[ spindle cell myoepithelioma of parotid gland: a case report]

Background: Myoepthelioma is a rare salivary gland tumor which is usually located in parotid gland and in minor salivary glands

Case report :We report a case of myoepithelioma arising in an accessory paritid gland in a 47-yearold woman who presented with a slowly expanding subcutaneous nodule on the left cheek, that was within the parotid gland at surgical resection . This tumor was composed of spindle cells. Immunophenotypical characterization demonstrated its myoepithelial nature

Conclusion: In the subcutaneous tissue, this unusual neoplasm may be confused with soft tissue tumors showing spindle cell features

unusual presentation of colonic duplication

Gastrointestinal duplication is an uncommon congenital abnormality, usually diagnosed early in life; a minority may remain unsuspected until adulthood. Ileal duplications are the most common while colonic duplications are rare and remain asymptomatic and undiagnosed in most cases. The main symptoms include pain and/or abdominal distension. Rarely, duplications present with signs of acute abdomen or acute bleeding. We report about a case of a colonic cystic duplication in an adult revealed by rectal bleeding. This report illustrates the difficulties that can be encountered when establishing this rare diagnosis and emphasis that colonic duplication should be looked for in search for an aetiology of obscure colonic bleeding

[Ewing sarcoma osseous and extra osseous: a clinicopathological study of 29 cases]

Ewing's sarcoma [ES] is a rare tumour accounting for 10% of primary malignant bone tumours in children and 3% of all childhood malignancies. ES belongs to a group of small round cell tumours. In this review, we will describe the main clinicopathological features of this rare tumour and discuss its prognosis. We report a retrospective study of 29 cases of ES, of which 4 were extraosseous, diagnosed over a period 11 years [January 1989 - December 1999]. Clinicopathological data were described. Hematoxylin-eosin staining and immunohistochemical study were reviewed. 12 patients were male and 17 were female [ratio: 0.8] with a median age of 16 years. 62.5% of tumours were located in flat bone and 33.3% in long bone. The medium size of the tumor was 10.6 cm [range:3-25cm]. 27.5% of patients presented with metastatic disease at time of diagnosis. Microscopically, tumour tissue was composed of round, small, blue cells with fine granular chromatin. Tumour cells strongly coexpressed CD99 and vimentin [100%]. Systemic treatment consisted of adjuvant chemotherapy [84.2%]. Local control was based on and surgery [57. 9%] or radiation therapy [36.8%]. A good response to chemotherapy was obtained in 37.5%; 13.7% of patients were alive without disease [medium follow up: 169 mois]; 34.5% of patients developed metastases [medium follow up: 23 months] and 10.3% developed recurrences [medium follow up :13 months]. Our study emphasizes two points: the great size of the tumor and the frequent location in flat bone which may explain the poor prognosis of Ewing sarcoma in our series despite the multidisciplinary treatment

[Histological features of celiac disease in south Tunisia: a study of 114 paediatric cases]

To report the histological features of celiac disease in a paediatric population originating from south Tunisia. A retrospective study of a series of duodenal biopsies from 114 children with celiac disease diagnosed over a period of 6 years [from January 1999 to December 2004]. The diagnosis was confirmed by histological results, serological studies and clinical response to gluten free diet. The average age of patients was of 6.2 years [range 6 months-15 years]. Sex ratio was 0.71. Symptoms were dominated by chronic diarrhea [48%], weight loss [50%] and anemia [20.1%]. Histological findings showed an intraepithelial lymphocytosis [Marsh type 1] in 12.2% of cases, type 2 was present in 1.7% of cases and type 3 [villous atrophy] in 86% of cases. A treatment with a gluten-free diet was indicated for all patients, only the cases who haven't presented a clinical amelioration [11 cases] have beneficed a control biopsie; a villous atrophy was persistent in 80% of this patients. Histological features in duodenal biopsies for the diagnosis and the follow-up of patients with coeliac disease. This allows an appropriate treatment and prevents further complications