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1.
Maroc Medical. 2013; 35 (4): 280-285
en Inglés | IMEMR | ID: emr-161697

RESUMEN

Endometrial stromal sarcoma is a rare uterine mesenchymal tumor, the retroperitoneal location is rare. We update on the imaging features and histology of the tumor, as well as the interest to consider this diagnosis for surgery suitable for sarcomas. [60 years old patient with a history of hysterectomy and pelvic bilateral oophorectomy 10 years ago, allowed for a large abdominal mass pelvic MRI showed abdominopelvic mass lateralized to the left of heterogeneous signal with a fluid portion hyperintense Tl, T2 and diffusion and a fleshy portion enhanced after gadolinium injection, the patient was operated with residual tumor R2. Histological examination showed that this is a retro location peritoneal sarcoma endometrial stromal uterine origin of low grade [operated there 10 years] strongly expressing the estrogen receptor and progesterone . The evolution was marked by a recurrence with ureterohydronephrose and pelvic sarcoma . Endometrial stromal sarcoma is a rare mesenchymal tumor, but that it must be mentioned before an abdominal mass in a postmenopausal patient. The location is unusual ectopic outside the context of endometriosis. A replay of histological slides is often necessary. Immunohistochemistry showed positive CD10 expression and the estrogen and progesterone receptors. MRI tumor has a heterogeneous signal on T2 hyperintense with beaches . Tl weighted, they are in isotactic or hypointense relative to the signal of the myometrium . Signs for a sarcomatous origin are: taking early contrast; intense than that of the myometrium, the heterogeneous signal with necrotic areas . The prognosis is compounded by frequent recurrences, the only prognostic factor is the quality of the first surgical resection, involving resection in one piece without breaking capsular end to avoid the spread sarcoma C The specialized immunohistochemical study remains essential for the diagnosis of endometrial stromal sarcoma, and a good analysis of the imagery with topographical precision to end direct the surgical gesture to minimize the risk of recurrence

2.
Maroc Medical. 2013; 35 (3): 186-190
en Inglés | IMEMR | ID: emr-161703

RESUMEN

The intracystic breast cancer is rare, it may present a misleading cystic appearance. Ultrasound shows an endocystic bud. Histology often found papillary carcinoma. Patient of 27 years followed for fibrocystic dystrophy. Breast ultrasound showed an heterogeneous cystic biloculee. The echographic control is increased the size of the cyst. Surgical excision shows that this is an intracystic papillary carcinoma in situ. MRI done at postoperative inflammatory banks, the recovery of post-operative banks reveals multiple microscopic foci of carcinoma in situ high grade. Mastectomy was performed. The intracystic ductal carcinoma is a rare malignant tumor of the ductal elderly woman. It is characterized by slow growth, with a good prognosis. Often discovered during a breast swelling recently enlarged. A mammogram shows a well-circumscribed oval mass, or sometimes indistinct in places. Breast ultrasound can reveal any complex cysts with a solid component, hyperechoic pendant to the inner wall of the cyst. Eliminates the doppler diagnostic reshaped heavy cyst content and confirms the tissue character by the presence of a central vascular pedicle. Ultrasound is the best test to distinguish between solid and liquid formations breast with mammographic appearance is close to intracystic carcinomas as medullary cancer and breast cysts. The best distinguishing criteria I seem to be: a large size of the intracystic vegetation, heterogeneous echogenicity and irregular edges of the intracystic mass. Some carcinoma in situ high grade can be mistaken for cystic lesions overhaul. The ultrasound meticulous analysis of the lesion i and its edges of its outline and its vascularization moving towards malignancy. Nevertheless, surgical resection is needed in doubt before any atypical cystic lesion

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