering IPT as a potential diagnosis of splenic masses that was difficult to diagnose before surgery. CONCLUSION: The uniqueness of the case under consideration lies in the rarity and the atypical localization of IPT of the spleen.

Hybrid Management of a Wünderlich's Syndrome Secondary to a Giant Ruptured Renal Angiomyolipoma: A Case Report.

Wünderlich's syndrome, a rare and life-threatening condition involving spontaneous renal hemorrhage, is commonly associated with renal angiomyolipoma (rAML). Management options for rAML include surveillance, mTOR inhibitors, selective arterial embolization (SAE), and surgery. When complicated by Wünderlich's syndrome, prompt and adequate interventional treatment is necessary to prevent fatal outcomes. We present a unique case of a young female patient with Tuberous Sclerosis Complex who experienced a massive ruptured rAML, leading to Wünderlich's syndrome. Our approach involved a multidisciplinary hybrid strategy, combining SAE and nephrectomy, highlighting SAE's valuable role even when radical treatment is required.

Primary cutaneous adenoid cystic carcinoma with lung metastasis: A case report with literature review.

Adenoid cystic carcinoma is a rare tumor that typically originates from secretory glands, most commonly found in the salivary glands. However, it can also develop as a primary cutaneous adenoid cystic carcinoma, which appears identical under the microscope to adenoid cystic carcinoma originating in other tissues. Distinguishing between primary cutaneous adenoid cystic carcinoma and extracutaneous adenoid cystic carcinoma with cutaneous metastases is crucial for determining the prognosis and appropriate management of the condition. In this case report, we describe a case of primary cutaneous adenoid cystic carcinoma located on the hand with lung metastases. Proper differentiation, treatment planning and regular clinical follow-up to monitor for any signs of recurrence or metastasis are essential to ensure favorable outcomes for patients with this rare neoplasm.

Perineal papilliferous syringocystadenoma: An unusual localization.

INTRODUCTION AND IMPORTANCE: Syringocystadenoma papiliferum (SCAP) is an infrequent, benign neoplasm originating from the apocrine or, less frequently, eccrine sweat glands. This condition predominantly manifests in regions such as the head, face, neck, and trunk. Notably, it is frequently associated with hamartomas of endocrine, sebaceous, or follicular origin, as well as with sebaceous nevi. CASE PRESENTATION: In the context of this study, we present a clinical case involving a 65-year-old patient who exhibited an atypical anatomical presentation of syringocystadenoma papiliferum. CLINICAL DISCUSSION: This case highlights the importance of considering SCAP as a potential diagnosis of perineal cystic masses that need a surgical excision due to the risk of malignancy transformation. CONCLUSION: The uniqueness of the case under consideration lies in the rarity of syringocystadenoma papiliferum (SCAP), the atypical perineal localization, and its occurrence at an advanced age (65 years).

Osseous hydatid disease: A mimic of other skeletal pathologies.

Hydatid disease is still endemic in several regions worldwide including Morocco, and is caused in most cases by the larval form of 2 species of the tapeworm Echinococcus: E. granulosus and E. multilocularis. Primary hydatid disease of the bone without systemic involvement is rare. The disease has a silent clinical evolution until it reaches complicated stages. Complications may include pathological fracture, neural deficit, infection, and fistulization of the abscess. Preoperative diagnosis is based on clinical history, imaging findings, and serological tests, which lack high sensitivity and specificity. Although the interpretation of imaging studies can prove to be very confusing because the bone changes evolve with time, and the nonspecificity of these findings often leads to a mistaken diagnosis. The diagnosis requires a high index of suspicion, especially in patients who reside in or travel to sheep-raising areas where hydatid disease is endemic. A high index of suspicion is necessary for the diagnosis, especially in patients that live in or travel to sheep-raising areas where hydatid disease is endemic. The treatment of choice remains surgical, following the principles of a locally malignant lesion. Chemotherapy (albendazole alone or in combination with praziquantel) is indicated when surgery is not possible or as an adjuvant treatment. The prognosis is often poor. We report the case of a 28-year-old woman with long-standing pain in the left hip joint in which the imaging findings were thought of as being either tuberculous or neoplastic. The result of a CT-guided biopsy concurred with an unexpected diagnosis of a hydatid cyst. This case highlights that in the absence of a high index of suspicion for echinococcal infection, the semblance of imaging findings of hydatid disease in the bone to those of other skeletal pathologies can lead to misinterpretation.

Diagnostic challenge: primary leptomeningeal melanoma with melanomatosis, illustrative case report.

Primary leptomeningeal melanoma is an extremely rare type of intracranial melanoma. It cannot be reliably distinguished from metastatic melanoma on neuroimaging and histopathological characteristics alone; its diagnosis is established only after exclusion of secondary metastatic disease from a cutaneous, mucosal or retinal primary. Prognosis is poor, partly due to its high rate of misdiagnosis. Herein, we report a case of a primary meningeal melanoma of the skull base with melanomatosis, in a 31-year-old man, mimicking meningioma. Our aim is to highlight the diagnostic pitfalls and to discuss the histopathological differential diagnoses, especially with other pigmented lesions of central nervous system.

Solitary infantile myofibromatosis of the petrous bone: a diagnostic pitfall in uncommon location illustrated by a case report.

Infantile myofibromatosis (IM) is the most common fibrous disorder of infancy and early childhood. Solitary intracranial involvement is rare and often unrecognized. This makes its early diagnosis and adequate management difficult. The majority of lesions are localized to the skull or dura with variable intracranial extension. Herein, we report a misdiagnosed and aggressive presentation of a solitary IM of the petrous bone. Our aim is to discuss histopathological differential diagnoses and management difficulties.

Bifocal Intracanial Rosai-Dorfman Disease Mimicking Lymphoplasmacyte-Rich Meningioma: Diagnostic Pitfalls About a Case Report.

Rosai-Dorfman disease (RDD) is a clonal histiocytic proliferation characterized by large S100 positive histiocytes with variable emperipolesis. Extranodal locations were confirmed with the central nervous system or the meninges involvement in less than 5% of cases, which is marked as a significant differential diagnosis of meningiomas in radiological and intra-operative pathological examination. Histopathology and immunohistochemistry are the keys to definitive diagnosis. We present a case of bifocal Rosai-Dorfman disease in a 26-year-old man, mimicking Lymphoplasmacyte-rich Meningioma. This case allows us to demonstrate the diagnosis pitfalls encountered in this localization.

Rare case of Malign Peripheral Nerve Sheath Tumor complicating a solitary giant neurofibroma of the thigh.

INTRODUCTION AND IMPORTANCE: Malign Peripheral Nerve Sheath Tumor is rare and can occur on a solitary neurofibroma or as part of neurofibromatosis type 1. The occurrence of a giant solitary neurofibroma in the thigh is rare and its complication in MPNST is much rarer. The diagnosis is based on a combination of radiological, histological and immunohistochemical evidence. CASE PRESENTATION: We present the case of a 55 years old woman who presented a mass of the posterior aspect of the thigh without any other abnormality on systemic examination. MRI showed a T1 hyposignal and a T2 hypersignal and the biopsy performed was in favor of a neurofibroma. After surgical resection, the histological study of the surgical specimen revealed an MPNST developing on a pre-existing neurofibroma. After 5 months, the patient had moderate knee stiffness with thigh amyotrophy. CLINICAL DISCUSSION: The occurrence of MPNST on a giant solitary neurofibroma of the thigh is extremely rare. MRI allows evoking the diagnosis but radiologists are confronted with a problem of differential diagnosis. Histological examination supports the diagnosis in addition to immunohistochemical examination. Only surgical treatment can give hope for a cure. Recurrences remain frequent with a 5-year survival of 50 %. CONCLUSION: Early diagnosis is essential to prevent the evolution of the tumor and the occurrence of poor prognostic factors compromising the management, increasing the risk of recurrence and affecting the overall survival of patients.

Hepatoid Adenocarcinoma of the Lung: A Rare Form of Lung Cancer.

Hepatoid adenocarcinoma is a rare type of extrahepatic adenocarcinoma with glandular and hepatocyte differenciation. The tumor can occur in many organs, generally in the stomach, the location of the lung being extremely rare. Despite poor prognosis and few effective treatment options, a timely and accurate histopathological diagnosis is key to optimal clinical management for long-term survival. Given the few reports published to characterized hepatoid adenocarcinoma, the emergence of any new case will contribute to improve understanding of the disease. Very few reports have been published to characterize hepatoid adenocarcinoma cytologically or even histologically. The aim of this work is to focus on the anatomoclinical characteristics of this rare entity. We present a retrospective study of 2 cases of pulmonary hepatoid adenocarcinoma confirmed by histological and immunohistochemical study.

Malignant peripheral nerve sheath tumors of the sino-nasal tract: about an unusual case report.

Malignant peripheral nerve sheath tumors are defined as malignant tumors arising from or differentiating toward the cells of the peripheral nerve sheath. They occur in about 8-16% within the head and neck region. Morphologically, some malignant tumors look like malignant peripheral nerve sheath tumors, particularly in the head and neck location; however, immunohistochemistry have a great contribution to distinguish between them. This case report is on a 45-year-old woman with a malignant peripheral nerve sheath tumor located in the sino-nasal tract.

In-silico identification of potential inhibitors targeting the DNA binding domain of estrogen receptor α for the treatment of hormone therapy-resistant breast cancer.

Estrogen receptor α (ERα) plays a critical role in breast cancer (BC) development. The standard therapeutic strategies for ERα- positive (ERα+) BC consist of impairing ERα signalling pathway by either estrogen competitors blocking its interaction with the ligand binding domain (LBD) or agents inhibiting the production of estrogen. These strategies are limited by many factors that lead to constitutive activation of ERα and consequently, resistance to treatment. Targeting the DNA binding domain (DBD) of ERα instead of its LBD with small-molecule inhibitors could be an alternative to impair ERα's signalling pathway. For this purpose, we conducted a structure based virtual screening of DrugBank against the crystal structure of ERα-DBD (PDB ID: 1HCQ) using the Glide module in standard precision (SP) and extra precision (XP) mode of docking. Molecules with XP Gscore less than -8 kcal/mol were selected and visually inspected to keep only the reasonable docking poses. Subsequently, these molecules were clustered using structural interaction fingerprints analysis and the complexes of the top ranked molecules of each cluster based on XP Gscore were subjected to 200 ns molecular dynamics simulations followed by MM-GBSA binding free energy calculation for the last 100 ns of each complex. In this study, we identified three molecules from DrugBank namely DB03450, DB02593 and DB08001 showing significant stability and strong interaction with the key amino acids during MD simulation suggesting a potential inhibition of the target. These molecules could be used as promising lead compounds to impair the ERα signalisation in hormone therapy-resistant breast cancer.Communicated by Ramaswamy H. Sarma.

Pseudovascular Squamous Cell Carcinoma of the Oral Cavity: A Diagnostic Pitfall About a Case.

Squamous cell carcinoma is the most common mucosal malignancy of the head and neck. Adenoid pseudo-angiosarcomatous SCC is a rare variant occurring commonly in the skin of the head and neck. However, involvement of oral cavity is extremely rare, with only few case reports in the English literature. Morphologically, the tumor shows marked acantholysis, with anastomozing channels mimicking vascular neoplasms. This variant represents a diagnostic challenge for pathologists, and immunohistochemical analysis remains essential for an accurate diagnosis. Herein, we describe the case of a pseudovascular SCC of the oral cavity in a 67 years old man with a brief revue of the literature to raise awareness on this rare variant; presenting diagnostic difficulties.

Concurrent Angiomyolipoma and Clear Cell Renal Cell Carcinoma in the Same Kidney: A Rare Finding in a Patient without Tuberous Sclerosis.

Synchronous renal cell carcinomas (RCC) and angiomyolipomas (AML) occurring in the same kidney are rare. Cases in the setting of tuberous sclerosis (TS) have been reported in the literature. However, the association of these tumors in the same kidney without TS is even more rare. We report here a case of a clear cell renal cell carcinoma (CCRCC) associated with an AML in the same kidney in a 42 years old female lacking the TS diagnostic criteria. The patient underwent a radical nephrectomy. Six months after surgery, the patient is healthy without signs of tumor recurrence or distant metastasis.

Leiomyosarcoma of the Renal Vein Mimicking a Primitive Renal Cell Carcinoma: Case Report of an Unusual Presentation.

Primary leiomyosarcomas (LMS) of vascular origin are rare tumors, and more than half of the cases arise in the inferior vena cava (IVC). Primary LMS of the renal vein are extremely rare tumors with only a few cases reported in the literature. Their diagnosis is made only by pathological features. Histologically, they are made of atypical spindle-shaped cells arranged in long intersecting fascicles. Tumor cells stain positive for myogenic markers in immunohistochemistry. Standard treatment consists of radical nephrectomy followed by chemotherapy and/or radiotherapy. Because of insufficient histological data and follow-up, the prognosis factors are not well identified. Overall prognosis of renal vein LMS is poor. We report here an exceptional case of a huge LMS of the right renal vein mimicking a primitive renal cell carcinoma, occurring in a 56-year-old male patient.

Primary Hodgkin lymphoma of the ulnar nerve: the first case report with review of the literature.

Hodgkin lymphoma is a lymphoid malignancy characterized by minority population of neoplastic cells (Reed-Sternberg cells and its variants) within a reactive inflammatory background. It encompasses two entities: classical HL (∼95% of cases) and nodular lymphocyte predominant HL (∼5% of cases). Primary lymphoma of peripheral nerves (PLPN) represent a very rare condition, since only 19 cases have been reported in the English literature to date, all of which are of a non-HL phenotype. A 20-year-old female presented an intramural mass of the ulnar nerve. Histological analysis revealed a Classical Hodgkin lymphoma. Further investigations failed to reveal nodal or extranodal involvement. PLPN is a very rare entity. There is a need for further understanding of this unusual lymphoma presentation.