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Erysipelas is a non-necrotizing acute dermal hypodermatitis most often of streptococcal origin. It most often affects the lower limbs. Erysipelas on surgical scar has been rarely reported in the literature. Few cases have been published since the first descriptions of this pathological entity by Baddour et al in 1982. We report the case of a 47-year-old patient. Operated for right breast mucinous carcinoma, she had neo-adjuvant chemotherapy followed by a surgical treatment (Patey) which occured without incident. The evolution was marked by the appearance after 11 months of the intervention of an Erysipelas on Patey scar. The patient was put on cefazol for 7 days intravenously injectable. The evolution was marked by the complete disappearance of the rash and the edema.

La fasciite nécrosante constitue une affection grave pouvant engager le pronostic vital par le biais des états de choc septiques. La localisation mammaire est exceptionnelle et le diagnostic est souvent porté tardivement du fait de la confusion fréquente de cette forme avec les abcès du sein. La prise en charge est médicochirurgicale multidisciplinaire. Le préjudice esthétique constitue la principale contrainte thérapeutique du fait d´une extension rapide des lésions de nécrose secondaire à une thrombose massive des vaisseaux cheminant dans les territoires des fascias. Nous rapportons le cas d´une fasciite nécrosante du sein droit chez une femme diabétique âgée de 57 ans et nous décrivons ainsi les particularités cliniques et les résultats thérapeutiques de cette forme rare.

Introduction: Mucinous carcinoma of the breast constitutes 1% to 4% of all breast cancers. Two different forms of presentation are distinguished: pure mucinous carcinoma and mixed mucinous carcinoma. The purpose of our work was to clarify the anatomo-clinical and radiological particularities of this rare form of breast cancer. Materials and methods: This was a retrospective study of a series of 14 cases of mucinous carcinoma of the breast, including 8 pure mucinous carcinomas and 6 mixed mucinous carcinomas treated at the Maternity and Neonatal Center of Monastir between January 2009 and December 2017. Results: The frequency of mucinous carcinoma of the breast in our study period was 1.9%. The average of the patients was 55 years old. The average tumor size was 40 mm. Mucinous carcinoma of the breast was pure in 8 cases, mixed in 6 cases. The clinical size of pure CM was smaller than that of mixed CM (41 mm vs 45 mm) [p = 0.12]. Axillary adenopathies were found in 28.5% of patients. Mammography detected a total of 19 masses with three cases of multifocality. The average size was 27 mm, there was no significant difference between subtype sizes. Pure CMs had an oval shape in 83% of the cases with microlobulated contours in half of the cases, mixed CM rather had an irregular shape (71%) with indistinct contours (85%) (p = 0.01/p = 0.04). On ultrasound, pure CMs had a homogeneous hypoechogenic oval mass appearance with microlobulated contours enhancing ultrasound. The mixed CMs had an irregular shape of non-geometric contours and heterogeneous hypoechogenic appearance with posterior ultrasound attenuation (p = 0.06). Microcalcifications were present in 37% of pure CM and 60% of mixed CM (p = 0.13). Ganglionic invasion was noted in 28% of cases. The extension assessment was negative in all cases. The tumors were of low histological grade with predominance of SBR I and II grades. They expressed hormone receptors in 85% of cases. Overexpression of the HER2 gene was noted in only one case. Conclusion: It is important to distinguish between the two pure and mixed forms, because the therapeutic attitude and the prognosis depend on it. The pure form remains a favorable prognosis, whereas that of the mixed form matches that of infiltrating ductal carcinomas.

Abrikossoff’s tumor or granular cell tumor is a rare soft and usually benign tissue neoplasm of neural origin. It occurs usually in the neck region or in the head. About 16% occur in the vulva. Some malignant cases have been reported in literature. Granular cell tumor was described first by Abrikossoff in 1926. The histogenesis of granular cell tumors is unknown. The clinical diagnosis of vulvar granular cell tumor is difficult. It may be mistaken for Bartholin gland cyst, lipoma or vulvar carcinoma when ulcerated. Histology is the mainstay of the positive diagnosis. Imagery is not essential for the diagnosis of Abrikossoff’s tumor. It is asked when the neoplasm is giant, or when there is a local recurrence or potential metastasis. Surgery is the gold standard treatment of Abrikossoff’s tumor. It consists of local excision with wide margins. Prognosis of granular cell tumor is usually good. Authors report a 25-year-old woman presented with an ulcerate tumor on the labium majus. The objective of this paper is to review the clinical and therapeutic aspects of Abrikossoff’s tumor located in the vulva from case report and literature review.

Primary neuroendocrine carcinoma of the breast is a rare tumor that has been considered special features within conventional breast carcinomas until recently. In this article, we present a case report of a 77-year-old woman with a metastatic grade I primary neuroendocrine carcinoma of the breast that has been growing for seven years. The patient was treated with hormone therapy with good outcome.

Secretory breast carcinoma (SBC) is a very rare subtype of breast carcinoma that reported mostly in young women, with a median age of 25 years. Despite the low frequency, SBC elicits pathologic interest because of their unique morphology and excellent prognosis. Authors report a 23-year-old woman presented with a nodule in retro areolar region of her right breast. Microbiopsic examination revealed neoplastic tissue. Pathological examination of tumor revealed SBC. This tumor is morphologically characterized by the presence of abundant eosinophilic secretions in intracellular vacuoles and intercellular spaces. The objective of this paper is to review the epidemiological, clinical, paraclinical and therapeutic aspects of SBC from a case report and literature review.

Intraoperative search for the sentinal node using patent blue is considered a non risk procedure. We emphasize the highly exceptional nature of this adverse effect previously observed in other disciplines using this coloring agent. We present a case of allergic reaction to patent blue in a patient who underwent left mastectomy with sentinel lymph node. About 25 min after the dye injection, the patient developed increased heart frequency and allergic skin reaction. The patient was treated successfully with decreased inspired fraction of inhaled anesthetic and fluid replacement. The patient recovered uneventfully and was discharged from the PACU 3h after the end of surgery without skin changes and was discharged from hospital on the morning after surgery. Allergic reactions with the use of patent blue are far superior to the hypersensitivity reactions seen with anesthetic and adjuvant drugs. Therefore, the anesthesiologist must be aware of cardiovascular instability associated with skin changes during the use of patent blue, for early diagnosis and appropriate treatment of this hypersensitivity reaction to this dye. Skin tests done later confirmed allergy to patent blue dye; the tests induced a small syndrome reaction. Surgical personnel who use patent blue dye should be made aware of the risk of allergic reactions, sometimes severe, to this dye.