Demons-meigs syndrome

Demons Meigs is a rare, anatomo-clinical syndrome associated, with a benign ovarian tumor, ascitis and hydrothorax. The interest assigned to this triad reside in its similarity to the malignant ovarian tumor in its advanced stage and in its perfect and definitive surgical curability. The authors report here a case of 65 years old female patient, who were consulted for hypogastric pains and signs of vesical compression. Clinical examination showed a well defined hypogastic mass, rounded in shape measured 15cm diameter in a moderately abundant ascitis. The abdomino-pelvic echographic examination, showed a left heterogenic ovarian mass associated with intra peritoneal effusion. Chest X-Ray showed right hydrothorax. As the general condition was conserved, diagnosis of Demons-Meigs syndrome was evoked. This diagnostic was confirmed in the preaperative period by the presence of an ovarian mass without macroscopic malignants signs of malignancy, also histological examination showed benign fibroma. A simple excision was sufficient to have a definite recovery without recurrence six years after the operation. The association of pleural effusion and an ovarian tumour is not synonymous of metastasic invasion. Demon Meigs syndrome must be evoked because the surgical excision of the ovarian tumour permits the definitive recovery without complementary treatment

[Breast carcinoma associated to cancer of the vulva]

The synchronous association of breast infiltrating ductal carcinoma and moderately-differentiated squamous cell carcinoma of the vulva is extremely rare. The interest assigned to this association is not only resides in its rarity, but also in the therapeutic problems that it can raise. A 50 year woman, presented with a lesion of the left labia major of the vulva, its diameter measured 2cm, The tumour was mobile, painful, and bleeds at the least contact. The biopsy concluded to a moderately-differentiated squamous cell-carcinoma. Systematic genital examination revealed the presence of a nodule the right upper quadrant of breast. It was hard, painless and without axillary's nodes. The surgical intervention consisted at a radical mastectomy, with axillary's lymphonodectomy; in followed by a radical vulvectomy and bilateral inguinal lymphatic nodes dissection. The pathological examination concluded to a breast infiltrating ductal carcinoma II rank of SBR, confirmed the histological type of the vulvar tumour, and showed an inguinal involvement node. A postoperative radiotherapy and chemotherapy has been done. The patient was well with a postoperative follow up period of 18 months. The coexistence of a breast infiltrating ductal carcinoma and squamous cell carcinoma of the vulva is an extremely rare occurrence. Two cases have been previously reported in the literature. A congenital origin is possible; adenocarcinoma can be developed from ectopic, mammary gland tissue in the vulva. The acquired origin is also possible; the vulvar localization can be secondary to a metastatic breast cancer. Nevertheless, these two etiological approaches suppose that in the two localizations, the cancers are of the same histological type. The association of distinct types is uncommon. The double localization poses a problem of operative time chronology, and of the necessity of adjustment of doses of radiotherapy or chemotherapy. It must be discussed case by case; indeed the reduced number published case doesn't permit to establish a standard protocol. The logical therapeutic attitude seems to be, the surgical excision in the same time; every localization being considered as isolated. Otherwise all complementary pen-operative treatment [radiotherapy, chemotherapy] should include an adjustment of doses

Pseudo-tumeur retroperitoneale d'origine appendiculaire [a propos d'un cas]

The authors reported the observation of retroperitoneal tumor like of the appendix at a 48 years old patient. They explained the diagnosis difficulty and how to avoid it

Hypoglycemie severe et sarcomes retropetitoneaux [a propos d'un cas]

The authors report here the case of a 65 year-old-woman who undergone surgery for retroperitoneal fibrosarcoma and who 3 years later presented behaviour and consciousness paroxystic disorders related to recurrence. The tumoral resection led to the disappearance of hypoglycemic crisis

Les schwannomes retrope'ritone'aux [a propos de 2 cas]

Based on two cases of retroperitoneal schwannomas, the one being benign and followed- up during 13 years, the other malignant, the authors discuss here some clinical, paraclinical and therapeutic features of these conditions. The retroperitoneal localization of schwannomas is uncommon. They usually occur between 30 and 50 years without sex prevalence. The clinical symptomatology is marked by signs of urinary and digestive compressions. The morphological examinations can reveal the tumour. They also specify its seat, its nature and its relationship. The schwannomas is malignant in the third of cases. Its treatment is mainly surgical. The prognosis depends on the histologic nature and extent of the tumoral resection. The following-up must be continuous in time since the belated recurrences are possible

[Retroperitoneal liposarcoma [R.P.L.S]: about 6 cases]

6 cases of R.P.L.S traited in the service of surgery B at Ibn Sina hospital, were reviewed, It was a big tumors [more than 6 Kg]. The C.T scan can gives the diagnosis of both localization and histology of tumor respectively in 90% and 40%. Cytoponction guided by echography can make diagnosis but there are move false negative. Histological examination is difficult there was more stage I in our study. The treatment of R.P.L.S is based on tumoral excision, which is often possible in spite of the great volume of tumor. One or more recurences were noted in 3 cases often in high grade of malignancy with lymphatic noeds and invasion of other organs. the use of radiotherapy can't ovoid this recurences. The survival rate was: -1 patient died at 4th year -2 were not seen after 3th an 5th years - 3 others were alive at 6 months, 1 year and 22 months

Les goitres plongeants A propos de 230 observations

We report a retrospective study of 23 intrathoracic goiters cases. It is question of 17 mediastinocervical cases and 6 cervico-mediastinal cases. No case of pure endothoracic goiter has been found to be present. There is a clear female prevalence [77% of cases]. In more than the half cases, the patients have a goiter history for more than 10 years. As for the compression signs, the tracheal compression is prevalent since that it was seen in 2/3 of cases. All patients underwent a successful cervictomy, carried out alone. No malignant intrathoracic goiter was seen in our series. The post - operative sequelae are most often simple in patients managed at time and the best conditions