[Idiopathic granulomatous mastitis associated with erythema nodosum: a case report]. / Mastite granulomateuse idiopathique associant un érythème noueux: à propos d'un cas.

Idiopathic granulomatous mastitis (IMD) is a chronic benign inflammatory disease of the breast which can mimic breast cancer. It is more common in young women of childbearing age and poses a challenge in diagnosis of inflammatory breast tumor. We report the case of a 26-year-old female patient who presented with inflammatory breast. Clinical examination showed apyretic patient with edematized and painless irregular smooth mass in the left breast measuring 4 cm surmounted by crusts and multiples fistulizing scars discharging pus by applying pressure, with mobile ipsilateral axillary adenopathy. The remainder of the physical examination showed inflammatory erythematous patches on both legs. A mammogram plus breast ultrasound was performed followed by biopsy that objectified fibrous mastopathy. Lumpectomy was performed due to the persistence of symptoms. Anatomopathological examination objectified granulomatous mastitis. Etiological research didn't identify a clear cause. Corticotherapy associated with antibiotic therapy was started with complete regression of symptoms after two months.

Management of adnexal masses' torsion during pregnancy.

With the increased use and quality of ultrasound in pregnancy, adnexal masses are being encountered with greater frequency. Most of the time such masses are asymptomatic. It can be discovered in an emergency. Surgical intervention may cause risks to the mother and her fetus, while observation without intervention may also lead to unfavorable complications, such as ovarian torsion or the development of a tumor. Therefore, the management requires a balance between the maternal and fetal risks. We report two cases of torsion of adnexal masses during pregnancy, and we provide a brief literature review on the management and prognosis of this condition in pregnancy.

Decidualization of an ovarian endometrioma complicated by a sigmoid fistula during pregnancy: a case report.

BACKGROUND: During pregnancy, the discovery of adnexal masses remains frequent. Such masses are mostly benign. Ovarian endometrioma is a rare etiology. The diagnosis may be difficult in some situations, such as decidualization. It may be asymptomatic or result in complications for which magnetic resonance imaging is needed. CASE PRESENTATION: We describe an unusual case of decidualization of an ovarian endometrioma complicated by a sigmoid fistula during a 7-week, 1-day pregnancy in a Arabic patient aged 38 years who developed acute pelvic pain with fever. She had a medical history of unexplored secondary dysmenorrhea. The diagnosis was suspected on the basis of magnetic resonance imaging findings. The management was based on surgery, during which exploration revealed a mass at the expense of the left ovary being very adherent and fistulized to the sigmoid. We performed adnexectomy followed by digestive ostomy. The result of pathological study with immunohistochemistry led to a diagnosis of decidualization of an ovarian endometrioma altered by infection. CONCLUSION: Decidualization of an ovarian endometrioma can lead sometimes to unexpected complications. The decision to provide surgery must be made with caution without delaying treatment in the event of a deep suspicion of malignancy and/or complication. The particular and exceptional complication discovered in our patient is the fistulization to the sigmoid.

[Uterine rupture in patients with healthy uterus: misoprostol complication (case study and literature review)]. / Rupture utérine sur utérus sain: complication du misoprostol (à propos d'un cas et revue de la littérature).

Uterine rupture in patients with healthy uterus during the 2nd and 3rd trimester of pregnancy is a rare and severe obstetric complication involving maternal and fetal vital prognosis as well as obstetrical outcome of patients in the absence of diagnosis and early treatment. It mainly occurs in women who have had scarred uterus and it is anecdotal in those with healthy uterus. We report the case of a primiparous patient with unscarred uterus who had had uterine rupture during labour induction with misoprostol for fetal death in utero (FDIU) due to intrauterine growth retardation (IGR) and severe oligohydramnios at 31 weeks of amenorrhea (WA). This study and the literature review highlights the importance of administrating misoprostol for labour induction with extreme caution as well as the clinical features, the risk factors, the diagnostic method and the therapeutic treatment of this rare but potentially serious condition.

[Immature teratoma of the ovary: about a case]. / Tératome immature de l'ovaire: à propos d'un cas.

Ovarian teratomas are tumors resulting from pluripotent germ cells. We here describe 3 different types of teratomas: mature, immature and monodermal teratomas. Immature teratoma accounts for less than 1% of ovarian cancers and mainly affects young subjects. We report the case of a 25 year female patient, admitted with abdomino pelvic mass. She underwent ultrasound and a pelvic CT scan followed by conservative treatment based on left annexectomy associated with multiple biopsies. Anatomopathological examination showed immature ovarian teratoma. Patient's treatment was supplemented by a hysterectomy with lumbo-aortic curage and omentectomy. We highlight, through this study and review of the literature, the predisposing factors for this type of rare and severe tumor and the radiological features suggesting these rare histological types of ovarian tumors, in order to improve the prognosis and multidisciplinary management of patients.

Peritoneal tuberculosis in pregnancy: a case report.

Peritoneal tuberculosis in pregnancy is one of the least common forms of extrapulmonory tuberculosis in pregnancy. Early diagnosis is important to prevent obstetrical and neonatal morbidity. We report the case of a 37-year-old pregnant woman who presented with abdominal volume increase, night-sweat, anorexia, loss of weight and abdominal pain at 23 weeks. A peritoneal laparoscopic biopsy was performed and confirmed the diagnosis of tuberculous peritonitis. The patient received antituberculosis chemotherapy. The recovery was good as gave birth to a healthy infant of 3200Kg at 37th week's gestation by vaginal delivery.

Borderline paratubal cyst: a case report.

Borderline para-ovarian cysts (PCs) are rare entities. They are commonly present in the third decade. Borderline PCs are often discovered fortuitously on routine ultrasound examination or they are common incidental findings during a laparotomy. They must be differentiated from simple ovarian cysts, peritoneal inclusion cysts and hydrosalpinges on ultrasound sonography. Papillary projections on the cyst wall should be searched carefully to suggest diagnosis. The treatment is surgical including fertility -sparing operation or more radical surgery depending on the case. The prognosis is good because borderline PCs are usually early-stage at diagnosis. Here is a report of a 38- year old woman with a borderline paratubal cyst. Adnexal torsion of hydrosalpinx was suspected; thus, she underwent an urgent surgery. Cystectomy was performed without rupture. The final diagnosis revealed a borderline PC. The patient underwent a radical surgery. Currently, she has had no evidence of disease recurrence.