Transient osteoporosis of pregnancy (TOP) is a rare and often misdiagnosed disease during pregnancy. The postpartum fatigue or stress fracture is a recognized cause of pain, the diagnosis of postpartum osteoporosis (PPO) should be considered in the differential diagnosis of disabling lumbalgia occurring either during pregnancy (especially in the third trimester) or immediately after delivery. We report here the case of a 31-year-old patient, primiparous with no particular history, who presented disabling radiating pubic pain on the fourth day of postpartum after her caesarean section, that pelvic MRI had shown a fracture of the left sacral fin, associated with osteopenia of the hip. Her phosphocalcic assessment had objectified a vitamin D deficiency.
Thrombocytopenia occurs in about 10% of pregnant women. This could be due to a normal variant of pregnancy (gestational thrombocytopenia), a pregnancy-specific condition (preeclampsia and HELLP syndrome) or a condition exacerbated by pregnancy (ITP, vasculitis, PTT). The prognosis and treatment vary enormously, based on the underlying cause. Gestational thrombocytopenia (accidental thrombocytopenia of pregnancy) is a mild, asymptomatic thrombocytopenia that usually occurs late in pregnancy. There is no association with fetal thrombocytopenia, and maternal thrombocytopenia disappears spontaneously after delivery.
The primum movens of pre-eclampsia is a systemic maternal endothelial dysfunction. Choroidal and retinal vessels are rarely affected or rarely explored, and their involvement is usually reversible in pre-eclampsia if the diagnosis is made in time to establish adequate surveillance and treatment for each situation. The underlying lesions to ocular disorders are retinal serous detachment (RSD), optic neuropathy and finally the most serious involvement is cortical blindness. The pathophysiological hypothesis is clearly proven by the various complementary examinations such as fundus examination, OCT (Optic Coherence Tomography), and fluorescein angiography. Clinically, there appears to be a parallelism between the clinical importance of edema and that of RSD.
We report the case of a patient who presented, during a severe pre-eclampsia (in an edematous form) on twin pregnancy, a favorable postpartum DSR with suspicion of optic neuropathy. A follow-up by internists was recommended.
This observation represents an unusual clinical aspect of a rare breast cancer, mucinous carcinoma which represents 1% of all breast cancers, with its two pure and mixed forms whose treatment and prognosis are not identical.
The pure form has a good prognosis despite the exceptional clinical presentation of this type of breast cancer hence the interest of this case study, Mrs. L, a 70 year-old without risk factors admitted for mastitis of the left breast with rapid installation over 2 months, suspected of malignancy, yet the couple mammography / ultrasound did not manifest this malignancy, it shows an aspect of opacity well circumscribed of sharp contours.
After the needle biopsy, the diagnosis of mucinous carcinoma was made which determined a suitable management is a neoadjuvant chemotherapy followed by a radical treatment, the hormonotherapy was continued in front of the expression of the hormonal receptors. Post-treatment surveillance did not report distant recurrence or metastasis.
Endometriosis is classically defined by the ectopic presence of tissues possessing the morphological and functional characteristics of the endometrium. Ovarian endometriosis is one of the most common locations. Its pathogenesis remains unclear, but a multifactorial origin has been proposed. The symptomatology is dominated by pain and infertility. The clinical examination is often poor. The suprapubic pelvic ultrasound, and especially the endovaginal ultrasound, remains the examination of first intension. Laparoscopy is the only test to affirm with certainty; biopsies, classify it into stages and choose the most appropriate therapeutic strategy. The treatment of the first intension remains surgical, the medical treatments being in the majority of the cases only palliatives. The therapeutic success depends on the radicality of the surgical excision.
We report the case of a postmenopausal patient with ovarian endometriosis simulating ovarian neoplastic pathology with review of the literature.
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