T. Karmouni

Osteosarcoma of the testis

Abstract  This report describes a case of primary osteosarcoma of the testis in a 60‐year‐old man. Treatment consisted of an inguinal orchiectomy with no adjuvant therapy. The patient is alive and doing well without recurrent disease at 18 months after diagnosis. Only three reports have been published on primary osteosarcoma of the testis. The origin of this tumor from undifferentiated mesenchymal cells or from a malignant transformation of pre‐existing teratomatous elements is still unclear. Management guidelines are difficult to establish due to the rarity of such tumors, but inguinal orchiectomy with careful follow up appears to be sufficient treatment.

Les fistules vésico-utérines : une expérience de 17 ans

OBJECTIVE To discuss the diagnostic and the prognostic problems of vesicouterine fistulas (VUF) emphasizing on the therapeutic characteristics that lead to successful treatment. MATERIALS AND METHODS The authors retrieve retrospective series of 16 cases, collected between 1989 and June 2006, and they analyze the clinical, diagnostic and therapeutic aspects. RESULTS The patients were young (29-40 years) with an average having three children. Cesarean was the most frequent etiology. The presentation symptoms were hematuria (in five cases), a urinary incontinence through the vagina (in eight cases) and both of them (in three cases). The diagnosis was suspected from the history and confirmed by the additional analyses. The treatment was surgical (excision of the fistulas) in 15 cases with an average follow-up of 2.5 years, the results on the functional aspect were satisfactory hence they were marked by the absence of urinary incontinence as well as the hematuria. On the obstetric aspect, the occurrence of pregnancy was noted in a patient at four years post-VUF repair. CONCLUSION Vesicouterine fistulas are not very frequent and most often secondary to a cesarean or to consequences of difficult delivery. The treatment is essentially preventive by improving the obstetrical techniques through avoiding the bladder injuries during the cesareans.

Lymphoepithelioma-like carcinoma of the bladder: a case report

IntroductionLymphoepitheliomas are malignant epithelial tumors of the nasopharynx characterized by an important lymphoid proliferation at histological examination. Lymphoepithelioma-like carcinoma is a rare tumor of the bladder for which the therapeutic strategy is not clearly defined.Case presentationWe report the case of a 64-year-old Moroccan man who presented with macroscopic hematuria. Investigations revealed a muscle-invasive lymphoepithelioma-like carcinoma of the bladder. Therefore he underwent a radical cystoprostatectomy with a good outcome.ConclusionThis case illustrates pathogenic, clinical and therapeutic features of this unusual tumor.

Le syndrome de Youssef (fistule vésico-utérine) : à propos de trois observations

Resume Les auteurs rapportent une serie de trois cas de syndrome de Youssef colliges sur une periode de 10 ans. Les fistules etaient toutes secondaires a une cesarienne. Le diagnostic a ete pose par l’examen clinique dans un cas. L’urographie intraveineuse (UIV) a ete realisee chez toutes les patientes et n’a visualise la cavite uterine que dans un cas. Dans les cas restants, le diagnostic a ete pose par l’urethrocystographie retrograde et mictionnelle (UCRM). Le traitement a ete chirurgical pour deux patientes, la 3 e patiente a refuse l’intervention chirurgicale. Avec un recul moyen de 15 mois, le resultat juge sur la disparition des signes cliniques a ete bon chez les deux patientes operees. Le but de ce travail est d’etudier les aspects etiopathogeniques, diagnostiques et therapeutiques du syndrome de Youssef.

Traitement endoscopique du reflux vésico-urétéral par injection sous-méatique de graisse autologue. A propos de deux cas

The authors report two cases of endoscopic treatment of vesico-ureteral reflux by submeatic injection of autologous fat. We describe the technique of prelevement and injection. The immediate results confirm the efficacity of this procedure. The long-term follow-up will allow us to adopt it and to give it some modifications.

Fistule vésico-vaginale néoplasique secondaire à une tumeur de vessie: une entité rare

Vesico-vaginal Fistula (VVF) secondary to bladder cancer is extremely rare. We report the case of a 54-year old post-menopausal patient with neoplasic Vesico-vaginal Fistula (VVF), without any surgical antecedents or recent obstetric trauma. Biopsy of the edges of the fistula confirmed urothelial carcinoma. In light of this observation, we here discuss VVF etiological forms and their different therapeutic strategies.

Mésothéliome paratesticulaire malin : cas clinique et revue de la littérature

Les mesotheliomes sont des tumeurs rares, liees surtout a l’exposition a l’amiante. La localisation dans la tunique vaginale est moins frequente que les localisations pleurale et peritoneale. Nous faisons etat du cas clinique d’un jeune patient de 30 ans qui presentait une masse testiculaire gauche avec lesion tissulaire intratesticulaire visible a l’echographie. Il a subi une orchidectomie ; l’examen anatomopathologique de la piece operatoire orientait le diagnostic en faveur d’un mesotheliome malin de la tunique vaginale. Une hemiscrotectomie a ete realisee par la suite, et le bilan d’extension n’a pas revele de lesion secondaire. L’evolution s’est averee favorable moyennant un recul de quatre ans. A travers ce cas clinique et par l’entremise d’une revue de litterature, nous analysons les aspects epidemiologiques, diagnostiques et therapeutiques de cette pathologie rare.

Complications de l’hormonothérapie anti-androgénique du cancer de la prostate

Les effets indesirables de l’hormonotherapie anti-androgenique (HAA) dans le traitement du cancer de la prostate sont attribuables a la carence d’androgenes. L’HAA entraine le syndrome de castration, qui se caracterise par une diminution de la libido, la dysfonction erectile, l’asthenie, des bouffees de chaleur, la diminution des capacites intellectuelles et la depression. Il en resulte egalement une augmentation de la graisse abdominale, ce qui favorise l’insulinoresistance et le diabete. La perte de la densite minerale osseuse secondaire a l’HAA entraine un risque fracturaire accru. Il existe de plus un risque cardiovasculaire important du aux facteurs metaboliques. L’effet therapeutique de l’HAA doit donc etre soupese en regard de la toxicite liee a l’hypogonadisme.

La néphrostomie percutanée : utilisation d'un matériel simple peu onéreux dans des conditions d'urgence en situation précaire

We describe a cheap and simply technique of percutaneous nephrostomy which can be used anywhere. It consists, under local anesthesia, of insertion of a drain into renal cavity using only a needle, a sheat and dilatator. With this technique, we placed 81 PCN with 97% of success, without complication.

Liposarcome rétropéritonéal. A propos d'un cas

Resume Nous rapportons un cas de liposarcome retroperitoneal traite par la chirurgie et la radiotherapie. A travers une revue de la litterature nous discutons les aspects diagnostiques et therapeutiques.