Besma Ben Dhaou

Ectopic Axillary Breast during Systemic Lupus.

Many breast changes may occur in systemic lupus erythematosus. We report a 41-year-old woman with lupus who presented three years after the onset of lupus an ectopic mammary gland confirmed by histological study.

Cervical Pott's disease revealed by retropharyngeal abcess

montrait une raréfaction des plissements duodénales puis faire é, un t sera [12] Changela K, Safai Haeri N, Krishnaiah M, Reddy M. Plummer-Vinson Syndrome with proximal esophageal web. J Gastrointest Surg 2016;20 (5):1074–5. http://dx.doi.org/10.1007/s11605-015-3051-3055. [13] Bakari G, Benelbarhdadi I, Bahije L, El Feydi Essaid A. Endoscopic treatment of 135 cases of Plummer-Vinson web: a pilot experience. Gastrointestinal Endoscopy 2014;80(4):738–41. Lettres à la rédaction

Kaposi’s Sarcoma Presenting as Lymphadenopathy in an Immunocompetent Patient

Introduction Kaposi’s sarcoma (KS) is an angioproliferative disorder first described in 1872 by Moritz Kaposi. Four main clinical presentations of KS have been described: classic, endemic, iatrogenic and epidemic. KS involvement of the lymph nodes is extremely uncommon in the classical variant form, especially if it precedes the skin manifestations. We describe the case of an elderly HIV-negative patient presenting with lymphadenopathy who was found to have KS. Case Report A 67-year-old patient was admitted for exploration of polyadenopathies in the context of a general decline in health. Physical examination revealed an erythematosus left lower limb rash associated with angiomatous nodules and multiple lymphadenopathies. The diagnosis of erysipelas in the left leg was retained and the patient was treated with good evolution of the rash but persistence of the angiomatous nodules and the polyadenopathies. Skin and lymph node biopsies led to a diagnosis of KS. The patient is proposed for polychemotherapy. Conclusion KS must be suspected in lymphadenopathies despite the absence of typical cutaneous signs of the disease and in immunocompetent patients. LEARNING POINTS Involvement of the lymph nodes is extremely uncommon in the classical variant form of Kaposi’s sarcoma (KS). Human herpes virus-8 is an important cofactor in all forms of KS. Pathology and immunohistochemistry are key to diagnosing KS. KS must be suspected in lymphadenopathies without typical cutaneous signs of the disease and in immunocompetent patients.

Wegners Granulomatosis Revealed by Exophthalmos

Ophthalmic involvement is frequent, between 30% and 70% of patient’s present ophthalmic symptoms during the course of Wegner’s granulomatosis. Orbital disease may present initially before the onset of systemic manifestations in only 8 to 16% of patients and it could delay final diagnosis. We report a case illustrates the diagnosis of Wegner’s granulomatosis presenting with proptosis (exophthalmos) of the orbit. Patient was treated with corticosteroid and intravenous cyclophosphamide (CYC) with good response. This case emphasizes early diagnosis and treatment to avoid further complications

Renal paraneoplastic vasculitis complicating lung adenocarcinoma.

Renal paraneoplastic vasculitis (RNPV) is rare. It can be revealed by glomerulonephritis, microaneurysms or renal failure. RPNV may precede the onset of the primary tumor, and treatment and prognosis depend on the etiology (primary tumor). A 54-year-old man who had a primary lung adenocarcinoma was admitted for nephrotic syndrome. The investigations revealed RNPV. The patient was treated with corticosteroids at high dose and cyclophosphamide with improvement of the renal condition; however, the patient died from worsening of his pulmonary neoplasia.