Neuroendocrine tumors with small cell cervical represent less than 2% of cervical cancers, and if their evolution depends on the volume and tumor stage, prognosis is generally dark Morphological characteristics and clinical features of these tumors are comparable with neuroendocrine tumors of the lung. This tumor can also be found in other sites such as the skin, gastrointestinal tract, pancreas and cervical region. We report two new cases of neuroendocrine carcinoma of the cervix small cell and through the literature data we review the different aspects of this rare entity.
Lactating adenoma is a benign tumor of pregnancy and lactation, found most often in the third trimester of pregnancy and less frequently during lactation. Clinically, it presents itself as a unique and discrete mobile mass. It is a rare benign tumor which the diagnosis requires pathological confirmation. Usually it disappears spontaneously. Chirurgical treatment is offered for aesthetic problems related to the size of the adenoma. The authors report a case of lactating adenoma discovered at eight months of the post partum. Through this case, they discuss the clinical, radiological, histopathological aspects and various therapeutic modalities of this tumor.
Isolated massive vulval edema in pregnancy is rare. The causative mechanisms remains poorly understood but it is probably related to mechanical, osmotic and hormonal factors. The differential diagnosis of vulval edema includes infections, tumors, lymph birth defects, trauma, inflammatory and metabolic diseases. The authors report a case of a 27 year-old primigravida woman with twin pregnancy who was admitted to the obstetrical emergency at 37 weeks of gestation for a severe anemic syndrom associated to a massive vulval edema with no sign of pre-eclampsia. Biological examination showed a severe microcytic hypochromic anemia associated to a hypoproteinemia. Other causes of vulval edema were excluded. After blood transfusion, the patient gave birth by Caesarean section. In the post partum period, the vulval edema resolved progressively. By the fourteenth day post cesarean section, the vulval edema had completely regressed. Three weeks later, a spontaneous regression of the vulval edema was observed. The aim of this report this case is to discuss the clinical aspects, differential diagnosis, causes and evolution of vulval edema in pregnancy.
The definition of borderline ovarian tumors is pathological. It is based on the combination of several histological criteria established by Hart and Norris and reviewed by Scully et al. : pluristratification and epithelial budding, increased mitotic activity which can be very variable, cytonuclear atypia (differential diagnosis with benign tumors), absence of stromal invasion (differential diagnosis of malignant tumors). Serous tumors represent approximately 55% of borderline tumors. They are bilateral in 28-50% of cases. This histological type is, however, more often associated with extra-ovarian locations, as found in 30% of cases on average peritoneal implants whose detection is fundamental because the class tumor stage III. These can be invasive or non-invasive, the prognostic value of invasiveness is controversial. Pre and intraoperative diagnosis of borderline ovarian tumors is difficult and requires a multidisciplinary approach, involving surgeons, pathologists, radiologists and medical oncologists trained as much as possible with this type of lesion border. Staging should be as complete as possible and should be as far as possible during the initial surgical resection. A restaging should be made when the initial staging is incomplete. Restaging does not affect patient survival but used to evaluate the prognosis of the initial tumor. Its indication still remains controversial: it is recommended for early-stage tumors, for which the treatment is now well codified. The authors discuss the issue of keeping the ovaries during hysterectomy for benign lesions throught the case of a patient of 50 years who benefited 9 years ago a subtotal hysterectomy for polymyomatous uterus and presented a bilateral serous tumor borderline on remaining ovary.
Ogilvie's syndrome is a rare postsurgical complication. The high mortality rate after caecal perforation explains the seriousness of this clinical situation. The early diagnosis is made by plain abdominal X-ray and abdominal scanner. Conservative treatment is usually effective and surgery should be reserved for complicated cases or refractory to conservative treatment. We report a case of Ogilvie's syndrome after cesarean section. A case is reported clinical evolution of a chronic colonic obstruction disease after cesarean section which has been treated by conservative methods as Prostigmine
Design hemodialysis is a rare event, maternal-fetal high risk because of the frequency of complications. However, improved technology and quality hemodialysis improves fertility in chronic hemodialysis patients of childbearing age with increasing number of pregnancies and decreased rates of premature and others complications. Indeed, treatment of anemia, and improved figures uremia by intensive dialysis in women on hemodialysis, and treatment of other complications, may improve outcomes. In chronic kidney disease and pregnancy exert on each other interaction: CKD sounds on fetal prognosis, while pregnancy can alter the course of the CKD. This pregnancy should be planned and benefit from joint monitoring by a nephrologist, obstetrician, especially when the patient is hypertensive, This pregnancy should be planned and benefit from joint monitoring by a nephrologist and obstetrician, especially when the patient is hypertensive, and effective contraception, reversible, safe and reliable, must be chosen in these patients and as well as those which have been grafted and of childbearing. But currently, the majority of patients suffering from this disease are likely to have a pregnancy, like other moms, no worsening of their kidney, thanks to recent advances in obstetrics and neonatology. We report a case of pregnancy led to 36SA in chronic hemodialysis patient from the age of 13, and we will consider successively the general factors of maternal and fetal prognosis in patients with CKD, complications that this pregnancy and the impact of pregnancy on chronic renal dialysis stage, to finally define the optimal treatment of hemodialysis pregnant women and confront the literature data rules.
The Retro Placental Hematoma (RPH) or placental abruption untimely normally inserted paroxysmal is an accident that threatens maternal and fetal prognosis. It is a major emergency obstetric pathology and remains the second leading cause of maternal mortality after postpartum haemorrhage. It is actually very difficult to have an accurate evaluation the frequency of the HRP because it requires a complete table including Pathologists; or simple macroscopic or microscopic findings; or purely clinical diagnosis for some. Its occurrence requires appropriate resuscitation and adapted care to improve the prognosis. We report our study of 49 cases the HRP hospitalized in Obstetrics and Gynecology of Instruction Military Hospital Mohamed V in Rabat, diagnosed on a suggestive clinical picture and the presence of hematoma after examining the issue. This is a descriptive and comparative retrospective study over a period of one year. This study compared two groups: with HRP feotale death in utero and HRP without fetal death in utero. This study aims to evaluate neonatal mortality and maternal morbidity related to RPH and therapeutic modalities. This pathology formerly known pathology multiparous tends to reach more and more heifer. The important blood loss and delay the expulsion worse prognosis causing severe maternal morbidity hence the need to expand the indications for cesarean of retro placental hematoma regardless of the fetal state. Our study aims to contribute to reduce mortality and morbidity Fetomaternal by improving our work is stepping up efforts for a rapid decision-making, and we must educate what especially pregnant women of the risk factors to see from the beginning of symptoms. The pregnancy monitoring, early diagnosis of RPH, an obstetrical treatment adequate, and a resuscitation well driving can improve the prognosis of this disease.