Search

Sacrococcygeal chordoma is a rare disease. It has been described in less than 3% of cases. We here report the case of a female patient with locally advanced sacrococcygeal chordoma treated at the Oujda Regional Oncology Center in Morocco. The treatment was based on exclusive radiotherapy; surgical resection couldn't be performed. At 2-year follow-up the tumor is clinically and radiologically stable and general condition of the patient is good. [ABSTRACT FROM AUTHOR]

Urogenital tuberculosis is little suspected and known by clinicians. Colorenal fistulas, although rare, are complex forms of renal tuberculosis occurring in patients with advanced-stage disease. They generally occur in the ascending and descending colon. We here report the clinical case of a 58-year-old female patient presenting to the Emergency Department with severe acute left pyelonephritis. Abdominal CT scan objectified left pyonephrosis with left colorenal fistula. The patient had poor clinical, biological outcome despite resuscitation measures and antibiotic treatments. Urgent left nephrectomy was performed with disconnection and drainage of colorenal fistula. Histology showed renal tuberculosis. The patient received antibacillary drugs according to 2ERHZ/4RH guidelines. The treatment of this type of TB should be adequate to avoid recurrences that could be more complicated to manage. [ABSTRACT FROM AUTHOR]

Stiff person syndrome (SPS) is a rare disease affecting the central nervous system which can be autoimmune, paraneoplastic or idiopathic in origin. Its typical classic presentation is characterized by progressive stiffness of the trunk and limbs, associated with spasms. The diagnosis is supported by the existence of continuous and spontaneous muscle activity on electroneuromyogram detection, the presence of serum anti-GAD antibodies, and a response to benzodiazepines. We report the case of a 46-year-old patient with a classic form of autoimmune stiff person syndrome associated with dermatitis herpetiformis. [ABSTRACT FROM AUTHOR]

Malignant melanoma is a disease with high metastatic potential which starts in melanocytes. The liver is the organ most often targeted for metastatic spread. Nonetheless, primary liver melanoma is very rare. Few cases have been described. We here report the case of a female patient with primary liver melanoma diagnosed based on liver biopsy results and confirmed by histological and immunohistochemical analyses as well as by providing a comprehensive assessment excluding other localizations. [ABSTRACT FROM AUTHOR]

Traumatic dislocations of the shoulder joint are generally described as an antero-inferior dislocations. Anterior-superior dislocations are extremely rare. We report a rare case of traumatic dislocation of the anterior-superior shoulder in a 45-year-old patient whose physical examination showed an anterior-superior subcutaneous protrusion of the head filling the subacromial space. The diagnosis was radiologically confirmed. MRI showed total rupture of the supraspinatus and subscapularis tendons. Shoulder instability occurred after reduction of the dislocation. Temporary glenohumeral arthrodesis was subsequently performed with good functional results. [ABSTRACT FROM AUTHOR]

Naevus unius lateris is a rare congenital hamartoma, originating from the ectoderm. It is considered as a verruquous variant of the epidermal naevus. Given its extensive unilateral distribution, it is frequently associated with neurological, musculoskeletal, auditory and visual abnormalities. We here report the case of a 9-year-old child with nevus unius lateris associated with neurological and eye abnormalities. [ABSTRACT FROM AUTHOR]

Solitary fibrous tumour is usually a benign and rare mesenchymal tumour. The first case was reported in patients with pleural involvement. Solitary fibrous tumour of the prostate is exceptional. We here report the case of a 77-year-old patient presenting with lower urinary tract symptoms such as dysuria and polalkiuria. CT scan and MRI showed the prostate lesion and determined its relation to adjacent healthy structures, an important factor in evaluating tumour resectability. Transrectal biopsy with immunohistochemical examination confirmed the diagnosis; CD34, Bcl2 and CD 99 were expressed. Radical prostatectomy was performed. [ABSTRACT FROM AUTHOR]

The sarcoidosis is a systemic granulomatous disease. It is usually characterized by skin manifestations which may be suggestive of progressive sarcoidosis with visceral involvement. We here report a case of pulmonary sarcoidosis revealed by the reactivation of an old cutaneous scar following a trauma occurred 20 years earlier. Radiological assessment showed mediastinopulmonary sarcoidosis stage 2. The diagnosis of sarcoidosis should be suspected in patients with any recent scar modification in order to establish early management. [ABSTRACT FROM AUTHOR]

We here report a case of bronchial cancer revealed by acanthosis nigrigans affecting the face. This rare mode of revelation may precede diagnosis of underlying neoplasia by several months . This study highlights the importance of suspecting primary lung cancer in patients with acanthosis nigrigans. [ABSTRACT FROM AUTHOR]

Intracavernous carotid artery aneurysm is rare but it leads to major complications. Common clinical picture is characterized by ophthalmoplegia associated with intense headaches. Cerebral angiography is used to confirm clinical suspicion and it guides therapeutic management. Endovascular embolization is the standard treatment. We here report the case of a 80-year-old woman presenting to the emergency room with right-sided exophthalmos and severe headaches occurring 2 weeks before her visit. The diagnosis of fissurized intracavernous carotid artery aneurysm was retained. [ABSTRACT FROM AUTHOR]

Aberrant course of the internal carotid artery is a rare congenital malformation. Aberrant course of cervical internal carotid artery accounts for 5% of cases. Several cases of fatal hemorrhage due to an injury to the aberrant internal carotid artery have been observed in patients undergoing pharyngeal surgery procedures. This was associated with a lack of detection during surgery. Ear nose and throat (ENT) practitioner need to know it. We here report a case of aberrant internal carotid manifesting as chronic cough due to the contact of the epiglottis with the pharyngeal mass caused by the aberrant artery. The patient was treated for chronic lung disease without success. This particular anatomical condition should be suspected in patients with pharyngeal mass before any invasive procedure. [ABSTRACT FROM AUTHOR]

Giant desmoid tumor has been rarely reported in the literature but it is a therapeutic challenge. We here report a case of tumor manifesting as painful abdominal mass causing a major esthetic problem. Radiological assessment allowed to determine its depth extension and limits of resection. Desmoid tumor of the abdominal wall was evoked and surgically resected, with simple outcome. This study highlights challenges in the management of this entity,due to its large size. [ABSTRACT FROM AUTHOR]

Traumatic transfixed wounds of the limbs due to embedded foreign body are rare. Antebrachial segment involvement can lead to tissue damage, requiring specialized surgical treatment. Few studies have been reported, but surgical removal of the foreign body is indicated. We report the case of a 23-year-old patient, victim of physical violence, presenting with a transfixed wound due to the implantation of an atypical knife in the forearm. Clinical and radiographic tests showed significant muscle and neurovascular lesions. Surgical removal of the knife and lesion repair were performed. Surgical treatment of these traumas must be performed by an experienced surgical team to avoid the occurrence of iatrogenic lesions. [ABSTRACT FROM AUTHOR]

Leriche syndrome or aortoiliac occlusive disease is a particular obliterative arterial disease of the lower limbs, consisting of thrombotic occlusion of the aortoiliac junction. We here report the case of a 20- year-old female patient with no particular past medical history, presenting with acute lower limb ischemia. Lower extremity echo Doppler showed overall decrease in arterial blood flow without visualization of endoluminal material. Lower limb angioscaner showed arterial thrombosis of the abdominal aorta extended to bilateral external iliac arteries. The patient subsequently underwent aortic-bi-iliac bypass surgery with good evolution as well as assessments for possible thrombogenic mechanism. [ABSTRACT FROM AUTHOR]

Staphylococcal scalded skin syndrom is a bullous dermatosis induced by exfoliating staphylococcal exotoxins. Children are most often affected. We report the case of a 6-month-old infant who had angina in the few days before leading up to bullous erythroderma and whose skin biopsy showed characteristic appearance of staphylococcal scalded skin syndrom. The development was rapidly unfavourable and the infant died in a refractory septic shock chart, despite the introduction of norepinephrine and anti-SAMR antibiotic therapy. The term staphylococcal scalded skin syndrome (SSSS) was separated from the toxic or allergic epidermal necrolysis by Lyell into the opposite anatomical aspect of these two entities: in scalded skin syndrome, Skin detachment is done by cleavage of the superficial part of the epidermis at the granular layer, while in toxic Lyell syndrome, the cleavage sits deeper at the level of the mucous body. [ABSTRACT FROM AUTHOR]

Multifocal tuberculosis is rare in immunocompetent subjects. It is characterized by the involvement of at least two extra-pulmonary sites, associated or not with lung disease. It is often difficult to diagnose. We here report a case of multifocal tuberculosis in a non-immunocompromised black African subject at the Hubert Koutoukou Maga National Hospital and University Center (CNHU-HKM) in Cotonou, Benin. The study involved a 23-year-old man, with no particular previous history, admitted with diffuse abdominal pain associated with alteration of general state. Clinical examination showed severe malnutrition and medium-volume ascites. Imaging tests (chest X-ray, ultrasound and computed tomography (CT) scan) showed multiple lung, liver, pancreatic, bone, lymph nodes and colic lesions suggesting multimetastatic tumor. Colonoscopy then showed budding lesion of the cecum. GeneXpert test showed Koch´s bacilli. The anatomopathological examination of colic biopsies and GeneXpert sputum test confirmed multifocal tuberculosis. The patient received antituberculosis treatment and nutritional support. However he died. Multifocal tuberculosis is a serious disease that is difficult to diagnose. Then it is frequently mis-diagnosed in tropical areas, especially when it occurs in immunocompetent patients. [ABSTRACT FROM AUTHOR]

Myeloid sarcoma is a rare ocular manifestation of acute myeloid leukemia. Bilateral manifestation preceding any clinical signs of leukemia is even rarer. We here report the case of a 16-month-old patient with rapidly progressive, inflammatory, acute bilateral exophthalmos associated with exposure keratitis. Computed tomography (CT)scan of the orbit and of the brain showed bilateral tissuelike infiltration into the orbital cavity. Blood tests showed biologic inflammatory syndrome, bicytopenia and circulating blasts 83%. Myelogram was performed based on the presence of circulating blasts; it showed acute myeloid leukemia (grade 4). Clinicians should suspect myeloid sarcoma in patients with bilateral exophthalmos and conduct a careful interpretation of blood test results. [ABSTRACT FROM AUTHOR]

Herniation of liver segments through defects in the anterior abdominal wall is rare. To our knowledge, only three cases have been described in the literature. This study reports the case of a 84-yearold man presenting to the emergency department with strangulated hernia of the linea alba showing dullness to percussion with protrusion of a sensitive and firm mass. Laboratory test results were normal. Abdominal CT scan showed herniation of liver segment through the linea alba with calculous cholecystitis. The patient underwent retrograde cholecystectomy with subhepatic Redon drain and repair of the herniation by overlapping suture, associated with two subcutaneous vacuum suction Redon drains. The post-operative suite was simple and the patient was discharged on the second postoperative day. Six months after surgery, our patient was healthy. Herniation of liver segments through defects in the anterior abdominal wall is rare. Patients usually show little evidence if clinical signs. Abdominal CT scan is essential to assess the viability of parenchymal liver cells. Patients´ management is studied on a case-by-case basis, it can be surgical or non-surgical. Herniation of liver segments is rare; few cases have been reported in the literature and, in these cases, patients showed little evidence of clinical signs. CT scan is essential to assess the viability of parenchymal liver cells. [ABSTRACT FROM AUTHOR]

Carotid-cavernous fistula is an abnormal communication between the carotid artery and the cavernous sinus. It is most commonly due to congenital arteriovenous malformations but it can also be caused by a trauma. It is a rare disease which can give rise to visual and life-threatening consequences. We here report the case of a young female patient aged 34 years who had been victim of road accident with craniofacial and lower limb trauma two years before her admission. Left exophthalmos with slowly progressive evolution occurred one year after road accident without other associated signs, revealing left carotid-cavernous fistula. What is peculiar about this case is the relatively long delay between the trauma, the onset of exophthalmos and the diagnosis of posttraumatic carotid-cavernous fistula. [ABSTRACT FROM AUTHOR]

Bilateral macronodular adrenal hyperplasia (BMAH) is a rare cause of adrenal Cushing's syndrome, accounting for less than 1% of cases. We here report the case of a 48-year-old patient with diabetes and hypertension presenting with clinical signs of Cushing's syndrome. Etiological assessment enabled clinicians to retain the diagnosis of Adrenocorticotropic hormone (ACTH)-independent hypercortisolism associated with BMAH. Unilateral left adrenalectomy was performed based on noriodocholesterol scintigraphy results, with good outcome. However, given the risk of recurrence and cardiovascular complications, long-term monitoring was scheduled. [ABSTRACT FROM AUTHOR]

Limbic encephalitis (LE) is a rare disease often of paraneoplastic origin. It is frequently associated with bronchopulmonary cancer. Diagnosis is based on brain magnetic resonance imaging (MRI). We here report the case of a 54-year-old female patient with a history of active smoking, presenting with chronic dry cough. Chest X-ray showed suspicious right lung opacity. Bronchial fibroscopy and bronchial biopsies were not contributory. Thoracoabdomino-pelvic computed tomography (CT)-scan and brain CT-scan showed a mass in the right upper lobe classified as T4N2M1a. CT-guided lung biopsy confirmed the diagnosis of bronchopulmonary adenocarcinoma. The patient had reported a recent history of memory disturbances associated with depressed mood, anxiety and paroxysmal confusion. Metabolic screening and tests for detecting infection were normal and brain MRI suggested limbic encephalitis. The evolution was characterized by rapid disease progression; the patient died in about ten days. [ABSTRACT FROM AUTHOR]

We here report the case of a 4-year-old male child presenting with congenital umbilical bud that, recently, had begun to bleed. Physical examination showed pinkish umbilical bud with blood stains but without any fistula, measuring about 1,5 cm in diameter. Abdominal ultrasound was performed, which suggested urachal sinus. Surgery revealed umbilical bud communicating, in the abdominal portion, with hyperemic, inflammatory Meckel's diverticulum placed 90 cm away from the ileocaecal angle in which many ascaris were detected. Anatomo-pathological examination of the surgical specimen showed diverticulitis. Thus, the diagnosis of Meckel's diverticulitis by Ascaris was retained. Resection and anastomosis with bud excision were performed. The postoperative course was simple even after a 6-month follow-up period. [ABSTRACT FROM AUTHOR]

This study reports the case of a 45-year-old female patient presenting with isolated pain in the right hypochondrium radiating to the back, evolving over the last several years. The patient had no medical history. Physical examination was normal. Computed tomography (CT) scan showed rightsided diaphragmatic hernia (Bochdalek hernia) with a part of the liver protrunding into the chest. The patient underwent robotic surgery. The postoperative course was simple. The patient had no recurrence at 1-year follow-up. Bochdalek hernia with intrathoracic liver herniation is rare in adult patients. It can be treated by robotic surgery. [ABSTRACT FROM AUTHOR]

We here report a case of embryonal paratesticular rhabdomyosarcoma in a young adult. The purpose of this study is to highlight this uncommon histological type of tumor in this age group, the rapid evolution of the lesion and the challenges of managing it in our context. [ABSTRACT FROM AUTHOR]

Combined deficiency of clotting factor V and factor VIII (DF5F8) is a congenital autosomal recessive disorder. This study involved a family of four children born to consanguineous parents. The eldest daughter was referred for assessment of activated partial thromboplastin time and prothrombin time associated with hemorrhagic manifestations. Coagulation factor dosing showed combined deficiency of factor V and factor VIII as well as normal levels of other coagulation factors. DF5F8 was detected in two girls and a boy. Two protein coding genes LMAN1 (lectin, mannose binding 1) and MCFD2 (multiple coagulation factor deficiency2) were involved in the intracellular passage of Factor V and Factor VIII, including some mutations which caused deficiency of Factor V and VIII. The diagnosis of DF5F8 is routinely possible, especially in patients born to consanguineous parents with a suggestive clinico-biological condition. [ABSTRACT FROM AUTHOR]

Diffuse infiltrate lung diseases (DILDs) are frequent in patients with connective tissue diseases. They can be suggestive of connective tissue diseases or occur during follow-up. Antisynthetase syndrome (ASS) is a complex and heterogeneous connective tissue disease. Antisynthetase antibodies, in particular the anti-Jo1 antibody, are found in patients with this syndrome. The prognosis of ASS is conditioned by the occurrence of DILD and its severity, thus guiding therapeutic management. We here report the case of a 57-year-old female patient presenting with acute febrile DILD revealing ASS. Outcome was favorable under bolus corticosteroids in combination with cyclophosphamide treatment. [ABSTRACT FROM AUTHOR]

Le pneumo médiastin spontané se définit par la présence d´air au niveau du médiastin survenant en dehors de tout contexte traumatique, iatrogène ou d´une maladie pulmonaire sous-jacente. C´est une affection rare, qui survient chez le jeune adulte et l´adolescent. Son principal risque est d´être confondu avec un tableau de fistule aéro-digestive, conduisant parfois à la réalisation d´investigations et de mesures thérapeutiques inutiles, voire délétères Nous rapportons le cas d´un pneumomedisatin spontané survenu chez une femme jeune au décours d´un effort de vomissement.

Nous rapportons un cas d´exanthème maculo-papuleux apparu après une semaine de prise de l´hydroxychloroquine 400mg prescrite pour une atteinte articulaire d´un syndrome de Goujerot Sjögren primaire chez une patiente de 41 ans. Cette dernière était suivie pour une lésion glomérulaire minime idiopathique depuis plus d´un an, traitée efficacement avec la corticothérapie. Les exanthèmes maculo-papuleux ont régressé après avoir reçu l´hydrocortisone, la desloratidine et l´arrêt immédiat de l´hydroxychloroquine. Notre cas reflète l´importance d´insister sur la prescription à faible dose de l´hydroxychloroquine chez les sujets avec des pathologies préexistantes rénales et aussi l´intérêt de sensibiliser et d´éduquer les patients des effets secondaires de l´hydroxychloroquine.

Spontaneous pneumomediastinum is defined as the presence of air in the mediastinum. It is not iatrogenic, due to a trauma or underlying lung disease. It is a rare condition affecting young adults and adolescents. The main risk of diagnostic error is due to the fact that features can be confused with those of aerodigestive fistula, sometimes leading to investigations and unnecessary and sometimes deleterious therapeutic measures. We here report a case of spontaneous, vomiting-induced pneumomediastinum in a young woman. [ABSTRACT FROM AUTHOR]

Fibrous dysplasia is a genetic and rare bone disorder affecting the young subject. Its pathophysiology involves genetic mutations leading to defective skeletal development with fibrous and medullary proliferations. Cephalic extremity is involved in one third of cases. We here report a case of surgically treated fibrous dysplasia of the frontal and ethmoid sinuses. The study involved a 31-year-old man presenting with chronic holocranial headaches. Computed tomography (CT) scan showed voluminous bilateral hyperdense expansive process in the frontal and ethmoid sinuses. Surgery was performed on the basis of functional signs and imaging data. Anatomopathological examination of bone fragments confirmed the diagnosis of fibrous dysplasia. Fibrous dysplasia is rare and characterized by slow disease progression. In the absence of a consensus on therapy, surgery remains the treatment of choice for unifocal forms. [ABSTRACT FROM AUTHOR]

SARS-CoV-2 infection is a major concern and a new threat to immunocompromised patients. Patients with chronic inflammatory bowel diseases (IBDs) are at increased risk of infections, in particular when they have active disease and are on immunosuppressive treatment. The purpose of this study was to assess the clinical, biological and radiological features of three patients with COVID- 19 associated with chronic IBD as well as their management and outcomes. The study was conducted at the Hassan II University Teaching Hospital in Fes, Morocco over a 3-month period. We assessed all patients with disease onset. All patients had mild symptoms or were asymptomatic. No changes or delays in treatment regimens occurred and none of patients developed severe COVID-19. Reverse transcription polymerase chain reaction (RT-PCR) test results were positive in all patients. Radiological examinations were conducted. Chest scanner showed ground-glass opacities in one case. Treatment was based on hydroxychloroquine with azithromycin. Outcome was good in all cases. This preliminary report suggests that patients with chronic IBD aren’t at higher risk of developing COVID-19 compared to the general population. [ABSTRACT FROM AUTHOR]

Dermatofibrosarcoma is a rare skin tumor. Morphological characteristics can be misleading and unknown to most of physicians. Diagnostic delay may affect patient´s management and prognosis. We here report the case of a young patient with lesions protruding from the abdominal wall mistaken for benign cysts. X-ray examination revealed subcutaneous adipose tissue mass. This was suspected of being a fibrosarcoma. The mass was resected with a macroscopic safety margin. The anatomo-pathological study confirmed the diagnosis of dermatofibrosarcoma. Clinical and radiological follow-up examinations didn´t show any recurrence. This study highlights the importance of suspecting this rare tumor requiring specialist treatment. [ABSTRACT FROM AUTHOR]

L´hydrocèle du canal de Nuck est une pathologie rare de la femme, souvent découverte durant l´enfance. Cette présentation rapporte un cas rare d´hydrocèle découverte à l´âge adulte au cours d´un bilan d´infertilité. A l´admission au service, la patiente a rapporté une tuméfaction inguinale droite chronique non douloureuse. L´imagerie a été typique d´une hydrocèle du canal de Nuck. L´échographie a retrouvé une formation kystique avec quelques fin septas et l´'imagerie par résonance magnétique (IRM) n´a pas retrouvé de communication avec le péritoine. Avec les mêmes moyens d´imagerie, un utérus bicorne non cloisonné a été découvert pouvant rentrer dans le cadre de son bilan d´infertilité. Le but principal de ce travail est de faire connaitre l´imagerie typique de l´hydrocèle du canal de Nuck un diagnostic peu connu et de le faire intégrer parmi les diagnostics différentiels des tuméfactions inguinales chez la femme. [ABSTRACT FROM AUTHOR]

Nowadays, the knowledge of vascular abnormalities is essential for all specialists in their clinical practice and may prevent serious complications through early interventions. Nutcraker syndrome is caused by left renal vein (LRV) compression, usually occurring in the fork formed by the abdominal aorta and the superior mesenteric artery (SMA) and leading to the narrowing of the aortomesenteric portion of the left renal vein and to the dilatation of its distal portion. Symptoms are dominated by lumbar, abdominal, pelvic pain and haematuria. Diagnosis is essentially based on modern imaging tests (computed tomography (CT) scan, Doppler-ultrasound, phlebography) and treatment is controversial. We here report the case of a 43-year-old woman, admitted with epigastric pain associated with pelvic heaviness following nutcraker syndrome requiring radiological screening on admission. [ABSTRACT FROM AUTHOR]

Nous rapportons un cas d'exanthème maculopapuleux apparu après une semaine de prise de l'hydroxychloroquine 400mg prescrite pour une atteinte articulaire d'un syndrome de GougerotSjögren primaire chez une patiente de 41 ans. Cette dernière était suivie pour une lésion glomérulaire minime idiopathique depuis plus d'un an, traitée efficacement avec la corticothérapie. Les exanthèmes maculo-papuleux ont régressé après avoir reçu l'hydrocortisone, la desloratadine et l'arrêt immédiat de l'hydroxychloroquine. Notre cas reflète l'importance d'insister sur la prescription à faible dose de l'hydroxychloroquine chez les sujets avec des pathologies préexistantes rénales et aussi l'intérêt de sensibiliser et d'éduquer les patients des effets secondaires de l'hydroxychloroquine. [ABSTRACT FROM AUTHOR]

Notre travail vise à rapporter, la place de la chirurgie à ciel ouvert dans la reprise d'une sténose urétérale étendue, ancienne et post infectieuse d'une part, et d'autre part, d'apporter notre expérience thérapeutique, cela à travers l'observation d'un patient âgé de 38 ans qui nous avait consulté dans notre service d'urologie des cliniques universitaires de Lubumbashi, pour douleur lombaire gauche, brûlures mictionnelles, fièvre sans horaire, Le bilan clinique et paraclinique, mettaient en évidence la sténose urétérale étendue. Une dérivation urinaire temporaire (urétérostomie gauche) était réalisée. Il a été repris, pour une urétérectomie suivie d'une réimplantation urétérovésicale gauche. Les suites postopératoires ont été simples, le patient a été revu 3 mois après l'intervention, il n'avait aucune plainte, la créatinine contrôle était normale, l'échographie et l'uroscan étaient dans les normes. English abstract The purpose of this study is to highlight the role of open surgery in the treatment of patients with a history of extended and postinfectious ureteral stricture as well as our experience with therapy. The study involved a 38-year old patient presenting at the urology service of the University Clinics of Lubumbashi with left lumbar pain, burning sensation during urination and fever. Clinical and paraclinical assessment showed extended ureteral stricture. Temporary urinary diversion (left ureterostomy) was performed followed by ureterectomy and left ureterovesical reimplantation. The postoperative course was simple. Three months after surgery the patient had no complaints, creatinine levels were normal, ultrasound and uroscan results were normal. [ABSTRACT FROM AUTHOR]

Orofacial clefts are common congenital malformations. Tessier's classification system is the most widely used; it consists of 30 variants including median mandibular clefts (Tessier's cleft No. 30). They can be isolated or associated with cleft of the lower lip, tongue or more rarely, of the sternum. They are very rare, less than 70 cases (all types taken together) have been reported in the literature. We here report an exceptional case of mandibular and sternal cleft with literature review. [ABSTRACT FROM AUTHOR]

despite the need for chemotherapy. This study reports the case of a 37-year old multiparous woman at 20 weeks and 4 days of amenorrhea (WA). She was hospitalized for dyspnoea (stage IV according to New York Heart Association (NYHA) classification). The patient had a syndrome of heavy left pleural effusion and bilateral mastitis. The diagnosis of metastatic breast cancer was retained based on cytological examination of pleural fluid and breast cytoponction revealing galactophoric carcinoma. The patient underwent pleural drainage with improvement of dyspnea but pleural fluid continued. After multidisciplinary consultation (MC), specific treatment of cancer was necessary. Five cycles of epirubicin- cyclophosphamide-5-FUbased chemotherapy was performed after the couple provided consent. Pleural fluid diminished significantly after the second cycle of treatment. After consultation with the obstetrician, chemotherapy was interrupted one month before the 37th week of amenorrhea. Pregnancy evolved favorable, vaginal birth was managed following rupture of membranes at term with good neonatal adaptation. After one-year follow-up, the mother was still on chemotherapy and the baby was in good health. Several parameters should be considered before the administration of antineoplastic agents, hence the role of early fetal and maternal monitoring. Multidisciplinary approach is recommended to support therapeutic decision and follow-up. [ABSTRACT FROM AUTHOR]

La fièvre jaune (FJ) est une fièvre hémorragique virale, causée par le virus de la fièvre jaune, transmise par les moustiques du genre Aedes. Au Tchad depuis 2013, 04 cas de fièvre jaune ont été identifiés et confirmés dans le cadre du programme national de surveillance de la fièvre. Nous rapportons ici l'observation clinique du dernier cas confirmé dans le district sanitaire de Lai. Il s'agit d'un homme de 57 ans sans antécédents médicaux et chirurgicaux significatifs et un statut vaccinal inconnu. Il a consulté le 21 avril 2020 pour fièvre, ictère d'épistaxis d'abondance modérée à faible et hépatomégalie douloureuse. Dont les explorations para-cliniques ont permis de mettre en évidence le virus de la fièvre jaune en post mortem par RT-PCR. Ainsi la confirmation de la fièvre jaune dans ce district, le faible niveau de couverture vaccinale, la réalité de la circulation du virus et la présence du vecteur dans le pays devraient avertir d'une réelle menace de ré-émergence de la fièvre jaune au Tchad. English abstract Yellow fever (YF) is a viral haemorrhagic fever caused by yellow fever virus transmitted by Aedes mosquitoes. Since 2013, in Chad, four cases of yellow fever have been detected and confirmed as part of the national fever surveillance program. We here report the last clinical case confirmed in the health district of Lai. The patient was a 57-year-old man with no significant medical and surgical history and unknown immunisation status. He consulted on April 21st, 2020 for fever, moderate to low abundance jaundice and epistaxis (nosebleed) and painful hepatomegaly. Paraclinical examinations, such as RT-PCR, objectified yellow fever virus in post-mortem tissue sample. Thus, confirmed yellow fever cases in this district, the low level of vaccination coverage, the circulation of the virus and the presence of vector in the country should warn of a real threat of reemergence of yellow fever in Chad. [ABSTRACT FROM AUTHOR]

Huge ovarian tumor is usually diagnosed at an advanced stage, in particular in developing countries. It can cause surgical complications. Anatomopathological examination is essential to establish the diagnosis. The role of tumor marker CA125 in a perimenopausal woman with pelvic mass has been widely debated. [ABSTRACT FROM AUTHOR]

Sclerosing encapsulating peritonitis is a very rare pathological entity. It is a chronic fibroinflammatory disease affecting the peritoneum and leading to the formation of diffuse egg-shell-shaped fibrous capsule which totally or locally encapsulate the abdominal viscera, in particular the digestive tract. Clinical signs are little specific and misleading. Medical imaging, including computed tomography, can help clinicians to make a diagnosis, by highlighting a thin peritoneal membrane encompassing an agglutination of digestive loops. Secondary types (postperitoneal dialysis, tuberculosis, medications, postintraperitoneal chemotherapy) are quite common, however idiopathic sclerosing encapsulating peritonitis is very rare and few cases have been reported in the literature. We here report the case of a 53-year-old woman with idiopathic sclerosing encapsulating peritonitis. [ABSTRACT FROM AUTHOR]

Mammary myofibroblastoma is a rare soft-tissue tumor. Extramammary myofibroblastomas are particularly rare. We here report the case of a 78- year-old man presenting with pelvic pain relieved by defecation or urination. Rectal examination showed a mass in front of the anterior rectal wall. The magnetic resonance imaging (MRI) showed a wellcircumscribed and heterogeneous mass measuring 10 x 6 x 8cm located behind the bladder which was pushed forward in front of the rectosigmoid. Immunohistochemical analyses showed diffuse coexpression on CD34 cells and desmin, Rb expression on most cells, oestrogen receptor expression, intense and diffuse P16 expression and a ki67 proliferation index of 25%. The patient had no recurrence 8 months after radiotherapy followed by surgery. Breast myofibroblastoma is a rare and benign tumor. Recurrence is hardly observed after local treatment. This study highlights the supporting role of radiotherapy in the efficacy of surgery. [ABSTRACT FROM AUTHOR]

This study reports the case of a 45-year-old female patient who underwent brain CT scan which fortuitously revealed de novo lesion. She was diagnosed with left isodense intradiploid lesion in the pterional region with bone lysis uniformly enhancing after injection of contrast medium. Magnetic resonance imaging showed T1-weighted hypointense lesion, spontaneously hyperintense signal on T2-weighted images and FLAIR images, strongly enhancing after gadolinium injection. Total tumor excision was performed. Histological examination showed chordoid meningioma. [ABSTRACT FROM AUTHOR]

Cemento-osseous dysplasia is a benign fibroosseous lesion affecting the alveolar bone. It is classified into three forms: periapical, focal or florid dysplasia. It is often asymptomatic and fortuitously discovered during a routine radiological examination. However, it may become symptomatic after superinfection, after patient's exposure to oral bacterial flora. We here report a case of florid cemento-osseous dysplasia associated with actinomycosis of bone in a 53-year-old Tunisian woman. This superinfection has been rarely reported in the literature; Boolean Searching on PubMed for the keywords "cemento-osseous dysplasia AND actinomyces" displays a single article (Smith et al. 2011). The treatment of actinomycosis infection often requires long-term antibiotic therapy, sometimes associated with surgical debridement, as in the case of this patient who underwent piezosurgery to treat dysplasia and necrotic bone. [ABSTRACT FROM AUTHOR]

La diversité des causes des artériopathies juvéniles nécessite une enquête étiologique systématique lorsqu'une ischémie critique des membres est diagnostiquée avant 50 ans. Nous aimerions présenter le cas d'une jeune femme ayant été diagnostiquée porteuse de la maladie du Lupus révélée par une ischémie distale du pied. The diversity of juvenile arterial disease aetiologies requires a systematic investigation when limb critical ischemia is diagnosed before the age of 50. We would like to share a rare case of a young woman who was diagnosed with Lupus disease revealed by distal ischemia of the foot. [ABSTRACT FROM AUTHOR]