Peritonitis on sigmoidal perforation in a cocaine user: A rare case report.

INTRODUCTION AND IMPORTANCE: Cocaine, the second most abused drug in Morocco after cannabis, has been associated with multiple cardiac, pulmonary, neurological, and digestive complications. Colonic perforation following cocaine abuse is relatively lesser-known and requires attention as abuse rates are increasing, and existing evidence is scarce. Only a few cases have been reported in medical literature. CASE PRESENTATION: We report the case of a 42-year-old male cocaine addict who presented with acute peritonitis. A laparotomy revealed a 3 cm perforation in the sigmoid, The absence of radiological, biological, and pathological evidence confirms the toxic origin of the perforation. CLINICAL DISCUSSION: Cocaine-induced ischemic colitis is a rare occurrence in a surgeon's clinical experience. This condition is typically confirmed through colonoscopy and often resolves without the need for surgery, although a small number of cases may advance to peritonitis, necessitating surgical intervention. CONCLUSION: Cocaine's adverse effects should be taken into account in the differential diagnosis of acute ischemic events in young adults. A general understanding of the significant complications associated with cocaine can aid in achieving early diagnosis and prompt treatment.

Littoral Cell Angioma of Spleen: A rare case report.

Introduction: Spleen's Littoral Cell Angioma is a rare benign vascular tumor. The main clinical presentation is isolated splenomegaly. Case presentation: we present the case of a 37 years old male patient who suffers from chronic pain in the left hypochondrium.The abdominal examination finds a painful splenomegaly related to a biological bicytopenia. The CT Scan shows a 32 cm splenomegaly.An exploratory laparotomy with splenectomy was performed. The histological and immunohistochemical study confirmed The final diagnosis of Littoral Cell Angioma. Clinical discussion: Isolated splenomegaly of unknown etiology is the main clinical sign. Splenectomy is required for a diagnostic purpose and substratum for histological study. Conclusion: Littoral Cell Angioma of the Spleen is a rare benign vascular tumor, however it should be highlighted by clinical and radiological features, the definitive diagnosis is made upon histological study.

Mesenteric cystic lymphangioma in an adult: An unusual case report.

Introduction: Cystic lymphangioma is a benign malformation tumor of the lymphatic system. Its location is variable, and mesenteric localization remains extremely rare. Case presentation: We describe a rare case of cystic lymphangioma of the mesentery in a 26 years old woman. The diagnosis was suspected following an abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI), showing a large polylobulated cyst in contact with the stomach, the tail of the pancreas, the spleen, and the antero-external cortex of the left kidney. The patient underwent laparoscopic surgery with a pericystectomy. Pathological examination confirmed the diagnosis of cystic lymphangioma of the mesentery. The patient's postoperative recovery was uneventful. After a Follow up of one year after surgery, there was no evidence of recurrence. Clinical discussion: Cystic lymphangioma of the mesentery is a benign malformation tumor of the lymphatic system. Its clinical aspects are very polymorphic; the diagnosis is evoked by radiological imaging but requires pathological confirmation. Surgery is the gold standard in the management of this pathology. Conclusion: We highlight the importance of radical surgical resection to avoid Cystic lymphangioma complications and minimize the recurrence risk.

Chronic lymphocytic leukemia, a rare cause of spontaneous rupture of the spleen.

INTRODUCTION: Spleen Spontaneous Rupture SRS is a rare phenomenon in which the spleen ruptures without associated trauma. This pathology is rarely caused by Chronic Lymphocytic Leukemia. PRESENTATION OF THE CASE: We present a case of a 59-year-old male patient with chronic Lymphocytic Leukemia, who was admitted with an acute abdomen whose clinical and paraclinical examinations revealed a spleen spontaneous rupture. The treatment consisted of a splenectomy. DISCUSSION: Spontaneous spleen rupture was first described by Rokitansky in 1861 and mentioned in many cases since, the common causes of non-traumatic Splenic rupture include myeloproliferative diseases, vasculitis, and infections. However, Chronic Lymphocytic Leukemia (CLL) remains an obscure cause of splenic rupture that requires unique attention. The diagnosis of splenic rupture should be considered in all patients with hematologic malignancies presenting with abrupt onset of abdominal pain, hemodynamic instability, or acute anemia. The choice between conservative treatment and splenectomy depends on different variables: the etiology of the SRS, the hemodynamic stability, the amount of packed red blood cells transfused. Thus, an interventional approach can be advocated for a spontaneous splenic rupture over nonoperative management. Splenic embolization can provide patients with the advantages of both operative splenectomy and conservative management. The mortality rate from SRS is 12.2 %. Neoplastic pathologies were most significantly associated with fatal outcomes. CONCLUSION: The high mortality rate seems to be mainly related to the delayed diagnosis and/or the severity of the underlying pathology. Given its seriousness, it requires a rapid diagnosis and adapted management.

Primary peritoneal high-grade serous carcinoma in a man: A case report.

Introduction and importance: Primary peritoneal serous carcinomas (PPSC) are exceedingly rare in male patients. Only a few cases were reported in the medical literature, it's diagnosis is difficult before surgery. Case presentation: In this article, we describe the case of a patient who presented a high-grade primary peritoneal carcinoma, the diagnosis was suspected radiologically following an abdominopelvic computed tomography (CT).the patient underwent exploratory laparoscopic surgery with biopsy of several peritoneal nodules. Pathologic analysis of specimen confirmed the diagnosis of Primary peritoneal serous carcinomas. The patient died one month after his diagnosis while undergoing chemotherapy and palliative care. Clinical discussion: PPSC is an inoperable malignancy, histology staining confirms the diagnosis, the chemotherapy and palliative care are the only offered treatment. The evolution of the disease is very dark with a poor prognosis. Conclusion: We highlight the important of testicular examination to predict apparition of PPSC in the future.

Management of a Left Lateral Aortic Paraganglioma During Pregnancy: A Rare Case Report.

Paragangliomas are rare neuroendocrine tumors mostly diagnosed in young adults. Their association with pregnancy is even rarer, and their impact is even more serious in the absence of adequate management, which may vitally involve maternal and fetal prognosis. In this report, we present a rare case of a left lateral aortic paraganglioma in a pregnant woman in her third trimester during her 31 weeks of gestation, who consulted for a hypertensive peak; the methoxylated derivatives were positive. An abdominal MRI showed a left lateral aortic mass, suggesting a paraganglioma. After a multidisciplinary discussion, the patient underwent laparoscopic surgical resection of the mass after preoperative medical preparation. Pathological examination confirmed the diagnosis of paraganglioma. The overall stay was six days without any short-term complications, including anything related to fetal viability, with a vaginal delivery at 37 weeks of amenorrhea. The patient was followed up for six months with no complications. We highlight the importance of preoperative medical preparation followed by surgical resection in the framework of a multidisciplinary consultation for an improved maternal-fetal prognosis.

Desmoid tumor of the anterolateral abdominal wall: A rare case report.

INTRODUCTION AND IMPORTANCE: Desmoid tumors of the abdominal wall are rare fibroblastic proliferative tissue, included in the group of soft tissue tumors, not metastasizing but locally aggressive as an infiltrating tumor and a source of recurrence. CASE PRESENTATION: This case report describes a rare case of desmoid tumor of the anterolateral abdominal wall presented with a large mass of the left flank and iliac fossa. The diagnostic was suspected radiologically following an abdominopelvic computed tomography (CT) and magnetic resonance imaging (MRI). An exploratory laparotomy found a large mass infiltrating the left rectus abdominis muscle, a part of the flat left abdominal muscles, and the left iliac crest. The patient underwent a total resection of the mass involving the left rectus muscle with autoplasty by a pedicled flap of the left LATA fascia with the placement of a bifacial mesh.Histologic analysis of the operatory specimen confirmed the diagnosis of a desmoid tumor of the abdominal wall.The patient has been discharged from the hospital on the fifth day post-operatory with an uneventful recovery; she was in good health after a one-year follow-up. CLINICAL DISCUSSION: Desmoid tumors of the abdomen are very rare. Although this tumor is histologically benign, it has the potential of invading vital structures and has a high rate of local recurrence.Histology staining confirms the diagnosis, surgery is the gold standard in the management of this pathology. CONCLUSION: We highlight the importance of radical surgical excision to avoid desmoid tumor complications and to minimize the recurrence risk.

Giant parathyroid carcinoma: Diagnostic, difficulties and therapeutic strategies: A case report.

INTRODUCTION: Parathyroid carcinoma is a very aggressive malignant tumor. It is mostly revealed by clinical primary hyperparathyroidism. CASE PRESENTATION: We report a rare case of parathyroid carcinoma in a 61-year-old-male patient who presented with a painless right-sided cervical tumefaction of hard consistency associated with cervical lymphadenopathy. Cervical ultrasonography showed a right parathyroid mass with intimate contact with the homolateral thyroid lobe. A parathyroidectomy enlarged to the adjacent thyroid parenchyma with a selective neck dissection level VI was performed. CLINICAL DISCUSSION: The clinical presentation is most often manifested with clinical features of primary hyperparathyroidism associating bone disorders. Surgery remains the treatment of choice. The benefit of adjuvant treatments is controversial and remains to be evaluated. CONCLUSION: Parathyroid carcinoma is a rare tumor. This rare entity is often presented with clinicobiological features of severe primary hyperparathyroidism.