Haroun Ayed

Voluminous Incidental Oncocytic Neoplasm of the Adrenal Gland With Uncertain Malignant Potential

A 74-year-old man presented with right flank pain and a palpable mass in the left flank. Blood pressure was normal. Contrastenhanced computed tomography (CT) showed a 17 × 16 × 12 cm retroperitoneal mass over the left kidney, solid and heterogeneous. There were also 3 retro aortic lymph nodes and bilateral renal lithiasis. Twenty four-hour urinary metanephrines and normetanephrines were normal. The patient underwent a resection of the mass with left adrenalectomy by a lumbar incision. Histological findings revealed an adrenal oncocytic neoplasm (AON) with uncertain malignant potential. Six months after surgery, CT control showed neither local nor distant recurrence.

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.

Purple urine bag syndrome, a disturbing urine discoloration

Purple urine bag syndrome (PUBS) is a rare and disturbing situtation for patients relative and the care team. Its mainly observed in long term bedridden with an indwelling urinary cathter use patients. PUBS is usually harmless and asymptomatic, but it may lead to severe conditions with a considerable morbidity and mortality. Authors report a case occurring in a 78 years old male patient, describing clinical and evolutive features, and discussing physiopathology and managment of PUBS.

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.

Splenogonadal fusion - a rare cause of scrotal swelling: a case report

BackgroundSplenogonadal fusion is a rare and benign condition. Diagnosis is challenging for clinicians. Despite its indolence, diagnosis is often confirmed after orchidectomy. Surgery is mandatory, particularly to rule out the extremely rare association with malignancy.Case presentationWe report a case of splenogonadal fusion in a 38-year-old North African man presenting a palpable scrotal mass. We describe clinical aspects, pathogenic hypothesis, radiological features, as well as surgical management principles.ConclusionsSplenogonadal fusion is rarely suspected and diagnosed preoperatively. A diagnosis is made once an ectopic testicular mass is associated with cryptorchidism and suggestive radiological signs. A better knowledge of the clinical and radiological features of splenogonadal fusion provides an opportunity for conservative surgery.

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.

Transitional Bladder Cell Carcinoma Spreading to the Skin

Cutaneous metastases from bladder malignancies are rare. We report the case of a 74 year old man who underwent cysto-prostatectomy and adjuvant chemotherapy for a pT3b N+ bladder transitional cell carcinoma. Four months later, he presented with skin disseminated pigmented lesions. Skin biopsy confirmed cutaneous metastasis from urothelial carcinoma.