Management of a giant retroperitoneal leiomyoma: a case report.

BACKGROUND: Leiomyomas are benign tumors observed mainly in adult women. The retroperitoneum is a rare location for leiomyomas; almost 100 cases have been reported. Because retroperitoneal leiomyomas are paucisymptomatic and the tumor size at diagnosis is relatively large, surgical management is challenging. Regular follow-up is required because recurrence and malignant sarcomatous transformation have been described in a few cases. CASE PRESENTATION: We report a case of a 52-year-old North African woman with a 22-cm retroperitoneal leiomyoma. A preoperative embolization was performed 2 days before surgery. The clinical, therapeutic, and evolutive aspects of this rare entity are discussed. CONCLUSIONS: Despite its benignity, retroperitoneal leiomyoma is a challenging diagnostic, therapeutic, and evolutive condition. Surgeons must consider mainly the tumor's vascularization. Regular follow-up is mandatory because malignant transformation cannot be excluded.

Scrotal calcinosis: two case reports.

BACKGROUND: Scrotal calcinosis is a rare and benign condition. It usually gives rise to few symptoms, and the impact is mainly functional and aesthetic. It is considered part of dystrophic calcinosis cutis. Surgical management is the only curative approach, and recurrence has been described in few cases. CASE PRESENTATION: We report cases of two North African white patients with operated scrotal calcinosis. We describe the clinical and histological aspects as well as a pathogenic hypothesis and surgical management principles. CONCLUSIONS: A surgical approach to scrotal calcinosis must consider the aesthetic and functional aspects postoperatively. A complete excision prevents recurrence. Psychological support is required in association with surgery because the lesions are benign and concern an intimate part of the body.

Enquete connaissances - attitudes pratiques sur les accidents d'exposition au sang dans des structures de premiere ligne a Tunis

Les accidents d'exposition au sang (AES) constituent une menace reelle pour le personnel de sante . A notre connaissance; dans les deux circonscriptions sanitaires D'EL Ouardia et de Djebel jeloud ; peu d'actions en matiere de prevention des AES ont ete mises en ouvre. Nous y avons donc effectue une enquete connaissances ;attitudes ; pratiques (CAP) durant le mois d'avril 2007 dans le but d'evaluer la situation initiale; de mesurer le niveau global des connaissances et des pratiques du personnels expose et d'aider a la definition d'un programme de formation et d'amelioration .Un questionnaire a ete adresse a 49 personnes en utilisant la technique de l'intervieuw directe . Les resultats ont montre une bonne connaissance du risque de contamination par les trois virus VHB ; VHC et VIH . Le taux de vaccination contre l'hepatites B est de 59 . Le recapuchonna des aiguilles ; considere comme un geste a risque ; est une pratique retrouvee chez 58des repondants. la conduite a tenir en cas d'AES semble etre insffisamment connue par notre echantillons. Ces resultats nous ont permis de mettre en place une demarche qui permet de renforcer la sensibilisation et d'ameliorer la prise de conscience des professionnels de sante vis-avis des risqu d'AES..Le recapuchonnage des aiguilles; considere comme un geste a risque; est une pratique retrouvee chez 58des repondants. La conduite a tenir en cas d'AES semble etre insuffisament connue par notre echantillon. Ces resultats nous ont permis de mettre en place une demarche qui permet de renforcer la sensibilisation et d'ameliorer la pise de conscience des professionnels de sante vis-a-vis des risques d'AES

Surgery for testicular cancer: indication, results and technical aspects.

The standard therapeutique approach to patients with advanced germ cell tumors of the testis is a combination of systemic chemotherapy with surgical removal of the residual disease. The indication of surgery, residual tumor resection (RTR) or retroperitoneal lymph node dissection (RPLND), has changed during the last 10 years. Sugery is not longer recommended after chemotherapy of pure seminoma and surveillance of the residual tumor is the favored option. RPLND is a critical component of the treatment armentarium in low-stage nonseminomatous germ cell. RPLND is an accurate staging tool prviding important information to dtermine the need for chemotherapy. When performed properly, RPLND eliminates the retroperitoneum as a site for relapse, wich in turn provides emotional and psychological relief to the patient, and simplifies the follow-up protocol. In advanced nonseminomatous tumours, surgery after chemotherapy is recommended in most of the cases since large studies have shown that a considerable proportion of patients with complete radiological remission after chemotherapy harbor vital carcinoma or teratoma. Prediction models of necrosis after chemotherapy in order to avoid RTR are generally accepted since the accuracy of most models is too low. RTR is indicated in patients with elevated markers after two different chemotherapy regimens (including salvage chemotherapy) either to resect teratoma or cystic residual disease or to remove chemorefractory disease. Laparoscopic approache is a viable staging tool; however, oncologic control of the retroperitoneum has not been reliably determined.

[Bladder fibrosis caused by eosinophilic cystitis]. / Fibrose vésicale due à une cystite à éosinophiles.

A 70-years-old man with no history of allergy or genitourinary problems had bilateral hydronephrosis, a marked decrease in bladder capacity and severe eosinophilic infiltration with fibrosis of the bladder wall. A total cystoprostatectomy with ileal bladder replacement was performed. We reviewed the literature of eosinophilic cystitis for clinical presentation, diagnosis and therapeutic options.