Seborrheic Keratosis: Report of a Rare Presentation and Reminder of the Current Knowledge of the Problem.

A 75-year-old man presented with an abdominal enlarging painless tumor of the skin evolving over the last 30 years. His past medical history was unremarkable. Physical examination revealed a brownish pedunculated cutaneous mass which had an irregular keratotic warty surface with no discharge or ulceration. The mass was clinically presumed to be a melanocytic tumor, or a verrucous carcinoma. A monoblock excision of the mass was performed with a good outcome. The specimen was then sent to our pathology department to rule out malignancy. Macroscopic examination revealed a brownish tumor of 7.5 × 7 × 1.5 cm which had fissures and cauliflower-like appearance. Final histological report concluded to a giant seborrheic keratosis.

Effects of rare earth element samarium doped zinc oxide nanoparticles on Mytilus galloprovincialis (Lamarck, 1819): Filtration rates and histopathology.

BACKGROUND: Doping was reported to improve the photo catalytic performance, antioxidant, antibacterial and other biological properties of nanoparticles. While, improving the nanoparticle properties, doping could change toxicity profile to living organism. Hence, the aim of this work was to assess the effects of samarium doped zinc oxide nanoparticles (Sm doped ZnO NPs) on the edible mussel Mytilus galloprovincialis. METHODS: Sm doped ZnO nanoparticles were characterized using X-ray diffraction (XRD), transmission electron microscopy (TEM) and Fourier transform infrared spectroscopy (FTIR) techniques. 156 mussels were exposed during 7 days to a low, intermediate and high concentration of Sm doped ZnO NPs (0.5, 1 and 1.5 mg/L, respectively). The filtration rates were assessed after 1 and 2 h. Histopathological alterations were determined in gills, digestive glands and gonads using a quantitative analysis. RESULTS: The filtration rates decreased in all individuals exposed to Sm doped ZnO NPs, a significant decrease was noted with the low and intermediate concentration (0.5 and 1 mg/L) of Sm doped ZnO NPs after 1 and 2 h, respectively. The histopathological index (Ih) estimated for gills, digestive glands and gonads showed differences depending on the organ and the nanoparticle concentration. The highest Ih were reported for digestive glands and female gonads exposed to the intermediate concentration (1 mg/L) of Sm doped ZnO NPs. As for gills and male gonads, the highest Ih were noted with the high concentration (1.5 mg/L) of Sm doped ZnO NPs. CONCLUSION: Results from this study revealed the toxicity of Sm doped ZnO NPs in Mytilus galloprovincialis gills, digestive glands and gonads. The toxicity induced by this nanoparticle varies depending on the organ and the concentration.

An unusually aggressive multiple non-ossifying fibroma of the distal tibia and fibula: A case report.

Background and purpose: Non-ossifying fibroma (NOF) is one of the most commonly seen benign bone tumours. Although renowned for their benign behaviour and tendency for spontaneous healing, these tumours can occasionally exhibit an aggressive course. Few published papers have focused on the treatment options of symptomatic NOFs.The aim of this case report is to discuss the clinical presentation of a painful and unusually aggressive multiple NOF of the distal tibia in a female adolescent patient. Case presentation: The case of a 17-year-old female patient who was complaining of a painful swollen right lower leg for the past few months. The symptoms became gradually worse, preventing her from sporting activities and becoming more and more debilitating. The patient was diagnosed with a particularly aggressive multiple non-ossifying fibroma of the distal tibia and fibula. She was treated with lesion curettage, bone grafting and external fixation with good clinical and radiological outcomes. Conclusion: Non-ossifying fibroma is a benign lesion that only requires observation in most of the cases. However, symptomatic lesions with aggressive behaviour or complicated with pathologic fracture may warrant surgical intervention.

Cholesterol Granuloma of the Breast Mimicking Cancer: A Case Report and Review of the Literature.

Cholesterol granuloma of the breast is an infrequent benign lesion with clinical and radiological findings suggestive of cancer. Herein, we present the case of a 52-year-old woman with no significant past medical history, who presented to the outpatient department for her routine breast screening. Physical examination revealed a painless palpable nodule in the upper external quadrant of the left breast, measuring 0.7 cm. On imaging, the mass met the criteria for Breast Imaging Reporting and Data System (BI-RADS) category 4B. Subsequently, a core needle biopsy of the mass was performed. Despite the alarming radiologic features, microscopic findings were consistent with breast cholesterol granuloma.

Synchronous primary gastric and renal tumors: a case report.

Synchronous multiple primary cancers of the stomach and kidney are very rare, only 45 cases of synchronous multiple primary cancers of the stomach and kidney had been reported in the literature up until 2020. Thus far, no particular risk factors have been identified. We present a case of synchronous multiple primary cancers of the stomach and kidney in a 67-year-old female presenting with a 3-month history of vomiting and abdominal pain. The diagnosis of gastric adenocarcinoma with signet ring cells was confirmed through upper endoscopy with biopsies, while CT-guided biopsies of the renal tumor confirmed the diagnosis of primary kidney neoplasm.

Having more than one cancer at the same time is known as multiple primary malignancies. Having cancers in both the stomach and kidney at the same time is even rarer, with only 45 cases reported in literature. The exact causes of such cancers occurring together are not yet known. We present a 67-year-old woman who was diagnosed with synchronous multiple primary cancers of the stomach and kidney. She presented with vomiting and abdominal pain. The diagnosis of gastric cancer was confirmed through upper endoscopy with biopsies, while biopsies of the renal tumor confirmed the diagnosis of primary kidney cancer.

Gastrointestinal bleeding due to jejunal metastasis of pleomorphic lung carcinoma: a case report.

Gastrointestinal metastasis of pleomorphic lung cancer presents with nonspecific manifestations, leading to delayed diagnosis. Herein, the authors report the case of a 56-year-old patient who presented with gastrointestinal bleeding due to pleomorphic lung carcinoma. Case presentation: A 56-year-old patient presented to the emergency department with melena. On examination, he was hemodynamically stable. He had a sensitive and mobile mass in the periumbilical region. A thoracoabdominal computed tomography scan showed a mass of the right apical superior lobe measuring 4 cm and a lobulated jejunal mass measuring 10 cm. A percutaneous biopsy of the lung tumor revealed primary pleomorphic lung carcinoma. The authors performed a midline laparotomy and made a bowel resection with an end-to-end anastomosis. The postoperative course was marked by severe nosocomial pneumonia, leading to septic shock and death. The histopathologic examination concluded with a metastatic lesion of pleomorphic lung carcinoma. Clinical discussion: The authors reported a rare case of jejunal metastasis of pleomorphic lung cancer. Pleomorphic carcinoma of the lung is a rare pathology that accounts for 0.1-0.4% of nonsmall-cell lung cancer. The prognosis is poor. In the presence of gastrointestinal bleeding caused by small bowel metastases of pleomorphic lung cancer, surgery is the treatment of choice. Conclusions: Small bowel metastasis of pleomorphic lung cancer is rare. Surgical treatment is the treatment of choice. The authors highlight the importance of suspecting gastrointestinal metastases in patients with pleomorphic lung cancer in the presence of nonspecific digestive symptoms.

Multiple hydatid cyst disease revealed by an expansive intracranial process: A case report.

Hydatid disease is a real public health problem in developing countries. Cerebral localization is rare; it does not exceed 2%. It is more frequent in children and adolescents. It is often primary in children. In adults, it is less frequent and generally associated with other localizations. We report the case of a 60-year-old Tunisian patient with pulmonary, hepatic and cerebral hydatid cyst, revealed by neurological symptoms with an expansive intracranial process on brain imaging.

Cribriform-morular thyroid carcinoma: A case report with review of the literature.

Cribriform-morular thyroid carcinoma (CM-TC) is a rare entity that usually occurs in association with familial adenomatous polyposis (FAP) but may be sporadic. Herein, we present a new case of cribriform-morular thyroid carcinoma occurring in a 28-year-old woman with no history of FAP.

The potential adverse effects of acrylamide on the oxidative stress response, fatty acids profile, and histopathological aspect of the Mediterranean Holothuria forskali respiratory tree.

Acrylamide (ACR), organic compound, has been widely used owing to its broad spectrum of chemical and industrial applications. This study aims at evaluating the response of the antioxidant defense system, fatty acid composition and histopathological aspect in the respiratory trees of Holothuria forskali against ACR exposure under laboratory conditions. Holothuries were exposed to 5, 10, and 20 mg L-1 ACR concentrations for 5 days. A significant increase in n-6 polyunsaturated fatty acids levels especially the arachidonic acid (ARA, C20:4n-6) and its precursor linoleic acid (LA, C18:2n-6) in ACR-treated organisms. Regarding the n-3 levels, eicosapentaenoic acid (EPA, C20:5n-3) levels were increased in treated groups despite an acute decrease in docosahexaenoic acid (DHA, C22:6n-3) levels was observed. Our results showed a significant increase in hydrogen peroxide, malondialdehyde, protein carbonyl, and metallothionein levels along with an alteration of the antioxidants status in all treated sea cucumbers. The exposure to ACR prompted the inhibition of Acetylcholinesterase activity in a concentration-dependent manner. The histopathological aspect was marked especially with the infiltration of coelomic cells which confirms our biochemical findings. Our study provided novel insights to create a link between redox status and fatty acid composition disruptions to better understand ACR-triggered toxicity.

Recurrence with lymph node and brain metastasis of an oncocytic carcinoma of the submandibular gland: A case report.

Oncocytic carcinomas of the salivary glands are rare. The submandibular gland is a rare location. It is usually associated with a poor prognosis and recurrence after treatment. We report a case of a 52-year-old man with a lymph node and brain metastasis recurrence of an oncocytic carcinoma of the submandibular gland.

A case of gastric metastasis originating from right-sided colon cancer 4 years after colectomy.

The stomach is rarely a metastatic site of other primary cancers. Gastric metastasis from colonic cancer is exceptional. We hereby report a case of a 54-year-old male patient who underwent a right hemicolectomy for right-sided colon cancer. The pathology exam revealed well differentiated adenocarcinoma, it was classified stage IIb. Regular controls performed including colonoscopy were normal. Four years after colectomy, the patient was admitted for hematemesis with epigastric pain with detoriation of general condition . Gastroscopy revealed a large ulceroproliferative mass in the antropyloric region. Histology showed that this tumor was an adenocarcinoma similar to the primary right colon cancer, which led to the diagnosis of metastatic gastric cancer originating from colon cancer.

Fatal invasive gastric mucormycosis: Two case reports.

Mucormycosis is a fungal infection affecting most commonly immunocompromised patients. Hereby, we report two cases: the first one is about a 61-year-old female with diabetes who presented with vomiting. The upper gastrointestinal endoscopy showed a budding grayish process which corresponded to an invasive mucormycosis in histology. As laboratory tests showed renal dysfunction, conventional amphotericin B was started at low doses since liposomal form was unavailable in Tunisia. Evolution was marked by a worsening of renal function leading to drug therapy withdrawal. Total gastrectomy was delayed because of a pulmonary embolism and was practiced 2 months later. The patient passed away 10 days after surgery. The second patient was a 59-year-old man who presented with vomiting and fast worsening of general state. At admission, he had a septic shock. Explorations revealed an invasive gastric mucormycosis. He died few days after admission. Thus, prompt diagnosis of mucormycosis and rapid initiation of treatment based on amphotericin B and surgical debridement is necessary to improve prognosis.

Impacts of engineered iron nanoparticles on oxidative stress, fatty acid composition, and histo-architecture of the smooth scallop Flexopecten glaber.

Engineered iron nanoparticles are widely used in environmental remediation, yet their potential toxic effects on marine biota remain poorly elucidated. This study aimed to gain insight into the nanoscale zero-valent iron (NZVI) toxicity mechanisms for marine invertebrates. Aside from the effect on oxidative status and histopathology, the effect of NZVI on lipid metabolism in bivalves was studied for the first time. To this end, specimens of Flexopecten glaber were exposed to ascending concentrations (0.5, 1, and 1.5 mg/L) of NZVI for 96 h. Results illustrate differential patterns of iron accumulation in the gills and the digestive gland. By increasing NZVI concentrations, the total iron level tended to markedly increase in the gills and decrease in the digestive gland, reaching 132 and 37.6 µg/g DW, respectively, in the specimens exposed to 1.5 mg/L. Biochemical and cellular biomarkers highlighted that NZVI caused oxidative stress (measured as hydrogen peroxide, malondialdehyde, and advanced oxidation protein product levels) and alterations of antioxidant defense systems, including reduced glutathione, non-protein thiol, glutathione peroxidase, superoxide dismutase, and catalase. Modulation of lipid metabolism with changed fatty acid compositions (mainly an increase in the saturation and a decrease in unsaturation levels) was also observed in both gills and digestive gland. Moreover, several histological damages, including lipofuscin accumulation, infiltrative inflammations, and digestive tubule alterations, were observed in the two studied organs, providing supplementary evidence regarding the toxic effect of NZVI. This study adds to the growing body of evidence pointing to the hazardous impacts of iron NPs on aquatic ecosystems.

Primary splenic lymphoma discovered on massive splenomegaly: A case report.

INTRODUCTION AND IMPORTANCE: Malignant lymphoma occurs in all the systemic organs. Rarely, large B-cell lymphoma is located in the spleen, making the diagnosis difficult. Herein, we report a patient presenting with massive splenomegaly due to LBCL. Splenectomy was essential to assess the diagnosis and to guide postoperative therapeutics. PRESENTATION OF A CASE: A 47-year-old woman, with no comorbidities, complained of weight loss and abdominal pain. She had a palpable spleen that extended below the navel. CT scan revealed massive splenomegaly and lymph nodes in the spleen hilum. Splenectomy was performed. Histopathological examination confirmed the diagnosis of large B-cell lymphoma. The postoperative course was uneventful. Three courses of chemotherapy were given. The patient was in remission after a follow-up of 8 months. DISCUSSION: Massive splenomegaly can be one of the circumstances of the discovery of large B-cell lymphoma. Splenectomy was then essential to confirm the diagnosis and to guide postoperative therapeutics. It also permits reducing hypersplenism and preventing spleen rupture. In patients with high operative risk, splenic needle biopsy should be taken into consideration. Splenic artery embolization before surgery can also be performed in patients having massive splenomegaly to reduce the spleen volume. We highlight the importance of splenectomy to confirm the diagnosis and to relieve the symptoms. Postoperative chemotherapy is essential to prevent relapses. CONCLUSION: Splenectomy is essential in spleen localized large B-cell lymphoma. It permits to confirm the diagnosis, relieve symptoms, and treatment of underlying hematologic malignancies. Postoperative chemotherapy is essential to prevent relapses.

Glyphosate exposure modulates lipid composition, histo-architecture and oxidative stress status and induces neurotoxicity in the smooth scallop Flexopecten glaber.

Glyphosate is the most sprayed pesticide across the globe. Its toxicity to non-target marine organisms has recently piqued the scientific community's interest. Therefore, the purpose of this study is to investigate the potentially toxic effects of glyphosate on scallops, an ecologically and economically important bivalve group. To do that, specimens of the smooth scallop Flexopecten glaber were exposed to different concentrations (10, 100, and 1000 µg L-1) of the technical-grade glyphosate acid (GLY) for 96 h. The detrimental effects of this pollutant were assayed at cellular and tissular levels. The obtained results showed that the GLY was able to induce oxidative stress in the gills and the digestive gland of F. glaber as revealed by the enhanced hydrogen peroxide (H2O2), protein carbonyls (PCO), malondialdehyde (MDA), and lipid peroxides (LOOH) levels and the altered antioxidant defense system (the glutathione GSH content and the superoxide dismutase (SOD) activity). Additionally, GLY was found to alter the fatty acid profile, to exert a neurotoxic effect through the inhibition of the acetylcholinesterase (AChE) activity, and to provoke several histopathological damages in the two organs studied. The obtained results revealed that the pure form of GLY may exert toxic effects on F. glaber even at relatively low concentrations.

Collision tumor of the appendix incidentally discovered in a patient diagnosed with an adenocarcinoma of the colon: a case report.

Collision tumor of the appendix is an extremely rare entity, defined as the coexistence of two independent tumors located in the same site without transitional changes. We describe in this report the case of a 75-year-old man who presented with an acute abdominal pain, nausea and vomiting. Physical examination revealed an abdominal distension with a hypogastric mass. Abdominal computed tomography showed colonic obstruction related to a sigmoid tumor. Therefore, a total colectomy was made. Macroscopic specimen examination showed a sigmoid tumor associated to a cystic dilatation of the appendix tip with mucoid content. Histological examination of the appendix showed the co-existence of two independent tumors located in the tip, without transitional changes: pTis low-grade appendiceal mucinous neoplasia and grade 1 neuroendocrine tumor. The latter was discovered incidentally during histological examination. We draw attention through our presentation to the importance of a thorough macroscopic and histological examination of the appendix.

Exposure of Mactra corallina to acute doses of lead: effects on redox status, fatty acid composition and histomorphological aspect.

The aim of this study is to elucidate the toxicity induced by PbCl2, administered in graded doses (1; 2.5; 5 mg/L), in the redox state, in the fatty acid composition and in the histological structure of Mactra corallina digestive glands. Our findings showed a progressive accumulation of Pb in the M. corallina digestive glands in all treated groups. After 5 days of treatment with PbCl2, an increase in H2O2, MDA, PCO, GSH, NPSH and MT levels was observed in the digestive glands of treated groups. Moreover, activities of antioxidant enzymes, such as GPx and CAT, increased while SOD activity decreased in all treated groups, indicating a failure of the antioxidant defense system. Furthermore, the cholinergic function was evaluated by assessing the acetylcholinesterase activity, which was inhibited in all the treated digestive glands compared to the control group. In our experiment, the levels of n-3 (Omega-3) and n-6 (Omega-6) polyunsaturated fatty acids were greatly altered in the groups treated with 5 mg/L of PbCl2 (p < 0.001). Indeed, DHA and EPA decreased significantly in the digestive glands treated with 2.5 and 5 mg/L of PbCl2, respectively. On the other hand, under exposure to the medium and high doses (2.5 and 5 mg/L), arachidonic acid (ARA) and linoleic acid (LA) significantly increased (p < 0.001). These changes in PUFA were confirmed by significant modifications in the polyene and peroxidation indices. The histological findings confirmed the biochemical results.HighlightsIntegrated parameters were used to explore the toxic effect of PbCl2 graded doses in Mactra corallina digestive gland.Metals accumulation in digestive glands of M. corallina was greatly dependent to dose of PbCl2.Metabolic and macromolecules damaging of clams digestive glands were more sensitive at higher PbCl2 doses.Fatty acids composition especially polyunsaturated fatty acids (PUFA) and essentials fatty acids such as docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) in clams digestive glands were intensively altered at higher PbCl2 doses.Inflammation responses revealed in studied tissue.

Bile duct infestation with Enterobius vermicularis diagnosed after cholecystectomy: About two case reports.

Intestinal infestation with Enterobius vermicularis is common, especially in the developing countries. However, its migration in the bile ducts is rare, often diagnosed after cholecystectomy. More investigations are needed to define its involvement in symptoms presented by patients and the likelihood of complications.

Traumatic neuroma of the bile duct: A case report.

We report the case of a bile duct traumatic neuroma in a 76-year-old man who presented with obstructive jaundice one year after cholecystectomy. Despite the radiological examinations, the preoperative diagnosis was difficult. The patient underwent a biliary resection with choledoco-duodenal anastomosis.

Assessment of the impacts of glyphosate and its commercial formulation Roundup® on the respiratory tree of the sea cucumber Holothuria forskali using a multivariate biomarker approach.

In this study, the potential hazardous impacts of the technical grade glyphosate acid (GLY) and its commercial formulation roundup (RD®) were evaluated for the first time on holothurians. To do this, redox status, fatty acid (FA) profile, and histopathology aspects were assessed in the respiratory tree tissue of the sea cucumber Holothuria forskali following short-term exposure (96 h) to a series of concentrations (10, 100 and 1000 µg L-1) of GLY and RD® (glyphosate acid equivalent). Our results showed that both GLY and RD® promoted oxidative stress highlighted with an increase of hydrogen peroxide (H2O2), malondialdehyde (MDA), lipid peroxides (LOOH) and advanced oxidation protein product (AOPP) levels in all treated groups. In addition, both glyphosate forms were found to perturb the FA composition. However, changes in saturated (SFA) and polyunsaturated (PUFA) including some essential FA (LA, ARA, EPA and DHA) revealed differential compensatory/adaptive processes in H. forskali depending on the treatment. GLY and RD® were also found to modulate the enzymatic (glutathione S-transferases, glutathione peroxidase and catalase) and non-enzymatic (reduced glutathione and ascorbic acid) antioxidant defense status. Taken together, our results revealed that the commercial formulation produced more pronounced effects on H. forskali respiratory tree than the pure form. This finding was further confirmed by the histological observations.