A febrile occlusion revealing a biliary ileus.

Biliary ileus is a consequence of the migration of a gallstone from the gallbladder to the digestive tract, most often via a biliodigestive fistula that causes a bowel obstruction. The clinic is atypical and capricious, including bowel obstruction and signs of cholecystitis, causing a delay in diagnosis. The therapeutic objective is to remove the intestinal obstacle by an enterotomy with stone extraction, with or without treatment of the biliary pathology (cholecystectomy and biliary fistula cure). The surgery remains the treatment of choice; laparoscopy and endoscopy present a less invasive alternative and are beginning to prove their effectiveness. The morbi-mortality remains high for biliary ileus, this is principally caused by the delay in diagnosis.

[Squamous cell carcinoma of the gallbladder complicating a cystic dilation of the cystic duct and common bile duct: a case report]. / Carcinome épidermoïde de la vésicule biliaire compliquant une dilatation kystique de la voie biliaire principale (VBP) et du canal cystique: à propos d´un cas.

Congenital cystic disease of the biliary tree is a known risk factor for gallbladder cancer. We here report a case of squamous cell carcinoma of the bile duct (BD) complicating a cystic dilatation of the bile ducts in a 54-year-old woman hospitalized for biliary pancreatitis. Abdominal scanner showed nodular thickening of the fundus of the gallbladder and fusiform dilation of the cystic duct and the main bile duct (VBP) with lesion of the tail of the pancreas, initially suggesting mucinous cystadenoma. Extended cholecystectomy involving the gallbladder fossa with resection of the distal biliary tract, choledocoduodenal anastomosis with caudal splenopancreatectomy + drainage were performed. Histopathological examination of the gallbladder mass revealed moderately differentiated invasive squamous cell carcinoma without infiltration of the hepatic parenchyma. The patient underwent adjuvant chemotherapy. The patient did not have the common symptoms of gallbladder cancer. Then radiology was necessary to make a diagnosis. Surgery is the best therapeutic option for early-stage gallbladder cancer, but adjuvant chemo-radiation may also be useful in treating these patients. Cholecystectomy with resection of cystic dilatation of the bile duct in high-risk patients are the most effective means of prevention.

The malignant degeneration of a phyllode tumour in man: A case report.

INTRODUCTION: Malignant phyllodes tumours of the breast represent less than 1% of all breast cancers. Few cases of phyllodes tumours have been reported in men. CASE PRESENTATION: We present the case of a 60-year-old man who was operated on one year ago for a breast tumour that had undergone a lumpectomy with an anatomopathological study in favour of a grade 2 phylloid tumour. He was admitted to hospital with a palpable mass in his right breast. The lumpectomy enlarged to the right pectoralis major muscle was then performed with clear surgical margins. Microscopic examination revealed high-grade malignant phyllodes. Postoperatively, after 3 months, the patient was given a breast MRI and a PET/CT scan which returned without abnormalities. The patient is followed for eight months and has shown no signs of recurrence. DISCUSSION: Malignant phyllodes tumours of the breast show clinical and mammographic signs comparable to those of benign lesions. The diagnosis is confirmed by histology, treatment is based on surgery, which may be a large lumpectomy or mastectomy, and the prognosis depends on several factors, the most important of which is the margin for surgical resection. CONCLUSION: The best treatment is a wide local excision with a safety margin of 1 cm, unless it is metastatic. Early diagnosis and surgery improves the prognosis.