Primary aneurysmal bone cyst of the patella: a case report.

An aneurysmal bone cyst is rare in the patella. We report the case of a 28-year-old woman who presented with chronic pain and no previous trauma history. Treatment included curettage of the cyst and filling with a corticocancellous graft. Thirty-one months after surgery, the knee was mobile and painless and graft incorporation was good.

[Placenta percreta: A rare etiology of spontaneous uterine perforation in the second trimester of pregnancy]. / Une étiologie particulière de perforation utérine spontanée au deuxième trimestre de grossesse : le placenta percreta.

Placenta accreta is an abnormal adherence of placenta to the uterine wall without interposition of decidua basalis. Placenta percreta is the rarest form but may complicate the pregnancy with acute severe hemorrhage. We report a case of placenta percreta with multiple perforations of an unscarred uterus reaveled by hemoperitoneum at 22 weeks in a 33-years-old gravida 2 para 1. Emergency total hysterectomy was performed. Risk factors, clinical approach and therapeutic managements are discussed.

[Thyroid localization of myxofibrosarcoma: first case in Africa]. / Myxofibrosarcome à localisation thyroïdienne: première observation en Afrique.

This case report describes a 45-year-old woman who was treated for a bulky ulcerated thyroid tumor with an offensive odor. The tumor had been ongoing for approximately 20 years. The patient had familial medical history of goiter. Histopathological diagnosis of the surgical specimen demonstrated myxofibrosarcoma associated with a classic thyroid tumor (vesicular adenoma). Based on this case, the author reviews the literature describing this rare soft-tissue tumor that is usually located on the extremities. Surgical treatment consists of radical tumor excision. A multidisciplinary therapeutic approach is necessary for efficient management by ensuring proper coordination of adjunctive treatment.

Epidemiologie et anatomo-pathologie des cancers colorectaux en Cote d'Ivoire

Consideres comme rares dans les pays en developpement; les cancers colorectaux sont de plus en plus frequents avec l'occidentalisation des habitudes alimentaires. Notre objectif a ete de decrire le profil epidemiologique et anatomopathologique de ces cancers dans deux CHU d'Abidjan en Cote d'Ivoire. Il s'agissait d'une etude retrospective realisee dans les laboratoires d'Anatomie pathologique de deux trois CHU d'Abidjan sur les cancers colorectaux histologiquement confirmes. La periode d'etude a ete de 24 ans (1984-2007). La frequence relative trouvee a ete de 3;34(394/11854) des cancers avec une predominance masculine (64). L'age moyen etait de 49 ans avec des extremes de 6 et 84 ans. Les polypes et les polyposes etaient les plus frequents des facteurs predisposants (41;66). L'ampoule rectale etait la zone la plus touchee (57; 82u). Les aspects vegetants; les adenocarcinomes et le stade pT2-T3 N1M0 ont constitues les aspects anatomopathologiques predominants. Ces cancers touchent ainsi des sujets jeunes avec pronostic souvent pejoratif

[Chronic abdominal pain and fever in an Ivoirian woman: Mycobacterium avium-intracellulare duodenitis in an AIDS patient in Abidjan, Cote d'Ivoire]. / Douleurs abdominales chroniques et fièvre chez une ivoirienne.

Duodenal infection by Mycobacterium avium-intracellulare is a common opportunistic disease in HIV-infected patients. Individuals with CD4 counts <50 cells/mm3 are at highest risk. The main symptoms are diarrhea, abdominal pain, weight loss, and fever. Endoscopic examination shows various abnormalities including disseminated nodules that may be yellowish, whitish, or pinkish in color. Other mucosal lesions may be found such as erosion, erythema, or friable edematous aspect. Since these findings are non-specific, it is important to obtain biopsy specimens for histological and microbiological examination. The most common histologic features are atrophic mucosa resembling Whipple's disease with strongly positive PAS staining. The presence of BARR in macrophages is typical of MAI. Diagnosis is based on identification of the bacteria using either conventional culture techniques or polymerase chain reaction (PCR). Differential diagnosis includes other gastrointestinal infections associated with AIDS, i.e., microsporidiosis, cryptosporidiosis, giardiosis, anguillulosis, CMV, and isoporosis. The course of the disease is usually unfavorable even with antibiotic treatment. The purpose of this report is to describe a case of duodenitis due to atypical mycobacterial infection in a 30-year-old woman who was seropositive for human immunodeficiency virus. She was hospitalized due to fever with deterioration of her general condition (more than 10% of body weight loss) and chronic abdominal pain with inflammation. Diagnosis of MAI was confirmed by biopsy and Ziehl-Neelsen coloration. The patient was treated with rifampicine, isoniazide, ethambutol, and pyrazinamide in association with stavudine, lamuvidine and efavirenz. Despite improvement of general condition, fever persisted and the patient died after 40 days of treatment.

[Three new cases of visceral leishmaniasis in Côte d'Ivoire]. / Trois nouveaux cas de leishmaniose viscérale autochtone en Côte d'Ivoire.

The objective of this work is to report three cases of visceral leishmaniasis in non-HIV infected native patients in Côte d'Ivoire. The three observations concerned adults aged of 31 and 65 and a five years old child without particular medical or surgery histories. Factors associated with visceral leishmaniasis regarding the younger and the older adults were respectively young age, chronic lymphoid leukaemia and Burkitt lymphoma. Clinical features in the three cases were chronic fever a myeloproliferative syndrome with wasting syndrome and pancytopenia. The diagnosis was confirmed by the existence of Leishmania in bone marrow, ganglionic juice and splenic samples. The species of Leishmania was not identified. Specific treatment was based on intravenous amphotericin B (Fungizone) relayed by Glucantim in one case because of side effects; however the treatment has been unsuccessful. These three new cases show that visceral leishmaniasis is a reality in Côte d'Ivoire therefore an epidemiological survey is requested in order to identify Leishmania species, reservoirs and vectors.