Metachronous bilateral isolated adrenal metastasis from rectal adenocarcinoma: a case report.

We report a case of adrenal metastasis from colorectal cancer in a 54-year-old woman. Nine months after resection for advanced rectal carcinoma, a computed tomography scan revealed bilateral adrenal metastasis. The level of serum carcinoembryonic antigen was normal. A bilateral adrenalectomy was performed after chemotherapy. Histopathological examination showed adenocarcinoma, compatible with metastasis from the rectal cancer. Adrenal metastasis should be considered in the patients' follow-up for colorectal cancer.

[Spheno-orbital mesenchymal chondrosarcoma. A case report]. / Chondrosarcome mésenchymateux sphéno-orbitaire. A propos d'un cas.

Mesenchymal chondrosarcoma is a highly malignant and extremely rare tumor of the orbit: only 18 cases have been reported to date. We report a case of spheno-orbital mesenchymal chondrosarcoma in a 36-year-old woman presented with a 4-month history of progressive left exophthalmia and temporal mass. A CT-scan of the orbit and MRI showed a spheno-orbital mass, with temporal fossa extension, fed by the internal maxillary artery visible on cerebral angiography. Surgery via a transcranial, left frontotemporozygomatic approach after selective embolization enabled subtotal removal. Definitive histologic examination revealed mesenchymal chondrosarcoma. Postoperatively, exophthalmia spectacularly regressed. We report our clinical findings and present a review of the literature.

Cavernous hemangioma of the parietal bone. A case report.

Intraosseous cavernous hemangiomas are a rare finding in the calvarium. It is a benign tumors arising from the intrinsic vasculature of the bone. We report one case observed in a 31 year-old female, presented with a progressive left parietal mass. A plain X-ray of the skull and cranial CT-scan showed a osteolytic lesion in the left parietal bone. Surgery consisted of total resection of the lesion and cranioplasty. The postoperative course was uneventful. Histological study revealed a cavernous hemangioma of the diploe. In view of this observation and the literature review, clinical; radiological and therapeutic aspect of this rare entity are discussed.

[Chronic lumbar pain considered to be "nephretic colic" after 7 years, due to a thoracic disc herniation at T10-11]. / Syndrome douloureux étiqueté "colique néphrétique" pendant 7 ans, dû à une hernie discale thoracique T10-T11.

The authors report the case of a 35-years-women with a thoracic disc herniation, who presented with seven years history of episodic acute ureteric colic. An early diagnosis of a spinal disc herniation was made difficult by the absence of neurological findings. Imaging studies showed no lesion in the genito-urinary tract. Magnetic resonance imaging demonstrated a postero-lateral disc herniation at T10-T11 level. The pain disappeared immediately after surgery decompression. A literature search showed that acute ureteric colic associated with a lower thoracic disc herniation has not been previously reported.

Non-dysraphic intramedullary spinal cord lipoma. A case report.

Non-dysraphic spinal cord lipomas are rare benign lesions, accounting for approximately 1% of all spinal cord tumors. Patients usually present with long histories of disability followed by rapid progression of their symptoms. Presenting symptoms include spinal pain, dysesthesic sensory changes, gait difficulties, weakness, and incontinence. Magnetic resonance imaging is the examination of choice. The T1- and T2-weighted images show increased and decreased signal intensity, respectively. The goal of intervention is decompression and generous debulking following by duraplasty. Early diagnosis of spinal cord lipomas and early surgery is advanced prior to irreversible disease progression. One new case of true non-dysraphic cervicodorsal spinal cord lipoma is reported.

[Giant epidermoid cyst of the skull with extra and intracranial extension. A case report]. / Kyste épidermoïde géant de la voûte à développement extracrânien et intracrânien. A propos d'un cas.

Intradiploic epidermoid cyst of the skull is a rare clinical entity that can exceptionally grow to a large size with intracranial extension. The authors report the case of a 38-year-old man with a giant epidermoid cyst of the parietal bone with extra and intracranial extension, presenting with focal neurological symptoms. The diagnosis was suggested at imaging (skull radiographs, CT and MRI), and confirmed at histology. Complete removal of the cyst and its capsule was performed followed by cranioplasty. Postoperatively, the patient was discharged free of symptoms. CT scan provides good evaluation of the bony lesion and may suggest intracranial extension. MRI is superior for evaluation of cerebral compression. The pathogenesis, clinical presentation, diagnostic evaluation and therapeutic management of these rare lesions are reviewed.

[Malignant stromal tumors of the small intestine: report of 9 cases]. / Les tumeurs stromales malignes du grêle: à propos de 9 cas.

PURPOSE: Analysis of imaging features of malignant stromal tumors of the small bowel and review of literature. MATERIAL AND METHODS: 9 cases of malignant stromal tumor of the small bowel with histological proof were imaged at US (8 cases), small bowel series (9 cases) and CT scan (3 cases). RESULTS: There were 6 cases of leiomyosarcoma and 3 cases of malignant schwannoma. Tumors involved the jejunum in 3 patients, the ileum in 4 patients, and the duodenum in 2 patients. The main clinical presentation was an abdominal mass (8 cases), which appeared heterogeneous and hypoechoic with eccentric lumen at US confirming its GI origin (7 cases). Small bowel series showed a bulky cavitary mass opacified via a thin fistula (7 cases), an ileo-ileal intussusception (1 case) and enlarged duodenal lumen (1 case). CT performed in 3 cases showed an intraperitoneal mass with soft-tissue density. A communication with the GI tract was noted in 1 case, and in another case, it showed an intestinal intussusception. US guided biopsy performed in 3 cases provided diagnosis in 2 cases (malignant schwannoma, leiomyosarcoma). Tumor growth was exophytic in 8 cases and dumbbell-shaped in 1 case. CONCLUSION: The imaging features of malignant stromal tumors of the small bowel are similar. It varies with the type of tumor growth and its size. The diagnosis may be suggested based on imaging features.

[Linitis plastica of the digestive tract. A case with involvement of the stomach and rectum]. / La linite plastique digestive. A propos d'un cas de localisation gastrique et rectale.

The digestive linitis plastica is a special form of the little differentiate adenocarcinoma that can reach all the segments of the digestive tube, if the gastric localization is the most frequent, the double gastric and rectal localization is rare (7%) either is simultaneous or successive. The pathologic examination arrives only at the diagnostic of the digestive linitis without biasing against its primitive and secondary character. We report a case of this association in order to focus the importance of search and difficulty of the histologic diagnosis. Mis H.N., aged of 69 years old was hospitalized because she was reached of subocclusive syndrome, the rectal touch, found a circumferential marrowing with indurated basis at 7 cm of the anal margin, the gastroduodenal transit and the high digestive fibroscopy were evokating of a total plastic linitis. The gastric biopsy confirmed the diagnosis by the presence of cells ou kitten ring. The patients died during the hospitalization, the pathologic study of the postmortem rectal swab showed the existence of a rectal linitis. The discovery of a gastric linitis makes necessary a systematic, endoscopic and radiologic complete physical examination in order to discover other digestive localizations, this darkens singularly the prognosis and complicates the therapeutic attitude.

[Crohn's disease of the esophagus. Apropos of a case]. / Maladie de Crohn de l'oesophage. A propos d'une observation.

The authors report a case of Crohn's disease of the esophagus, stomach, small intestine, colon and rectum in a 34-year-old patient. The esophagus was affected three months after diagnosis of the ileo-rectal lesion. They discuss clinical and therapeutic aspects of the condition. They stress the value of upper endoscopy with multiple biopsies in providing the diagnosis. Treatment is essentially medical, surgery being restricted to fistulas after failure of medical treatment and parenteral nutrition, and to severe stenoses after failure of endoscopic dilatation.

[Syndrome of the ovarian vein. Apropos of 3 cases]. / Le syndrome de la veine ovarienne. A propos de 3 cas.

About three cases of ovarian vein syndrome and a review of the literature, on overall study of this rare entity is done addressing its different pathogenie, clinical, radiological and therapeutic aspects. The authors stress the importance of ureteroscopy with biopsy in order to confirm the diagnosis of the ovarian vein syndrome.

[Compressive goiters. Apropos of 80 cases]. / Les goitres compressifs. A propos de 80 cas.

Our retrospective study is based on 80 compressive goitres collected over a period of 7 years in the general surgical department of the Ibnou Rochd University Teaching Hospital, Casablanca. Dyspnea was the predominant clinical manifestation and was encountered in 82.5% of cases, followed by dysphonia (65%), dysphagia (46%) and finally venous compression (8.7%). Hyperthyroidism was encountered in 26.25% of cases, 57% of these being due to Grave's disease. The goitre extended mediastinally in 38% of cases but resection was possible on cervicotomy alone. Post-operative sequelae were minor in nature, though one death did occur. On histological examination 85% of these goitres were benign and only 15% were of a malignant nature. This is in agreement with the data in the literature which confirms that compression is not synonymous with malignancy.