A. Jalil

Primary lymphoma of the ovary

Involvement of the ovary by malignant lymphoma is a well-known late manifestation of disseminated nodal disease. Primary ovarian lymphoma is rare. We report a case of primary ovarian non-Hodgkins lymphoma with bilateral involvement which was managed by surgery and chemotherapy. A 29-year-old woman was admitted with signs and symptoms suggestive of an ovarian cancer. Computed tomography revealed an abdominal tumor measuring 20 cm in diameter, without enlarged lymph nodes. The diagnosis of malignant lymphoma was established after bilateral adnexectomy and histological study of the excised tissue. The tumor was classified as a diffuse large B-cell lymphoma. The patient has been advised 8 cycles of standard CHOP regimen and is presently on treatment. She has now been without disease for 7 months after the surgery. According to previous reports the treatment principles and prognosis of primary ovarian lymphoma is the same as that of other nodal lymphomas.

Association d’une tumeur ovarienne de la granulosa juvénile à un syndrome de Maffucci

The authors report a rare case of the ovarian juvenile granulosa cell tumor associated with Maffuccis syndrome (enchondromathosis + hemangiomas), no heriditary mesodermal dysplasia. Sarcomatous changes of chondromas are encountered most frequently; however other various typed neoplasma have been reported: ovarian juvenile granulosa cell tumor may occur not infrequently in female patients with Maffuccis syndrome in the first or second decades. Sarcomatous changes of choromas established prognosis of the Maffuccis syndrome.

Primary Carcinosarcoma of the Skin

Primary cutaneous carcinosarcoma is a biphasic tumour containing both malignant epithelial and malignant mesenchymal elements. The disease is a rare malignant skin tumour of unknown aetiology with significant potential to recur locally and to metastasise. Surgery is the primary therapeutic modality. We describe an unusual case of primary cutaneous Carcinosarcoma localised in the hand.

Paget disease of the male nipple.

Breast cancer occurring in the mammary gland of men is infrequent. It accounts for 0.8% of all breast cancers, which is less than one per cent of all newly diagnosed male cancers and 0.2% of male cancer deaths. However, Paget disease of the male nipple is extremely rare. We report a single case of Paget disease with infiltrative ductal carcinoma of the breast in a 61-year-old man.

Fistules urétérovaginales post-radiques. À propos de 12 cas

Resume Les auteurs rapportent une serie de 12 observations colligees durant une periode de 15 ans (1985–2000). L’âge moyen des malades est de (38 ans) (27–44 ans). Dix fistules ureterovaginales (84 %) sont secondaires a une radiotherapie suivie d’une intervention de Wertheim. Deux fistules ureterovaginales etaient survenues apres l’association de curietherapie–radiotherapie externe pour carcinome epidermoide du col uterin. Le diagnostic est pose sur les donnees de l’anamnese, le test d’etancheite vesicale et l’examen gynecologique sous valve. L’urographie intraveineuse montre le siege, l’etendue, le type de lesion et le retentissement sur le haut appareil. Le traitement a consiste en une uretero-ureterostomie chez 7 patientes ; une reimplantation ureterovesicale avec vessie psoique chez 3 patientes ; une endoprothese JJ chez 2 patientes. Sur le plan local, l’evolution etait favorable chez 84 % des patientes. Sur le plan general, 2 deces survenus suite a des metastases viscerales avec insuffisance renale avancee chez 2 patientes qui avaient ete perdues de vue pendant 3 a 7 ans.

Surgical management for squamous cell carcinoma of vulva.

To analyze our surgical management and the result of squamous cell carcinoma (SCC) of vulva. Retrospectively, we collected 38 cases of SCC; 17 cases of them were early SCC and 21 cases were locally advanced. The patients underwent primary surgery. The survival was estimated using Kaplan-Meier analysis and the log rank test. The mean age was 60.78 years. Total vulvectomy was performed in all patients. Superficial and deep incision of bilateral inguinal lymphadenectomy was performed by separates incisions for SCC infiltrating more than 1mm. The average tumor size was 53 mm (10 to 140mm). Morbidity was 42.1%. Lateral resection margin ≥8mm was obtained in 57.1%. Eighteen patients benefited from adjuvant radiotherapy. The follow-up median was 19.4 months (6 to 61.5 month) with 05 recurrences in 12 months. The survival using the Kaplan-Meyer analysis at 5 years, was 62.1% (71.2%N- vs 46.7%N+; p = 0.13). We identified two groups for locally advanced vulva cancer. Primary surgery keeps its place. Neo adjuvant radio chemotherapy followed by surgery is the alternative treatment for locally extensive lesions.

Cancer du rein : à propos de 47 cas

Resume Les auteurs rapportent une serie de 47 cas de cancers renaux chez l’adulte, colliges au service de chirurgie carcinologique de l’institut national d’oncologie de Rabat entre janvier 1985 et janvier 1999. Nos cas se repartissent en 16 hommes et 21 femmes (57 %) avec un âge moyen de 49 ans (29–70 ans). Le cortege de signes cliniques est variable, le motif de consultation le plus dominant etait les lombalgies unilaterales (81 %), une hematurie (25 %), une masse lombaire (10 %). L’uroscanner etait effectue chez tous les malades. La localisation la plus frequente etait polaire inferieure (53 %), la taille du processus tumoral etait entre 5 et 17 cm de diametre. Le traitement etait chirurgical chez 46 patients par une nephrectomie totale elargie avec un curage ganglionnaire de principe. Les suites operatoires ont ete simples. Un deces suite a des metastases synchrones chez un malade non operable. Le suivi moyen s’etend de 2 a 15 ans. L’apparition de metastases asynchrones est observee chez 6 patients operes apres un delai de 9 a 36 mois. La survie a 5 ans est de 100 % pour le stade PT1, 78 % pour les PT2 et de 34 % pour les PT3.

Elastofibroma dorsi: case report and review of the literature

Elastofibroma dorsi (ED) is an uncommon benign soft tissue tumor with an uncertain pathogenesis. It mostly occurs in the infrascapular region of elderly people with a female predominance. Typically bilateral, ED can also be unilateral. While many patients remain asymptomatic, ED can be responsible of a periscapular arch source of ache. The diagnosis of ED is set on magnetic resonance imaging, and the pathological study ensures the diagnosis after surgical excision and establishes the differential diagnosis with malignant neoplasic process. The prognosis is excellent with extremely rare recurrence cases. Herein we report a case of a 54-years-old woman with a bilateral painful ED. The diagnosis was based on clinical and MRI findings that revealed bilateral tumors. Surgery was decided due to the symptomatic nature of the tumors. Pathological study confirmed the diagnosis. The post operative course was uncomplicated. We update through a review of the literature aspects of the diagnostic and therapeutic care of Elastofibroma dorsi.