[Vaginoplasty from peritoneal tube of Douglas' poutch for androgen insensitivity syndrome (two case reports)]. / Vaginoplastie utilisant le péritoine du cul-de-sac de Douglas pour le traitement du syndrome d'instabilité aux androgènes (à propos deux observations).

The androgen insensitivity syndrome (AIS) formerly known as testicular feminization is transmitted on a recessive X-linked. Its diagnosis is usually made at puberty if primary amenorrhea is present because the external genitalia are female. We report the case of two sisters aged 30 and 18 years, with testicular feminization syndrome discovered during the exploration of primary amenorrhea. Clinical examination found fairly well developed mammary glands, an hypertrophied clitoris, two formations in the labia majora corresponding to the testicles and agenesia of vagina. The uterus has not been seen on pelvic ultrasound and computed tomography scan of the pelvis. Cytogenetic analysis has objectified the chromosomal formula: 46 XY. We performed a vaginoplasty using peritoneum from the pouch of Douglas, a clitoroplasty and bilateral orchiectomy. The result was excellent. A neovagina with a depth of 6 cm was created. After 6 months of follow-up, the two sisters keep beautiful vaginal cavities with regular digital dilation. Peritoneum vaginoplasty is a simple and easy method for creating a neovagina with minimal complications. Its anatomical and functional results are satisfactory.

[Hemoptysis revealing an endobronchial metastasis of testicular choriocarcinoma]. / Hémoptysie révélant une métastase endobronchique d'un choriocarcinome testiculaire.

The choriocarcinoma are neoplasms developed from testicular germ cells in men or fetal trophoblasts in women. The most common sites for metastatis are in the lung, but the endobronchial location is unusual. We report the case of a young patient of 27 years, hospitalized for hemoptysis of moderate volume, occurring in the context of deterioration in his general condition. The radiological assessment revealed an opacity of the right lung and bronchoscopy showed a highly vascularized middle lobe stenosis with biopsy confirming the diagnosis of choriocarcinoma. Urogenital examination found an enlarged left testicle and ultrasound confirmed a tumor-like expansive process with no liver or spleen involvement. HCG levels were high. The patient underwent a left orchiectomy via inguinal, pathological and immunohistochemical study confirmed the diagnosis of testicular choriocarcinoma. The patient received three cycles of chemotherapy based on the BEP with good tolerability. This has allowed chemotherapy, despite endobronchial metastasis, to achieve remission of good quality. The frequency of atypical choriocarcinoma metastases is very low, and treatment is mainly based on chemotherapy.