Anencephaly is a congenital malformation of the nervous system. It’s the most common neurological malformation after spina bifida. Its diagnosis is antenatal and a medical termination of pregnancy is recommended.
Breast angiosarcomas are rare tumors, their diagnosis is difficult and the prognosis is worst. We report the case of radiation-induced breast angiosarcoma. The diagnosis is histological and was only made on the surgical specimen. The treatment was essentially surgical. Through this case as well as a review of the literature, we have made an update on this disease.
The decision of pregnancy for a woman with Rheumatoid arthritis (RA) requires considering the consequences of RA on conception and course of pregnancy but also on pregnancy on the course of RA. Fertility is not decreased in RA, however, fertility is lower in RA. Complications of pregnancy such as hypertension, preeclampsia or caesarean scar are more frequent in RA, although there is an increase that is fortunately unimportant. Pregnancy represents for two thirds of women with RA a period of calm with sometimes capricious course of the disease, despite the considerable reduction in the treatment. Several hormonal and immunological mechanisms explain this improvement.
The experience of pregnancy, accompanied by physical and emotional changes, will have an impact on the couple's sexuality. The purpose of this study is to focus on the issue of sexuality during pregnancy, to look at its variations and describe the different changes in sexual parameters. In our study about 170 cases, 91.76% continue to have sexual intercourse during pregnancy, 7.6% thought it could be responsible for miscarriages, infection or bleeding in 26% and 20% respectively. The main reason for the continuation of the sexual intercourse was looking for husband’s pleasure and the preparation and facilitation of delivery. In contrast, female pleasure was expressed in only 4% of women, discomfort at the time of the sexual act dominated the reasons for which sex was stopped or spaced.
There has been a gradual downward trend in most sexual parameters: frequency of sexual intercourse, sexual desire, sexual satisfaction, and frequency of orgasm.
This is a 28-year-old woman nulligeste, followed for hypothyroidism under levothyrox consults for a primary infertility of 1 year. She did an infertility checkup: an ultrasound examination that showed a myomatous uterus and ovaries seat of a dermoid cyst. In hysterosalpingography, she has opacified tubes up to their isthmic portion without peritoneal diffusion. The husband's investigation is normal. She had a diagnostic laparoscopy that showed bilateral tubal agenesis with a negative methylene blue test. The patient is proposed for in vitro fertilization.
Parietal endometriosis is a rare clinical entity whose pathophysiology remains unclear. It occurs most often after gynecological or obstetrical surgery. We report the case of a patient with cyclic pain at the level of the caesarean section scar. With clinical examination, two nodules on both sides of the scar increase in size associated with pain punctuated by the menstrual cycle. Pelvic ultrasonography showed two nodular formations of hypoechoic, avascular Doppler echo, apparently in relation to endometriotic nodules. Hence the decision to excise the lesion widely, whose anatomopathological study confirms the diagnosis of parietal endometriosis. Postoperative follow-up was straight forward with a follow-up of 12 months without recurrence of lesions or pain. Through our case, we will insist on the characteristics of this pathology, which will allow the practitioner to understand the interest of the diagnosis and early management of this condition as well as the possibility of its prevention during each gynecological surgery or obstetric.
Cervical pregnancy is one of the few ectopic locations after abdominal pregnancy. It is characterized by the migration of the conceptus the cervical canal sometimes simulating an ongoing abortion. Her diagnosis should be suspected in any woman with risk factors who has suggestive clinical criteria. The ultrasonographic criteria that have been described for this diagnosis are: closed internal orifice of the cervix, peritrophoblastic vascular flow detected in infra-cervical. MRI can be helpful in confirming the diagnosis. The anatomopathological study comes to focus on the diagnosis in case of surgical treatment. The treatment of cervical pregnancy uses several local, systemic methods, endoscopic, and surgical. Until now, no standard treatment is available in the literature. The therapeutic indications are then variously appreciated in the literature, the medical treatment using the Methotrexate is currently the treatment of choice before 12 weeks of amenorrhea, with or without potassium chloride. As for surgical treatment is placed in second line after failure of methotrexate, however some experienced practitioners prefer hysteroscopic resection, and embolization of the uterine artery associated or not with medical treatment. The choice of the technique will depend on the evolution of the initial treatment.
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.
Mullerian duct anomalies are the most common congenital anomalies of the reproductive system and septate uterus is the most frequently diagnosed Müllerian anomaly.
Almost associating with urinary tract anomalies such as horseshoe or pelvic kidney, renal agenesis, duplication of the collecting system, or ectopic uterus. Septate uterus is one type of congenital uterine anomalies, in which there is a septum from the fundus to the cervix. Currently, it is believed that hysteroscopic metroplasty is a leading choice for patients if their recurrent spontaneous abortion is resulted from septate uterus.
The paratubaires cysts are usually benign disease entities, frequently encountered in clinical practice, but rarely complicated twist; hence the importance of this work and we report the case of an adnexal torsion on paratubal 8cm cyst in a patient of 24 years.
Myasthenia gravis is a neurological disease that affects favorite with the young woman of childbearing age. The study of reciprocal interactions between gravis and pregnancy is essential to know for proper management of these patients whose follow-up should be done in close collaboration between obstetrician, neurologist, anesthesiologist and pediatrician.
Wegener granulomatosis is an autoimmune small vessel vasculitis highly associated with anti-neutrophil cytoplasmic antibodies and characterized by necrotizing granuloma of respiratory tract, disseminated vasculitis and glomerulonephritis. Its clinical manifestations and organ involvement arevery widely.
The etiology of Wegener granulomatosis is linked to environmental and infectious triggers inciting onset of disease in genetically predisposed individuals. Complications most often occur when the disease is not treated. Kidney disease causes glomerulonephritis with hematuria. It can quickly get worse with kidney failure, but can be prevented when the condition are controlled by medicines.
We report a case of a pregnant woman with Wegener
Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries and affects predominantly postmenopausal women. It is estimated, however, that 15%
Background: The clinical reasoning is expressed daily in the ability to solve clinical problems of patients. Its supervision is essential to establish an individualized educational plan that encourages its development. Objective: To analyze the impact of clinical reasoning learning sessions as remediation strategy of clinical reasoning difficulties. Method: exploratory retrospective study of medical students analyzing the difficulties of clinical reasoning and pedagogic practice of supervision promoting its development through the introduction of clinical reasoning learning sessions guided by a course book and grids evaluation as remediation strategy. Results: After the application of our supervision model of the clinical reasoning, 94.6 % of students were satisfied. They thus suggested the introduction of clinical reasoning evaluation before clinical examinations 7th year. Conclusion: the introduction of clinical reasoning learning sessions both in diagnosis and remediation of difficulties reasoning proves a real need. It would be appropriate to propose models applicable in other disciplines and to integer its evaluation in university program of internship
Composing of less than 1% of all ovarian cancers, immature teratoma is a malignancy that mainly affects the young. Immature teratoma of the ovary together with pregnancy is rare. To our knowledge, this association was rarelly reported in the literature
The authors report the case of an immature teratoma found in the first trimester of pregnancy in a young primigravida.
Through the analysis of this observation and data in the literature, they discuss the different aspects of this association.
Juvenile granulosa tumor is a sex cord stromal tumor extremely rare, with usually estrogenic effects, while virilizing form is exceptional, often discovered at a stage confined to the ovary, justifying therefore a conservative treatment. Its prognosis appears favorable, depending on early management. However, its evolvement may be hampered by early and aggressive recurrence. We report a new case compiled in Obstetrics Gynecology Service (HMIMV) of virilizing form of juvenile granulosa cell tumors, discovered during a recent exacerbation of a preexisting androgen syndrome in a girl of 24 years. It's extreme rarity prompted us to report it highlighting, through a literature review, its diagnostic features, therapeutic and evolutionary.
The neurofibromatosis type 1 (NF1) or von Recklinghausen's disease is an autosomal dominant disease. The association of NF1 to breast cancer is unusual and rarely r eported in literature. We report a case of this rare association. The discovery of breast cancer at a 51 years old patient in an advanced stage (T3N1M0), occasioned the appearance of dermatological lesions which are pathognomonic of neurofibromatosis1. Monitoring of patients with neurofibromatosis type1 seems justified to detect Early a possible association to breast cancer.
Bowen vulvar disease is defined as squamous cell carcinoma strictly intraepithelial, it's a viral infection which mostly affects postmenopausal women. It can be associated to other lesions specially gynecological cancers. The diagnosis is essentially histological. The evolution can go to invasion. Its treatment is based on surgery. We report the case of a female patient of 46 years, who consulted for a vulvar ulceration range of 5 cm in diameter, treated with wide excision, the histological examination is in favor of Bowen's disease. Through a review of litterature, we focus on the clinical, evolutionary and therapeutic features of this pathology.
Ovaries are a frequent site of metastasis of the breast cancer. The annexielles metastases of breast cancer often present as a challenge for diagnosis and therapeutic.. Distinction between ovarian metastasis and primary ovarian cancer may sometimes be difficult. The surgical resection tends to increase survival a surgical option should consist of at least bilateral oophorectomy, even when the contralateral ovary appears to be normal. We presente cas of patient of 36years old female, followed by breast cancer since 2011 stade 1 initially (T1N1Mx), was underwent Patey (infiltrating ductal carcinoma) followed radiotherapy and chemotherapy, hormonotherapy, four years later the patient complaint of abdominal distention, abdominal ultrasound showed ovarian masse then open laparoscopy was done, left adnexectomy was realized and finally histological diagnosis revealed Ovarian metastasis of the breast cancer.
The obesity, factor of morbimortalite, is considered as a real health public problem. In gynecology, its consequences on the fertility and the contraception are sever and the obesity is at the origin of important obstetric complications that must make consider these pregnancies as at risk. Our practices have to take into account these complications by assuring an adapted and premature care to improve the maternal and neonatal outcomes.
Feto-maternal red cell alloimmunization is defined by the presence in a pregnant woman of alloantibodies directed against blood group antigens present on the red blood cells of the fetus and inherited by the father. It arises from the immune response to a first contact to these same antigens during a prior transfusion, transplant or pregnancy. The placental transfer and the fixation of the antibodies on the fetal red cells antigenic targets lead to a haemolysis in the fetus and the newborn. The resulting haemolytic disease can show different clinical forms, from a mild anaemia with neonatal hyperbilirubinemia to a major fetal damage with stillbirth caused by hydrops fetalis. The objective of management strategies of feto-maternal alloimmunization is to detect and monitor maternal alloimmunization and to appreciate the effects on the fetus or the newborn.
Endometrial stromal tumors are rare and are less than 5% of uterine tumors. They are composed of cells closely resembling endometrial stromal cells in the proliferative phase. They are classified into two categories: the stromal nodules, benign, and endometrial stromal sarcomas, including endometrial stromal sarcoma (low grade) and undifferentiated endometrial sarcoma (formerly high grade). The diagnosis is most often does retrospectively after histological analysis of the surgical specimen. The classical treatment is abdominal hysterectomy with bilateral oophorectomy. The adjuvant treatment are not yet established and the optimal treatment of this entity is still not clear. We report the case of a patient of 46 years, admitted for pelvic pain with abdomino-pelvic mass Ultrasound and MRI have found a polymyomatous uterus with interstitial body mass with a compression effect on the endometrium. The patient underwent total hysterectomy with bilateral oophorectomy, Histology with additional immunohistochemical concluded endometrial stromal sarcoma of low grade, stage IB, hormone receptor-negative. Through this rare case and with a literature review, we focus on the epidemiological, diagnostic, therapeutic and prognostic of that entity.
Introduction: Recurrent disease is a genetic autoinflammatory disease autosomal recessive with particular ethnic distribution. Chronic disease evolution paroxysmal often beginning at childhood and characterized by inflammation of the serous with the main risk amyloidosis. Colchicine is the standard treatment. The management of the carrier pregnant women with this disease should be done in collaboration between internist, obstetrician and nephrologist in patients with renal impairment. Observation: We report the case of a woman in labor to 41 years, G5P2 mother of two children with a history of two spontaneous abortions, for MFM Followed by colchicine stopped since the desire to design with pregnancy marked by the occurrence of one crisis first trimester of pregnancy. The evolution was unremarkable and vaginal delivery of a newborn male eutrophic 10/10 Apgar. Discussion and conclusion: FMF Treaty and colchicine have no major impact on the reproductive life of women of childbearing age subject to proper monitoring and good compliance. Obstetrical prognosis is especially marked by the increased risk of abortion in cases of early pregnancy crisis.
The cornual pregnancy is a rare entity that represents almost 2% of ectopic pregnancies. Its diagnosis is almost always based on laparoscopy. The risk of rupture with severe bleeding remains high. The surgical treatment is often conventionally cornual radical resection, although cases medical methotrexate have been described. The objective of this work is to describe a rare form of ectopic pregnancy and expose its diagnostic features, management and prognosis. Patient and method: We report the case of a cornual pregnancy discovery intraoperatively in a patient of 27 years, admitted for acute pelvic pain with bleeding in the first quarter with pelvic ultrasound: empty uterus, endometrium 10mm, with an average abundance of peritoneal effusion. Rate of beta-hcg 2017. Given the strong suspiscion of ectopic pregnancy the patient was admitted immediately block with discovery of a right cornual pregnancy ruptured. Discussion and Conclusion: Interstitial pregnancy ectopic pregnancy is a rare, difficult to diagnose which may involve life and maternal fertility prognosis. Taking conventional charge is surgical. In subsequent pregnancies the clinician wary risk of recurrence of interstitial pregnancy and uterine rupture.
Introduction: The combined degeneration of the cord is a rare cause of myelopathy, it is linked to a deficiency in vitamin BI2 which is the most common cause pernicious anemia. Rapid diagnosis is necessary because the recovery is more complete than replacement therapy with vitamin B12 is administered early. Pregnancy by increasing needs of the mother's body can be a vitamin deficiency. However, we have little data in the literature that describe the impact of this disease on the course of pregnancy. Observation: We report the case of a 24-year-old primigravida in the third trimester of pregnancy presented a radiculo-cordonal syndrome later in connection with a hypovitaminosis B12. The course of pregnancy was unremarkable, with a marked improvement in his neurological symptomatology in vitamin supplementation. Discussion and conclusion: combined degeneration of the cord is the main secondary to neurological hypovitaminosis B12. MRI can guide the diagnosis, favorable after adequate vitamin supplementation is a therapeutic test to retain the diagnosis. There is no particular impact of the disease on pregnancy or pregnancy on the disease. However, some cases of IUGR, preeclampsia and pseudo Hellp syndrome were described. In terms of obstetrical prognosis is marked by an expansion of instrumental delivery instructions and those depending on the severity of neurological involvement. Epidural and spinal anesthesia should be avoided. General anesthesia should not use nitrous oxide.
The Uterine fibroma pathology is common and the relationships between fibroids and pregnancy are triple: Fibroids can prevent conception and implantation; the fibroid may complicate the course of pregnancy, at delivery and postpartum period 'and pregnancy-induced condition can facilitate the development of fibroids to complications. We report the case of a patient who was followed in our department from 17 weeks+2days of pregnancy whose ultrasound revealed fibroid located in the uterine isthmus .Through our case and with the support of the literature, We will insist the complications that can occur and understand the importance of diagnosis and early management of this entity.
The malignant germinal tumors of the ovary are rare, but a rest curable whatever is the stage. We report the observation of 24 years old patient, married, never get pregnant , who was sent in our hospital for pelvic pains, the gynecological examination revealed an abdominal mass in the umbilical level . The pelvic ultrasound and the abdominal CT scan showed a heterogeneous solid mass in depends on the ovary. A laparotomy was indicated, allowed a right adnexectomy. The anatomopathologique examination is returned in favor of a dysgerminoma. The germinal tumors of the ovary are rare tumors which affect the girls and the young women, they have a good prognosis whether his stage with an optimal treatment and the majority of the patients keep their reproduction functions.
Conn adenoma is the first cause of secondary hypertension of endocrine origin. His discovery during pregnancy is a rare situation. The objective of this work is to review the diagnostic features and management of this disease during pregnancy. Observation: We report the case of a primigravida 24 years hospitalized in the second trimester to tetraparesis related to a secondary hypokalemia Conn adenoma. Adrenalectomy were expected in the second quarter, but the occurrence of thrombophlebitis of the left leg had repporter gesture until postpartum. The patient was hospitalized several times for blood pressure control but showed during his last hospitalization 35SA SFA having imposed a fetal extraction by high way. Discussion and Conclusion: The Conn adenoma discovered during pregnancy has certain diagnostic and therapeutic features that need to know for proper care.
Oral contraception is used by one hundred million women worldwide for contraceptive purposes. Side effects are widely publicized. However non-contraceptive benefits are unknown women and the medical profession and deserve to be explored. A review of the literature allowed us to gather a majority of non-contraceptive benefits of oral contraception.
Introduction: If the uterine leiomyoma is a common and well known disease entity, ectopic location, is rare. The treatment is surgical enucleation and the diagnosis is histological. The objective of this work is to describe a rare location of myoma. Observation: We report the case of a patient of 50 years postmenopausal, who consulted for a vaginal nodule. MRI has to say vaginal tumor origin. The patient therefore underwent surgical resection of a nodule 1cm white and firm. Histological study has allowed us to retain the vaginal leiomyoma diagnosis. Discussion and conclusion: The leiomyoma is a benign mesenchymal tumor whose extra-uterine seat is rare. In her vaginal location, it is usually asymptomatic, discovered incidentally during a clinical examination. Vaginal myoma is usually a nodule on average 3cm, firm and painless, affecting middle-aged women. Radiological explorations show the origin of the vaginal origin of the lesion. Surgical resection is required because of sarcomatous degeneration have been described. The diagnosis is based on histological examination of the tumor.
The prevalence of pregnancy after breast cancer is increasing, since breast cancer occurs in 10-15% of cases in patients under 40 years. This literature review aims to make an update for defining a multidisciplinary management of a patient with a desire for pregnancy after breast cancer.
Aplasia cutis congenital is a rare congenital absence of skin, exceptionally involves extremities. Most cases are sporadic but familial autosomal dominant pattern can be found. The etiology remains unclear, both genetic and environmental causes have been implicated. This lesion has primarily a clinical diagnosis. Imaging studies may be used to evaluate underlying tissues and investigate other comorbid abnormalities. Treatment modalities depend upon the extent defect and involvement of underlying tissues. Genetic counseling is useful in cases of hereditary form. We report a new case of extensive bilateral aplasia cutis congenital of extremities in a new born, occurred as an isolated sporadic case without family history, no teratogenic medication and no evidence for an amniotic band or infection in pregnancy.
Kasabach Merritt syndrome is defined by clinical and biological association of a purplish-red vascular tumor rapidly extensive, thrombocytopenia, a variable degree of disseminated intravascular coagulation and sometimes anemia. It usually occurs in neonates and infants less than 6 months, sometimes in utero. The imaging can confirm the diagnosis and search for deep locations. This syndrome can be life-threatening by the risk of bleeding, coagulopathy, thrombosis, compression and heart failure. The therapeutic management should be early, multidisciplinary adapting therapeutic benefits to risks in order to improve the prognosis. We report a case of Kasabach Merritt syndrome, we insist through a literature review of diagnostic, therapeutic and evolutionary difficulties.
Pseudo tumoral peritoneal tuberculosis is a rare clinical form witch clinical and para clinical aspects can mimic advanced ovarian cancer leading to unjustified radical surgery, with high risk of morbidities, often in a young woman. We report a new case of pseudo tumoral peritoneal tuberculosis in a girl of 21 years old in which diagnosis of ovarian cancer with ascitis and peritoneal carcinomatosis was suspected clinically, radiologically and biologically by rising CA125. Exploratory laparotomy with extemporaneous histological examination has confirmed tuberculosis diagnosis.
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.
Maternal benefits of fetal extraction have been clearly demonstrated in the case of hemodynamic failure. However, in case of respiratory failure very little data are available. The aim of our study is to discuss the management of patients with respiratory distress during pregnancy secondary to a pleuropulmonary disease.
Vaginal Angioleiomyoma is a rare entity. We report a case of vaginal Angioleiomyoma with literature review. Our case was about a 48 years old woman who consulted for a nodule in the posterior wall of the vagina. The surgery allowed removal of a tissue-like structure of 2 cm. The final histologic diagnosis was a vaginal Angioleiomyoma.
Endometrial adenocarcinoma usually occurs after menopause. This tumor is extremely rare in women younger than 30 years. Its treatment includes hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy and in same cases, radiotherapy. We report a case of endometrial Adenocarcinoma in a 26-year-old patient. Through this case the authors emphasize the need of endometrial evaluation in young females with abnormal bleeding before starting any medical treatment. Specific problems of endometrial cancer at young age include delay in diagnosis, difficulty in pathologic interpretation of the curetting tissues and the motivation of most patients to preserve their fertility.
Interstitial pregnancy is a rare form of ectopic pregnancy, but it is associated with the highest risk of morbidity and mortality and needs early diagnosis. Interstitial, angular and cornual pregnancies are mistakenly and frequently confused and need a strict distinction. Interstitial pregnancy refers to an ectopic pregnancy that is implanted in the interstitial portion of the fallopian tube. Its correct diagnosis can be quite difficult; it relies heavily on quantitative beta-hCG assays and ultrasound and potentially on laparoscopic evaluation. The diagnosis by transvaginale ultrasonography is based on multiple criteria. Several effective treatment options for treatment of interstitial pregnancy have been described but the most appropriate technique remains controversial. Managing an interstitial pregnancy is dependent upon whether the ectopic pregnancy has ruptured, the stability of the patient, the gestational age at diagnosis and the patient's desire for future fertility. The greatest risk to patients after successful treatment remains recurrence of interstitial pregnancy and the uterine rupture during subsequent pregnancy this is why a transvaginale ultrasonography should be performed 5-6 weeks after the last menstrual period and a cesarean delivery should be planned at term or performed, if tocolysis fails in cases of preterm labor. To illustrate the particularities of this form of ectopic pregnancy we report two cases with a brief up date.
Tuberculosis of the breast is a very rare infection, it occurs chiefly in women of childbearing potential, usually as an apparently primary infection and constitute a diagnosis and therapeutic challenge. Administration of antituberculosis agents is the mainstay of therapy. Surgery is required in some cases. We report one case of breast tuberculosis. The diagnosis was put on histology with good outcome under anti bacillary treatment. Through the literature data we recall the epidemiological, clinical, diagnostic and treatment of this pathology.
Endometriosis of a wall scar is a rare clinical entity, and in the perineum is exceptional occurring after gynaecological or obstetrical surgery. The origin remains vague. The clinical characteristic of these lesions implies an inconstant painful swelling during menstruation; however only the histological examination of the specimen will be able to confirm the diagnosis. The treatment is primarily surgical and relies on the complete surgical excision of the lesion.
Collision tumor means the coexistence of two adjacent tumors, but histologically distinct without mixture into the fabric. These tumors involving the ovaries are rare. Benign cystic teratomas are often present at the same time as other abnormalities of the ovary. The most common histological combination in the ovary is the coexistence of cystic mature teratoma with mucinous tumors, its association with serous tumors is rare and the incidence is unknown. Ovarian mature cystic teratomas are benign often diagnosed in young girls. We present a rare case of a triple coexistence of a large tumor collision (consisting of a serous cystadenoma, mucinous cystadenoma and a mature cystic teratoma Benin) in the same ovary in a girl of 16 years.
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.
Genital tuberculosis of women is part of extra pulmonary forms of tuberculosis. It is an uncommon disease in developed countries, but remains endemic in developing countries. The causative agent is, in most cases, Mycobacterium tuberculosis. Genital tuberculosis is a cause of infertility. The definitive diagnosis is made by biology or histology. Because this affection is paucibacillary, these tests may be falsely negative; In fact, diagnosis can then be focused on radiological, endoscopic and nosological arguments.
Granulosa cell tumors of the ovary are rare, and included in the sex cord-stromal tumor category. They have a low malignancy potential and generally have a good prognosis. They are the most frequent hormone-secreting tumors of the ovary and may lead to suggestive clinical symptoms. Some biological markers (serum inhibin B and AMH) may be helpful for diagnosis, though their sensitivity is not perfect. Preoperative imaging diagnosis remains challenging due to the wide variability in morphology and lack of epidemiological data in the literature (small patient populations). From a review of the clinical of one case of granulosa cell tumor of the adult and a review of the literature, we will describe its clinical, paraclinical, therapeutic and prognostic.
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.
As a consequence of breast imaging development and development of screening, benign epithelial breast diseases (BEBD) represent a growing percentage of breast pathology diagnoses. Some BEBD have to be individualized (radial scars, papillomas, complex sclerosing adenosis, lobular intraepithelial neoplasia, flat epithelial atypia, atypical hyperplasia), being preinvasive lesions or markers of increased breast cancer risk, or being associated with suspect radiological aspect. BEBD should be managed in a pluridisciplinar way and correctly diagnosed by percutaneous biopsies or surgical specimens. The goals of surgery vary according to lesions. It always allows a complete surgical specimen analysis and therefore a search for atypical or cancerous cells. Surgery can also have a preventive role by reducing the risk of potential malignant transformation. Finally, it enables in some cases the excision of a radiologically suspect mass. So the aim of this review is to give a clinical and morphological description of most common BEBD, underlying their cancer risk, specific diagnosis, therapeutic, follow-up and psychological repercussions.
Introduction: Cystic lymphangioma of the ovary is a rare benign vascular tumor. Its histogenesis is still hypothetical and its preoperative diagnosis difficult to establish. We report a case of cystic lymphangioma of the ovary that was a problem with differential malignant ovarian tumor diagnosis, with a recent review of the literature. Observation: Patient 35 years primigravida primipara without significant pelvic pain consults history dating back more than three months without increased abdominal volume or urinary or digestive signs associated. A pelvic ultrasound done complemented by magnetic resonance imaging have objectified aspect for a right ovarian cyst formation by 8 cm to confront the histological data. The patient underwent a right oophorectomy returned for mature cystic teratoma of a cystic hygroma associated. The postoperative course was uneventful and no recurrence was noted. Results: Cystic lymphangioma of the ovary is rare benign tumor formation. There are no specific symptoms. Radiology despite progress remains inconclusive in the diagnosis of this tumor type. Histological study is the only way to confirm the diagnosis. The outcome was favorable, no cases of malignant transformation have been reported. Conclusion: Cystic lymphangioma of the ovary is a rare benign tumor of the malformation. The diagnosis rarely made preoperatively should be considered in any cystic ovarian mass. Only complete surgical resection of the tumor is associated with prolonged survival and a favorable prognosis.
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