Ahmed Saadi

Vasitis: An Uncommon Diagnosis Mimicking Incarcerated Inguinal Hernia

Vasitis or inflammation of the vas deferens is a rarely described condition. Clinically, it presents with nonspecific symptoms that can be confused with other more common conditions, especially an incarcerated inguinal hernia. The diagnosis may be suggested by ultrasound or, more precisely, by computed tomography.

Le lymphangiome kystique rétropéritonéal: à propos de 5 cas et revue de la littérature

Cystic lymphangioma is a rare, benign malformation of the lymphatic vessels which may be observed on various locations. Retroperitoneal location is less common than mesenteric location. Cystic lymphangioma has a polymorphic clinical presentation. Diagnosis is based on imaging but requires histological confirmation. Surgery is the treatment of choice. The aim of our study is to analyze the clinical manifestations, complications, diagnostic and therapeutic aspects of this tumor. We report a case series of 5 patients with retroperitoneal cystic lymphangioma (4 women and 1 man) operated in our department between the years 2004 and 2014. Their medical records were reviewed retrospectively. Follow-up was based on clinical examination and abdominal CT scan. The average age was 45 years. The mean follow-up was 32.6 months. The most common symptoms indicative of retroperitoneal cystic lymphangioma were pains and/or an abdominal mass. Abdominal CT scan was the most useful diagnostic test. Total resection was immediately achieved in 4 patients and it was deferred for up to 5 years in one patient. He underwent annual ultrasound monitoring. One patient underwent nephrectomy. No recurrence or complications were noted in 5 patients. Retroperitoneal cystic lymphangioma is a rare condition. Its therapeutic management is based on complete resection in patients with symptomatic lesions or complications, in order to limit the risk of recurrence. Complete resection may be deferred in asymptomatic patients.

Discovery of Renal Tuberculosis in a Partial Nephrectomy Specimen Done for Renal Tumor.

The association of renal cancer and renal tuberculosis is uncommon. While the incidental discovery of renal cell carcinoma in a tuberculous kidney is a classical finding, the discovery of tuberculous lesions after nephrectomy for cancer is exceptional. We report the case of a female patient aged 60 who had a partial nephrectomy for a 5 cm exophytic kidney tumor. Pathological examination concluded that renal clear cell carcinoma associated with follicular caseo tuberculosis.

Retrovesical hydatic cyst: About 4 cases.

INTRODUCTION The hydatid cyst is a real public health problem in Tunisia. The retrovesical localization is rare. It is considered an aberrant or ectopic location defined by the development of the parasite in the subvesical and retrovesical fat. METHODS From 2004 to 2013, 4 patients with retrovesical hydatid cyst were hospitalized and operated in the Department of Urology at the Charles Nicolle hospital of Tunis in Tunisia. The average patient age was 40.75 years (range: 23-76). Signs of bladder irritation were the most frequent presenting complaint. No cases of hydaturia were noted. The diagnosis was made on the ultrasound and the computed tomographic urography. Hydatid serology was positive for 3 patients. In 3 cases, a hydatid cyst of the liver was associated. A total cysto-pericystectomy was performed for 1 patient, for others it was partial. RESULTS The postoperative course was uneventful. No urinary fistula or infection of the residual cavity was observed. One patient had a retroperitoneal cyst recurrence requiring reoperation. CONCLUSION Retrovesical location of hydatid cyst is rare and treatment is primarily surgical.

Female urethral diverticulum containing calculi: A rare and tricky condition

A female urethral diverticulum (UD) is an uncommon clinical entity. It occurs in 0.6–6% of the female population. The diagnosis is often delayed as the symptoms can be misleading. The complications are mainly local consisting in malignant degeneration, urinary infection and stone formation. The latter is reported in 1.5–10% of cases. The key steps in the management of UD with calculi are: a high index of suspicion, the use of imaging studies and open surgical excision. Through presenting a case of female UD with calculi and a literature review, we deal with the diagnostic, therapeutic and evolutive aspects of this pathology.

A Case Report of Scrotal Squamous Cell Carcinoma Secondary to Chronic Urinary Irritation

Most scrotum cancers are associated with occupational exposure. We report a case of a squamous cell carcinoma of the scrotum in a patient with a proximal meatus, secondary to mistreated urethral stricture. Based on our observations in this case, we think that chronic urinary inflammation of the scrotal skin may also be considered as a risk factor of scrotal cancer.

Le synovialosarcome primitif de la verge

Le synovialosarcome represente un sous-type rare des sarcomes des tissus mous. Son apparition au niveau de la verge est exceptionnelle et seulement deux cas ont ete rapportes dans la litterature auparavant. Nous rapportons un nouveau cas de synovialosarcome de la verge chez un jeune patient de 27 ans, en essayant par l’entremise d’une revue de la litterature de discuter des aspects radiologiques, histologiques, immuno-histochimiques, therapeutiques et pronostiques de cette tumeur exceptionnelle.

Superselective embolisation of bilateral superior vesical arteries for management of intractable hematuria in context of metastatic bladder cancer

Hematuria due to locally advanced or metastatic bladder cancer is a common condition and is often a management problem. Percutaneous embolisation is a mini-invasive option to handle this situation. We report a case of a patient with a metastatic bladder cancer and who presented with an abundant hematuria and severe anemia. After failure of endoscopic resections and “flush” of radiotherapy haemostatic and refusal of cystectomy by the patient, he was treated by superselective embolisation of bilateral superior bladder arteries with excellent immediate results. The technique is safe and effective in the short term. The long-term effectiveness requires further investigation.

Bilateral Orbital Metastasis of Prostatic Adenocarcinoma

Despite the high incidence of prostate carcinoma, metastases of the uvea are very rare and bilateral localization is even more. We report here the case of a 77-year-old man diagnosed with a metastatic prostate carcinoma. Two months later, he presented a decreased vision in his right eye and blurred vision in the left eye relevant to metastatic lesion on his right iris and left choroidal metastasis. The urologist should evoke possibility of ocular metastasis in patients with prostate cancer presenting visual disorders.

Cystite gangréneuse de la vessie compliquée d’une perforation spontanée en intrapéritonéal

La cystite gangreneuse compliquee d’une perforation en intraperitoneal est une pathologie extremement rare. Le facteur etiopathogenique principal est l’ischemie de la paroi vesicale. L’intoxication alcoolique comme facteur a l’origine d’une ischemie parietale cons titue un mecanisme complexe mais grave du fait de l’etendue des lesions et du terrain sur lequel se greffe cette complication. Ce cas clinique rapporte l’observation d’un patient de 36 ans, alcoolique chronique, hospitalise en raison d’un tableau clinique de peritonite aigue; L’exploration chirurgicale a revele une gangrene localisee de la vessie a l’origine d’une perforation spontanee en intraperitoneal. Apres reparation chirurgicale, la fonction et la capacite vesicales sont revenues a la normale.