[Lateral nail squamous cell carcinoma: case report]

Squamous cell carcinoma [SCC] of the lateral nail fold is rare, it has been suggested that trauma, roentgen radiation, arsenic exposition, dyskeratosis and infections [HPV] are risk factors for the development of these carcinoma.This tumour is mostly a slow growing and low grade malignancy which rarely metastasis.Early diagnosis by biopsy, especially in patients with predisposing factors, may lead to treatment and prevent the tumour from metastasizing. Report of new case. We report one case of [SCC] of the lateral nail fold of the thumb in a 66 year old man, treated with local excision; function and cosmetic results are more acceptable. A review of the literature was made in order to precise the epidemiological, diagnostic and therapeutic characteristics

[Non alcohol steatohepatitis: pathologic study of 9 cases]

Non alcohol steatohepatitis is an acquired chronic hepatopathy frequently of metabolic origin. Histopathologically, it is characterised by a steatosis associated with necrotic inflammatory lesions mimicking alcohol hepatitis. This disease is complicated by cirrhosis in 15 at 30% of cases and by hepatocellular carcinoma in 13% of cases. The aim of our study was to evaluate the clinico-epidemiological features of this disease and the histopathological degree of hepatic failure. 9 cases of non alcohol steatohepatitis are diagnosed in our hospital in 3 years between 2001 to 2004. The clinical features of patients were determined. The aspect and extent of steatosis was noted and the degree of the necrotical activity was evaluated by the Lee score. We observed strong women prevalence with a sex-ratio of 0,125 and a high frequency between 40 and 60 years. Obesity and diabetes are the most common metabolic disorders encountered in our series. In opposition to published cases, a hepatomegaly and signs of portal hypertension are the most frequent clinical lesions noted in our study. Histopathological evaluation of Lee score finds a mild to moderate activity and fibrosis in nearly all our cases. One case of cirrhosis is noted

[Primary synovialosarcoma: a case of unusual location]

Report a new case of primary Synovi alosarcoma. We report a case of a 16 year old girl, who presented with a tumefaction on the right clavicle evolving or 3 months. Various explorations carried out, in particular thoracic scanner and imagery by magnetic resonance, showed a multilocular cystic formation of the seat and the clavicle reaching the mediastinum. A pathological examination of the part [piece] highlighted a biphasic synovialosarcoma of grade III. This diagnosis was validated by the immunohistochemistry study and the detection of transcribed specific fusion of the synovialosarcoma, SYT-SSXI. The unusual locations of the primitive SS must be known because the diversity of their microscopic aspects may cause confusion in the diagnosis. The immunohistochemistry, and more recently the cytogenetic studies, helps to solve these problems of differential diagnosis

[Krukenberg tumor: a clinico pathological study of 5 cases]

Krunkenberg tumor is defined as the ovarian metastases of a primary digestive tumor composed of a signet ring cells. Describe the different characteristics of Krukenberg's tumor to improve diagnostic criteria and the therapeutic approche. Five cases of Krukenberg tumor are diagnosed 5 year period between 2002 and 2005. The c1inic-pathological feature are reported. The patient age was ranged from 31 to 58 years. Most ovarian tumors were diagnosed synchronously cases]. It was a gastric carcinoma in 3 cases and a colonic carcinoma in 2 patients. Histological diagnosis wass easy. We found in 2 cases a metastasis of colonic mucinous adenocarcinoma with signet ring-cell, in 2 other cases it 's a gastric adenocarcinoma with exclusively signet ring cell and in the later case it was a gastric moderately differentiated adenocarcinoma with signet ring cell component. Surgical treatment was given in only 3 patients. Prognosis is always unfavourable. The only-hope for improved prognosis is to search for ovarian metastasis in all cases of digestive tumor

[Comparative study of appendical mucocela and pseudomyxoma peritonei. About 25 cases]

Aim: to study the clinicopathological features of the different types of appendical mucocele and to compare them with those of pseudomyxoma peritonei

Methods: 25 cases of appendical mucocele were operated in the Cap-Bon region in Tunisia during a period of 13 years from 1994 to 2006

Results: 9 retentionnal cysts, 13 mucinous cystadenomas, one serrated adenoma, one hyperplasia of the mucosa and one cystadenocarcinoma were diagnosed. Five cystadenomas as well as the only case of cystadenocarcinoma were associated with pseudomyxoma peritonei. Pseudomyxoma peritonei occurred 20 years later than in simple appendiceal mucocele and complicated 5 cases of cystadenoma with low grade dysplasia and 1 case of cystadenocarcinoma

Conclusion: Preoperative diagnosis of appendical mucocele and pseudomyxoma peritonei should be made on scannographic features in order to assess the adequate surgical management

Digestive polyposis, a retrospective study of 20 cases

Three main polyposis syndromes are transmitted as an autosomal dominant disorder: familial adenomatous polyposis [FAP], juvenile polyposis syndrome [JPS] and Peutz-Jeghers syndrome. Evaluate this management of digestive polyposis. Our study included 20 patients which were collected in the departements of pathology surgery and garstroenterology of MT Maarmouri's Hospital, Nabeul city. We reported 15 cases of adenomatous polyposis with 2 family groups. We identified a family group of JPS with 3 members and 2 cases of Peutz-Jeghers syndrome. We found 11 cases of colonic adenocarcinoma out of the 15 patients affected by adenomatous polyposes. FAP is a generalized disorder involving the entire colorectum segment with numerous extra-colonic manifestations. The risk to develop colonic cancer is 100%. JPS is characterised by the development of numerous gastrointestinal juvenile polyps and occurs usually before 20 years old, the progression to cancer is rarely observed. Peutz-Jeghers syndrome consists in hamartomatous polyps associated to a characteristic mucosal pigmentation. The patients are usually young adults and have an increased incidence of cancer in extradigestive sites

[Prune belly syndrome: Early prenatal diagnosis and management]

Prune Belly syndrome in characterized by a combination of megacystis, anterior abdominal wall distension with deficiency of the abdominal wall musculature, and bilateral cryptorchidism. Diagnosis is easy after 15 weeks of gestation, but may be difficult at the end of the first term. Authors report 2 cases of Prune Belly syndrome diagnosis at 11 and 14 weeks of gestation respectively. Afterliterature review, diagnosis and prognosos particularities of this syndrome are discussed

[Prevalence of the microscopic colitis to the course of the chronic diarrhea: about 150 cases]

The goal of our survey is to value the microscopic colitis frequency at 150 patients, colliged on a period of 6 years [1997-2003], that have a chronic diarrhea with a normal total coloscopy and that benefitted of systematic biopsies. The microscopic colitis has been recovered at 44 patients on 150 either 29,3%. 16 of our patients [37%] are put on Salazopyrine, they answered well to the treatment with a receding of 3 years. The microscopic colitis is a pathology whose frequency seems under valued, it is certainly benign but can give a frequent diarrhea requiring a curative treatment

[Do biologic parameters [prothrombin time platelets], allow to assess the degree of fibrosis in liver diseases?]

The goal of our study is to assess the performance of a score combining 3 serological parameters [PT, platelets and transminases] in predictive hepatic fibrosis. The study involved 54 patients, 29 of which resulted in distributing them according to the score of Metavir into 2 groups: Group A with mild fibrosis [F1,F2] and group B with severe fibrosis [F3,F4]. PT, platelets and transminase values in serum were assessed for all patients. The total score of the 3 biological parameters combined, was significantly more enlabled in the severe fibrosis group than in the mild fibrosis group [P=0,01] but it was not of much importance in 30% of cases as it did not allow to classify the patients with certainty in group A or in group B. This score does not seem to grant exemption from needle liver biopsy, but it can be improved by the association of other direct markers of fibrosis