[Outcome of malignant vulvar tumors]

Vulva anatomy - FIGO classification- Vulva tumors anatomopathology - Treatments of vulva cancers. Our study is a retrospective, longitudinal and continuous one. It concerns 11 malignant vulva tumors which were treated in the d‚partement "C" of the centre of maternity of Tunis. The period of study is fifty four months [2002-2006]. The aim of our study is to analyse the characteristics of the vulva cancer and to compare our results to litterature. Mean age of our patients is 67 years old. They are all menaused. The principal signs are vulva tum‚faction in 72,7% of the cases, vulva pruritis in 27,3% of the cases and genital bleeding in 27,3% of the cases. The mean period of consultation is of 14 months. We have ten cases of vulvar epidermoid carcinoma and one melanoma. The treatment was surgical in the eleven cases [10 total vulvectomy and one hemivulvectomy] They all benefited of an inguinal bilateral curage. The adjuvant radioth‚rapie was indicated in 3 cases. A patient was classed stage lb of FIGO, 7 stage II, one stage III and one stage IVA. Nine patients are in remission, 3 are dead: 2 because of their cancer and one due to a pulmonar embolism. The survival of 6 month is 72, 2%.The prevention of this cancer passes by the close follow of dystrophic states and viral pathologies of the vulva

[Placenta percreta: a rare aetiology of metrorrhagies in the first and second trimesters of pregnancy about two cases and review literature]

The placenta percreta is an abnormal placentar adhesion with invasion of all the uterine wall with sometimes an extension to the organs bordering the womb by chorial villiosities. It is a pathology rarely diagnosed during the first trimester of pregnancy. We report in this work two cases of placenta percreta diagnosed in the first trimester of pregnancy in the A service of the centre of maternity and of neonatology of Tunis. After a review of the literature we tried to make lignt on risk factors inherent to this pathology and to propose a practical behaviour. The first patient of the study was 28 years old, with bicicatricial uterus. She was admitted in urgency for abundant metrorragies in the tenth week of pregnancy, A molar pregnancy was suspected and an attempt of uterin evacuation failed. In front of the importance of bleeding an haemostais hysterctomy was made. The second patient was 39 years old, and had as antecedents of cures of uterine synechy. She was admitted in the 19[th] week of pregnancy, for a late abortion. In front of the complete placentar retention and the aggravation of bleeding, the diagnosis of placenta accreta was evoked and a haemostasis hysterectomy was realized. In both cases histological exam confirmed peroperative discoveries and concluded the diagnosis of placenta percreta. The difficulty of the management of the placenta percreta is due to the fact that this pathology is almost always met in a unexpected way in an urgent context. Antenatal diagnosis is recently described as possible in the first trimester of pregnancy

[Gestational pemphigoid - about two cases and review of the literature]

Gestational pemphigoid is the most clearly characterized dermatosis of pregnancy. It is a rare vesiculo-bullous eruption that develops during the last trimester or even in postpartum and causes severe pruritus.The objective of this work is to study the clinical aspects and especially the materno-foetal involvement of this pathology. We report the case of a 35 years old patient who was admitted on a term of 32 weeks of pregnancy for generalized bullous eruption. The diagnosis of gestational pemphigoid was confirmed on clinical and histological arguments. The patient had a caesarian section for acute foetal suffering. Evolution in post partum was characterized by a progressive disappearance of lesions. The patient presented a recurrence of this dermatosis during the second pregnancy. Gestational pemphigoid is a rare dermatosis during the pregnancy. Materno-foetal transmission is possible and expose to a higher risk of prematurity and hypotrophy of the newborn child

[Irvan syndrome rare etiology of vasculitis]

Clinical study of retinal vasculitis secondary to IRVAN syndrome. A 20 years old female patient presented visual impairment of the left eye under 1110. Ophtalmoscopy and retinal angiography showed macular edema with exsudates and bilateral retinal vasculitis with irregular diameter, papillar floorescence and peripheral ischemic retinopathy of both eyes. Serologic exams and anterior chamber punctore analysis were normal eliminating infectious and inflammatory causes of vascuhtis. The diagnosis of IRVAN syndrom was retained and peripheral panphotocoagulation proposed for both eyes. IRVAN Syndrome affect young women, without association with systemic desease. It's a rare etiology of vasculitis. The diagnosis is clinical and doesn't nead a lot of investigations