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

Role of pathology in nasopharyngeal cancer

Nasopharyngeal cancers account for 45% of all ear -nose and throat cancers at the National Institute of Oncology [cancer registry]. Carcinomas are by far the most frequent with the particularity of being tightly linked to the presence of Epstein-barr virus, sensitive to radiation therapy and lymphophilic revealed by cervical masses in 40% of the cases. A precise and reliable anatomo pathological diagnosis is therefore manasatory before intiating any treatment. Methods and The authors report the results of histopathologic techniques [routine and special stains immunohistochemistry] in the diagnosis of 143 biopsies of the rhinopharynx with a frequency of undifferentiated carcinoma of the nasopharynx [UCNT]. All biopsies of suspicion of relapse were inflammatory corresponding to mycotic inflammation in half of the cases. A special emphasis is made on the conclusive contribution of in situ hybridization on paraffin sections in positive and differential diagnosis with regard to the results described in the litterature. Therefore, in the particular context of nasopharynx cancer-frequent in our country, sensitive to radiation therapy but with possible relapses-, the authors emphasise on the specific utility, besides basic and special stainings and immunohistochemistry, of in stiu hybridization of paraffin sections, to search for the presence of Epstein-barr virus particles in tumoral cells. This technique should, indeed, be used as reliable routine technique allowing positive diagnosis of relapses and differential diagnosis in the cases of cervical masses without a known primary site and an extensive cancer of the rhinopharyngeal and sinonasal regions