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Background: Among the different forms of ectopic pregnancy, cesarean scar pregnancy is one of the most uncommon with an estimated incidence of 1/1800 pregnancies. A major risk of massive hemorrhage, it requires active management as soon as it is diagnosed because it can affect the functional prognosis of the patient (hysterectomy) but can also be life-threatening. Different surgical techniques are generally proposed in first intention to patients who no longer wish to have children, who are hemodynamically unstable and/or in case of failure of medical treatment. Case presentation: We hereby report the case of a young 19-year-old patient with no particular medical history, gravida 2 para 1 with a live child born after a cesarean section for fetal heart rhythm abnormalities during labor 5 months earlier and who presented to the emergency room of our structure for the management of a cesarean pregnancy scar diagnosed at 6 weeks of amenorrhea. She was successfully managed with an intramuscular injection of methotrexate. The follow-up was uneventful. Conclusion: The implantation of a pregnancy on a cesarean section scar is becoming more and more frequent. With consequences that can be dramatic, ranging from hysterectomy to life-threatening hemorrhage, clinicians must be familiar with this pathological entity and be prepared for its management. The latter must be rapid and allow, if necessary, the preservation of the patient's fertility. In this sense, conservative medical treatment with methotrexate injections should be proposed as a first-line treatment in the absence of contraindication.

Background: Ovarian fibroma is a very unusual epithelial tumor representing less than 1% of all ovarian tumors. It can be asymptomatic and discovered during surgery or be associated with a pleural effusion preferentially located on the right side and a more or less abundant free ascites in the framework of the so-called Meigs syndrome. The challenge of management then lies in distinguishing benign from malignant since clinically, radiologically, and biologically everything points towards malignant which requires radical surgical treatment. We report here the case of a 69-year-old postmenopausal patient with a clinical form of Meigs' syndrome that strongly suggested ovarian cancer. Case presentation: We hereby report here the case of a 69-year-old patient, menopausal, gravida 4 para 3 with 3 live children delivered vaginally and one miscarriage. She presented with ascites, hydrothorax, and a solid tumor of the ovary. Serum CA 125 and HE 4 levels were very high. ROMA score was highly suggestive of malignancy. A hysterectomy with adnexectomy was performed. It was only the histological evidence of ovarian fibroma and the rapid resolution of its effusions that confirmed Meigs syndrome. Conclusion: Meigs syndrome is an anatomical-clinical entity that associates a benign tumor of the ovary, ascites, and hydrothorax. Highly elevated CA 125 and HE-4 tumor markers often point clinicians toward a malignant tumor and compel radical surgical treatment. This case report reminds us once again that only histology confirms the diagnosis of cancer.

Omphalocele (exomphalos) is one of the mostcommoncongenital malformations of the abdominal wall. The size of the defect and the severity of the associatedabnormalitiesdetermineoverallmorbidity and mortality. Prenatal screening and diagnosis of associatedabnormalities are important for proper management. The purpose of this article is to discuss the approach of prenataldiagnosis and the therapeuticmodalities of omphalocèle through a case reportedwithinourobstetricgynaecologydepartment CHU IBN SINA RABAT.

Cystosarcoma phyllodes of the breast are rare, and it accounts for less than 1% of the malignant tumors of the breast. Its clinical and radiological characteristics are those of benign tumors, and only a fast tumoral growth can evoke diagnosis. The diagnosis is confirmed by anathomopathology and immunohistochemistry. Surgical extended resection is the treatment of choice. Adjuvant radiotherapy may be administered in patients with high-grade tumors, positive surgical margins, or postoperative recurrence. Here we present a case of a woman affected by a sarcoma phyllodes tumor, an uncommon oncologic disease.

Angioedemaisdefined as a non-inflammatory, localized, transientedema of the subcutaneous and/or submucosal tissues, thatappearswithin a few hours and disappearscompletelyafter the attack. Bradykinin-mediatedangioedemais rare, accounts for 1% of angioedemas and canbe life-threateningwhenit affects the upperairways. It must bedifferentiatedfromallergic histamine-mediatedangioedema, which carries a risk of anaphylaxis, and the more common non-allergic histamine-mediatedangiœdema, whichisonlyexceptionally life-threatening. Lack of knowledge of thispathologycan lead to the administration of treatmentsusuallyused to treatupperairway oedema but ineffective in the case of bradykininmediatedangioedema (corticosteroids, antihistaminic, adrenaline). Thus, anyangiœdemaoccurringabove the shoulders and not or incompletelyresponding to anaphylaxistreatment should lead to the suspicion and the treatment of bradykinin-mediatedangiœdema and to the administration of a specifictreatment. Evenminorsurgery, any invasive diagnostic procedure, pregnancy, and physical or emotional stress can trigger an angioedemaattack.We report the case of a patient from the ObstetricGynecologyDepartmentatCHU IBN SINA in RABAT.

Objective:Abdominal pregnancy is a rare form of ectopic pregnancy with very high morbidity and mortality for both the mother and the fetus. Diagnosis and management can pose some difficulties especially in low-resource centers. The objective of this stady is to illustrate the different epidemiological, clinical and therapeutic data of abdominal pregnancy. Patient and observation:We present an additional case of primary omental pregnancy at 12 gestational weeks presenting with symptoms of hemoperitoneum and acute abdomen. Pregnancy status was confirmed after admission. Transvaginal ultrasound examination revealed a single viable fetus with a large amount of free peritoneal fluid, but no intrauterine sac or adnexal mass Laparotomy was done according to pre-operative diagnosis of ruptured tubal pregnancy. Bilateral tubes and ovaries were intact omental pregnancy was detected and partial omentectomy was performed. Conclusion:Early diagnostic of omental pregnancy is difficult but essential to reduce the high mortality.

Mature cystic teratoma is the most common type of ovarian germ cell neoplasm, but occasionally, it can undergo malignant transformations, especially in postmenopausal women. These secondary malignant neoplasms are most commonly squamous cell carcinomas. The absence of clinical and radiological specificity of this transformation means that the diagnosis remains purely histological. Data is insufficient regarding the appropriate management given their rarity. However, the treatment is multidisciplinary and is based on surgery and a platinum-based chemotherapy regimen. We report the case of a 53-year-old postmenopausal female patient with malignant transformation of the ovarian teratoma who was treated surgically and whose outcome was favorable. The diagnosis of the teratoma was evoked on imaging, while the diagnosis of squamous cell carcinoma was revealed on histology. Malignant transformation is an uncommon complication of mature ovarian teratomas. No clinical, radiological, or biological sign is specific; therefore, resection of any ovarian mass, even asymptomatic, is required.