R. Khiari

A rare cause of a scrotal mass: primary leiomyosarcoma of epididymis

Most masses encountered within the scrotal sac are neoplastic and occur within the testis; however a subset (2–3%) of these tumours is extra-testicular and usually arises from paratesticular tissue. Although uncommon, these tumours have a high incidence of malignancy reaching 30%, mainly represented by sarcomas (90%). Tumours occurring in the paratesticular region may be clinically indistinguishable from testicular tumours, thus resulting in initial misdiagnosis. In addition, the clinical findings are by no means specific to a tumour type and cannot distinguish between a benign and a malignant tumour, which results in difficulty in diagnosis and management. All paratesticular tumours are amenable to adequate surgical resection. Definite diagnosis is determined by histological evaluation. Leiomyosarcoma, the second most common paratesticular sarcoma after liposarcoma, is represented in the literature primarily as case reports. We report a case of LMS arising from the epididymis and focus on clinical presentation and differential diagnosis of such tumours

Article originalRésection transuréthrale de la prostate bipolaire versus monopolaire : étude prospective randomiséeBipolar versus monopolar transurethral resection of the prostate: A prospective randomized study

PURPOSE To compare bipolar with standard monopolar transurethral resection of the prostate (TURP). MATERIAL AND METHODS A prospectively randomized study was conducted between January 2010 and September 2011. Primary end points studied were efficacy (maximum flow rate [Qmax], International Prostate Symptom Score) and safety (adverse events, decline in postoperative serum sodium [Na+] and haemoglobin [Hb] levels). Secondary end points were operation time and duration of irrigation, catheterization, and hospitalization. RESULTS Sixty consecutive patients were randomized and completed the study, with 29 patients in the monopolar TURP group and 31 in the TURIS group. At baseline, the two groups were comparable in age, prostate volume, mean prostate-specific antigen value, International Prostate Symptom Score, and they had at least 12 months of follow-up. Declines in the mean postoperative serum Na+ for bipolar and monopolar TURP groups were 1.2 and 8.7 mmol/L, respectively. However, there was no statistical difference in the decline in postoperative Hb between the two groups. The mean catheterization time was 26.6 and 52 hours in the bipolar and standard groups, respectively. This difference was statistically significant as was the difference in the time to hospital discharge. The IPSS and Qmax improvements were comparable between the two groups at 12 months of follow-up. CONCLUSION No clinically relevant differences in short-term efficacy are existed between the two techniques, but bipolar TURP is preferable due to a more favorable safety profile and shorter catheterization duration.

Résection transuréthrale de la prostate bipolaire versus monopolaire : étude prospective randomisée

PURPOSE To compare bipolar with standard monopolar transurethral resection of the prostate (TURP). MATERIAL AND METHODS A prospectively randomized study was conducted between January 2010 and September 2011. Primary end points studied were efficacy (maximum flow rate [Qmax], International Prostate Symptom Score) and safety (adverse events, decline in postoperative serum sodium [Na+] and haemoglobin [Hb] levels). Secondary end points were operation time and duration of irrigation, catheterization, and hospitalization. RESULTS Sixty consecutive patients were randomized and completed the study, with 29 patients in the monopolar TURP group and 31 in the TURIS group. At baseline, the two groups were comparable in age, prostate volume, mean prostate-specific antigen value, International Prostate Symptom Score, and they had at least 12 months of follow-up. Declines in the mean postoperative serum Na+ for bipolar and monopolar TURP groups were 1.2 and 8.7 mmol/L, respectively. However, there was no statistical difference in the decline in postoperative Hb between the two groups. The mean catheterization time was 26.6 and 52 hours in the bipolar and standard groups, respectively. This difference was statistically significant as was the difference in the time to hospital discharge. The IPSS and Qmax improvements were comparable between the two groups at 12 months of follow-up. CONCLUSION No clinically relevant differences in short-term efficacy are existed between the two techniques, but bipolar TURP is preferable due to a more favorable safety profile and shorter catheterization duration.

A rare highly aggressive tumor of the kidney: The pure epithelioid angiomyolipoma

Renal epithelioid angiomyolipoma (EAML) has been recognized as a mesenchymal tumor in the 2016 World Health Organization classification of renal tumors, and a member of the family of PEComas, which may occur sporadically or in association with tuberous sclerosis syndrome (TSC). EAML is considered a potentially malignant neoplasm, since one third of the reported cases of EAML developed metastatic lesions. The “pure” form of EAML is extremely rare. It is composed of predominant or pure epithelial component and has minimal to no adipocytic component. We herin report a case of pure EAML of the kidney.

Paratesticular Angiomyofibroblastoma-Like Tumor: Unusual Case of a Solidocystic Form

The angiomyofibroblastoma-like tumor of the male genital tract is a rare benign tumor. A total of 34 cases have been reported in the literature. We herein report an exceptional case of solidocystic form in its paratesticular location, in a 79-year-old man. Clinical examination objectified a right testicular induration. Macroscopic examination of the orchidectomy objectified a paratesticular solidocystic tumor formation. Microscopically, the solid area was composed of vessels with small caliber and turgidity of endothelial cells. These vessels were surrounded by clusters of epithelioid cells, sometimes having the appearance of giant cells. They were associated with spindle cells. The cystic area was uncoated. Immunohistochemically, the fusiform cells expressed Desmin and Smooth Muscle Actin. Endothelial cells and clusters of cells surrounding large vessels expressed CD34. The expression of receptors for estrogen and progesterone was negative. To our knowledge, this is the second solidocystic case of angiomyofibroblastoma-like tumor of male genital tract.

Angiomyolipome épithélioïde rénal mimant un carcinome rénal

Epithelioid angiomyolipoma is a rare form of potentially malignant angiomyolipoma, recently considered separate entity by the World Health Organization classification of renal tumors. This lesion poses a problem in differential diagnosis with clear cell carcinomas. There are no clinical or radiological specific criteria that characterize this tumor. Immunohistochemistry revealing epithelioid cells with positive HMB45 marker is essential for diagnosis. Treatment should be discussed during the multidisciplinary consultation.