Idiopathic granulomatous mastitis - new approach in operative treatment

Introduction. Idiopathic granulomatous mastitis (GM) is described as a very rare, non-lactating, chronic mastitis that occurs primarily in women of childbearing age. Significant clinical problem related to GM is the diagnostic differentiation from breast cancer. Less advanced forms of GM can be successfully treated with limited surgical excisions and radical treatment is recommended only for the most extensive forms. Case report. First examination of the patient, by the surgeon at Oncology Institute of Vojvodina was in December 2018., when initial suspicion of breast cancer was set up. Core needle biopsy was performed and after histopathological (HP) analysis, confirmation of GM was obtained. The patient was initially offered Prednisone and Methotrexate therapy, which she refused and accepted only surgical treatment. Surgical treatment was performed few weeks after needle biopsy and consisted of performing a nipple spearing mastectomy with excision of the orifices of all fistulous ducts and their primary sutures. The HP findings of the operative specimen confirmed the diagnosis of GM. While there were no signs of dieses relapse, patient was suggested secondary reconstruction of the left breast. Twelve months after the primary operation, secondary breast reconstruction was performed with the interposition of a contoured silicone implant into a muscle pocket in a standard manner. Conclusion. Nipple spearing mastectomy with secondary breast reconstruction is aesthetically satisfactory treatment for patients with locally advanced GM.

Obstructing Trachea Tumor: Myoepithelial Carcinoma about a Case

Myoepithelial carcinoma, also called malignant myoepithelioma, is an extremely rare tumor of the salivary gland type. It is defined as a malignant neoplasm in which the tumor cells exhibit exclusively myoepithelial differentiation. Our case is a 48-year-old patient with no specific history who was presented to the hospital emergency room for respiratory difficulty and dysphagia progressively evolving for 08 weeks. A cervical CT was done which revealed a hypodense tumor process in T1 of 4 cm long axis obstructing the trachea well limited and richly vascularized. The diagnosis of tracheal myoepithelial carcinoma was made after histological and immunohistochemical analysis on a biopsy pending analysis of the operative specimen. Treatment remains initially surgical with appropriate postoperative radiotherapy and chemotherapy.

Primary Malignant Fibrous Histiocytoma of Proximal Humerus with Pathological Fracture- Case Report

Malignant fibrous histiocytoma (MFH) is a tumor of late adulthood that occurs in men more commonly than women. Proximal humerus involvement in PMFH is comparatively rare. A 45 year old female presented with complain of pain and mild swelling over the left shoulder with restricted range of movement since 15 days. Radiography of the affected part was suggestive of an osteolytic eccentric lesion with a pathological fracture. A trucut needle biopsy showed minimal tumour tissue with abundant necrosis and showed giant cells with pleomorphic mononuclear cells. So intralesional curettage followed by osteosynthesis with PHILLOS plating and bone cementing was done. Intra operative specimen sent for histopathological examination showed presence of fibroblast cells arranged in storiform pattern s/o MFH along with occasional multinucleated giant cells. Postoperatively patient was started with adjuvant chemotherapy. Patient had good results functionally and clinically with no signs of recurrence till follow up of 1.5 years.

CYSTIC LYMPHANGIOMA A CASE REPORT

Cystic lymphangioma of the pancreas is a rare benign vascular tumor. Its histogenesis is still hypothetical and its preoperative diagnosis difficult to establish. We report a case in a 26-year-old boy who presented with abdominal pain with the notion of a constipation-type transit disorder. Radiological investigations showed an intraperitoneal mesenteric cystic tumor. A complete resection of the mass was performed. Pathological examination of the operative specimen confirmed the presence of cystic formations, the wall of no need keep it.to the end which was lined by a squamous, endothelial epithelium with a fibrous wall dotted with a few lymphoid clusters in favor of cystic lymphangioma.

Acute intussusception in adults; study of two observations at the Friendship Hospital Sino-Guinean in Kipe

Aim The study aim to make our contribution to the study of intussusception in adults, rare pathology in adults, acute intussusception also called (AII) refers to penetration of an intestinal segment into the underlying segment, by turning into a glove finger (invagination roll). The aim of this work is to report two cases of acute intussusception in adults in the surgical department of the Sino-Guinean friendship hospital in kipe. Republic of Guinea. Material and Method This is a prospective two-year study, running from October 1, 2018 to September 30, 2020 Inclusive. All patients admitted for operated for acute intestinal invagination, whose age is between 25 and 50 years were included in our study. The operative specimen was analyzed anatomo pathologically after fixation with 10 percent formalin. Clinical presentation It concerned a man and a woman, in both cases the localization was ileal. Treatment was surgical and consisted of ileal resection followed by end-to-end ileoileale anastomosis in two planes. The operative consequences were simple. Conclusion Acute intussusception in adults is rare, the symptoms are noisy.

Currarino Syndrome (SC): A case at the University Hospital of Mother and Child Lagune Cotonou

Introduction: The Currarino syndrome (CS) is one of the rare syndromic forms of anorectal malformations (ARM). Observation: This is the clinical case of a 3 days male newborn admitted for high ARM in the pediatric surgery Department of the Lagune Mother and Child University Hospital of Cotonou. An emergency colostomy was performed. At the age of 7 months as a prelude to anorectoplasty, the distal colography revealed a semilunar pelvic opacity in front of the sacrum. The posterior sagittal approach according to Peña could not reveal the distal end of the intestine. The reconstruction of the sphincter-muscular complex was done on a tracheal tube. The abdominal approach allowed the discovery and resection of a presacral mass. The rectal pouch end found was then lowered. Post-operative follows up was uneventful. The standard postoperative X-ray revealed a partial agenesis of the sacrum. The histology of the operative specimen found a cystic lipoma. The diagnosis of CS was done. The search of a HLXB9 mutation was not possible. Conclusion: The clinical observation associated with standard radiological investigations highlighted the triad: anorectal malformation, presacral tumor, and partial agenesis of the sacrum, which upheld the diagnosis of CS; but the search for an indispensable HLXB9 mutation was lacking for the genetic link.

The Endobronchial Inflammatory Myofibroblastic Tumor

The inflammatory myofibroblastic tumor is a rare tumor described in the literature as a type of inflammatory pseudotumor. It mainly has a pulmonary location but can appear at endobronchial or mediastinal sites on rarely. While it is a benign tumor, it can sometimes be unpredictable due to its invasive characteristic as well as its resurgence after complete excision. We report the case of a patient presenting hemoptysis. The bronchoscopy revealed a bud in the left upper lobe bronchus, and the biopsy pointed to a myofibroblastic tumor. In one month, interval, the bud extended to the left main bronchus, hence the indication of a left pneumonectomy, performed by posterolateral thoracotomy. The study of the operative specimen confirmed the biopsy diagnosis. The particularity of our case is the endobronchial presentation and the fast evolution of this inflammatory myofibroblastic tumor, which requires a pneumonectomy.

Pheochromocytoma in a patient presenting with ventricular fibrillation and carotid dissection: a case report

Background Pheochromocytoma is an endocrine tumour secreting catecholamines, most often revealed by clinical symptoms (headache, palpitations, diaphoresis, or resistant hypertension). Some cases of ventricular arrhythmias were described in the literature, without any formal link between arrhythmia and pheochromocytoma. Case summary We report a case of pheochromocytoma discovered after cardiac arrest due to ventricular fibrillation in a 46-year-old patient. The diagnosis was suggested by clinical symptoms (headache, palpitation, and diaphoresis) and suspected on the abdominal computed tomography scan. The diagnosis was corroborated by metaiodobenzylguanidine scintigraphy and finally confirmed by anatomopathological analysis of the operative specimen. The cerebral imaging showed a dissection of the left internal carotid artery and an intraparenchymal haematoma that might be secondary to a catecholaminergic discharge of phaeochromocytoma and severe hypertension. Discussion Since pheochromocytoma is accessible to curative treatment, its detection in case of cardiac arrest is essential to decrease the risk of arrhythmic recurrence.