Introduction: Demons-Meigs syndrome combines a benign tumor of the ovary with ascites and pleural effusion. It is a rare disease and the pathophysiological mechanism is not yet well understood. The aim of our study is...Introduction: Demons-Meigs syndrome combines a benign tumor of the ovary with ascites and pleural effusion. It is a rare disease and the pathophysiological mechanism is not yet well understood. The aim of our study is to report a case of Demons-Meigs syndrome, to determine its different characteristics and to make clinicians aware of the malignant predictive value of CA 125 in front of an ovarian tumor. Observation: The patient was 42 years old and had no previous history. She presented with intense abdominal pain of sudden onset, prompting a medical consultation. On clinical examination, the abdomen was distended with signs of peritoneal effusion and right pleural effusion. Ultrasound revealed a well-circumscribed, ovarian mass with an internal fluid component and hypervascularization on Doppler. The CA 125 level was elevated (293.9 U/ml). Exploratory laparotomy revealed two bilateral, firm, solid ovarian tumors without vegetation or peritoneal lesions. Macroscopically, one of the tumors was well circumscribed, lobulated with a smooth outer surface. It measured 20 × 17 × 8 cm and weighed 1400 g. The other tumor measured 19 × 11 × 5 cm, weighed 1090 g and had the same characteristics as the other tumor. Histologically, both tumors were a proliferation of fibroblastic spindle cells organized in short intersecting or storiform bundles, without cyto-nuclear atypia or excess mitoses. The diagnosis retained was bilateral ovarian fibroma in the context of a Demons-Meigs syndrome. Conclusion: Demons-Meigs syndrome is a rare entity. The concomitant elevation of the CA 125 level is not always an indicator of ovarian cancer. The curative treatment is surgical based on tumor removal ensuring the disappearance of peritoneal and pleural effusions.展开更多
Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an a...Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an apyretic context. She had no notion of irradiation or particular personal history apart from wearing glasses since the age of 5 years. She weighed 70 kg (BMI = 31). Biological examinations were normal. The brain scan showed a left frontal extra-axial tumor process measuring 76 × 60 × 55 mm. Tumor resection was performed. Macroscopically, the surgical specimen was found to be 8 firm, lobulated, yellowish-white fragments measuring 14 × 11 × 2 cm and weighing 150 g in total. The histological examination showed a proliferation of meningothelial cells, with a tendency to stratify and to roll up on each other in an onion bulb shape, without excess of mitoses and without cortical infiltration, evoking a meningioma. Meningioma in children remains a rare tumor. In our case, seizures were the only revealing signs of this disease. Cerebral computed tomography oriented the diagnosis. Anatomopathological examination was essential for confirmation.展开更多
Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objecti...Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.展开更多
Gastrointestinal lymphoma is a non-Hodgkin’s lymphoma that develops from MALT (Mucosa Associated Lymphoid Tissue). It is a rare entity representing 1% of tumors of the gastrointestinal tract. In Madagascar, few studi...Gastrointestinal lymphoma is a non-Hodgkin’s lymphoma that develops from MALT (Mucosa Associated Lymphoid Tissue). It is a rare entity representing 1% of tumors of the gastrointestinal tract. In Madagascar, few studies have been performed on these lymphomas. Our objective is to report a series of digestive lymphoma in order to evaluate the epidemiological and anatomical-clinical aspects. This was a retrospective, cross-sectional, descriptive bicentric study conducted at the Department of Pathology at the Soavinandriana Hospital Center (CENHOSOA) and the Department of Pathology at the University Hospital Center of Andrainjato over a period of 4 years from January 1<sup>st</sup>, 2016 to December 31<sup>st</sup>, 2019. During the study period, we collected 14 cases of primary digestive lymphoma representing 16% of all lymphomas. We noted a female predominance with a sex ratio of 0.75. The mean age of the patients was 35.64 years with extremes of 3 and 78 years. The clinical signs were dominated by occlusive syndrome (57.14%), abdominal pain (21.44%), digestive hemorrhage (7.14%), intestinal invagination (7.14%) and lingual swelling (7.14%). Regarding the location, the ileum was the most frequently affected (42.85%), followed by the stomach (14.29%), the ileo-caecal area (14.29%), the sigmoid (14.29%), the colon (7.14%) and we also noted a lingual location (7.14%). The most frequent histological type was diffuse large B cell lymphoma (42.86%) followed by MALT lymphoma (35.71%), Burkitt’s lymphoma (14.29%) and diffuse small cell lymphoma (unclassified) (7.14%). We did not observe a significant association (p > 0.05) between the site involvement and the histological subtypes. Among the 14 cases, 3 were confirmed by immunohistochemistry. Primary lymphomas of the gastrointestinal tract include several anatomic entities with different presentation and prognosis. Pathological examination is essential for diagnosis. Immunohistochemical examination is a valuable aid for immunophenotyping despite its difficult access in Madagascar. A multidisciplinary collaboration is necessary for an optimal management of these rare lymphomas.展开更多
文摘Introduction: Demons-Meigs syndrome combines a benign tumor of the ovary with ascites and pleural effusion. It is a rare disease and the pathophysiological mechanism is not yet well understood. The aim of our study is to report a case of Demons-Meigs syndrome, to determine its different characteristics and to make clinicians aware of the malignant predictive value of CA 125 in front of an ovarian tumor. Observation: The patient was 42 years old and had no previous history. She presented with intense abdominal pain of sudden onset, prompting a medical consultation. On clinical examination, the abdomen was distended with signs of peritoneal effusion and right pleural effusion. Ultrasound revealed a well-circumscribed, ovarian mass with an internal fluid component and hypervascularization on Doppler. The CA 125 level was elevated (293.9 U/ml). Exploratory laparotomy revealed two bilateral, firm, solid ovarian tumors without vegetation or peritoneal lesions. Macroscopically, one of the tumors was well circumscribed, lobulated with a smooth outer surface. It measured 20 × 17 × 8 cm and weighed 1400 g. The other tumor measured 19 × 11 × 5 cm, weighed 1090 g and had the same characteristics as the other tumor. Histologically, both tumors were a proliferation of fibroblastic spindle cells organized in short intersecting or storiform bundles, without cyto-nuclear atypia or excess mitoses. The diagnosis retained was bilateral ovarian fibroma in the context of a Demons-Meigs syndrome. Conclusion: Demons-Meigs syndrome is a rare entity. The concomitant elevation of the CA 125 level is not always an indicator of ovarian cancer. The curative treatment is surgical based on tumor removal ensuring the disappearance of peritoneal and pleural effusions.
文摘Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an apyretic context. She had no notion of irradiation or particular personal history apart from wearing glasses since the age of 5 years. She weighed 70 kg (BMI = 31). Biological examinations were normal. The brain scan showed a left frontal extra-axial tumor process measuring 76 × 60 × 55 mm. Tumor resection was performed. Macroscopically, the surgical specimen was found to be 8 firm, lobulated, yellowish-white fragments measuring 14 × 11 × 2 cm and weighing 150 g in total. The histological examination showed a proliferation of meningothelial cells, with a tendency to stratify and to roll up on each other in an onion bulb shape, without excess of mitoses and without cortical infiltration, evoking a meningioma. Meningioma in children remains a rare tumor. In our case, seizures were the only revealing signs of this disease. Cerebral computed tomography oriented the diagnosis. Anatomopathological examination was essential for confirmation.
文摘Introduction: Meningiomas are tumors formed by arachnoid cells, typically attached to the inner surface of the dura mater. Malignant forms are rare and no case has been reported in the Malagasy literature. The objective of our study is to report two Malagasy cases of malignant meningioma and to discuss the epidemiological and anatomical-clinical particularities of this tumor. Observation: The first patient, a 41-year-old woman, presented with a rapidly progressive intracranial hypertension syndrome. The patient had undergone surgery two years earlier for a grade II meningioma and had no family history of meningioma, neurofibromatosis, or personal history of brain irradiation or head trauma. Her brain scan showed a heterogeneous polylobed left parieto-occipital mass with a meningeal implantation base. The anatomopathological examination of the samples revealed a malignant meningioma. The second patient was a 33-year-old man, operated for grade I meningioma eleven months before admission, with no other personal or family history. The patient was hospitalized for tumor recurrence with signs of intracranial hypertension. The brain computed tomography (CT) scan showed a heterogeneous extra-axial tumor in right temporo-parietal lobe. Surgical excision was performed. On histological examination, a proliferation of tumor cells of meningothelial appearance with papillary architecture was observed, leading to the diagnosis of malignant meningioma. Conclusion: Malignant meningioma is a rare and serious entity. The clinical manifestations are nonspecific and imaging may mimic a low-grade meningioma. The diagnosis of certainty is histological and is based on essentially morphological criteria. The latter condition the overall survival of the patient and the therapeutic conduct.
文摘Gastrointestinal lymphoma is a non-Hodgkin’s lymphoma that develops from MALT (Mucosa Associated Lymphoid Tissue). It is a rare entity representing 1% of tumors of the gastrointestinal tract. In Madagascar, few studies have been performed on these lymphomas. Our objective is to report a series of digestive lymphoma in order to evaluate the epidemiological and anatomical-clinical aspects. This was a retrospective, cross-sectional, descriptive bicentric study conducted at the Department of Pathology at the Soavinandriana Hospital Center (CENHOSOA) and the Department of Pathology at the University Hospital Center of Andrainjato over a period of 4 years from January 1<sup>st</sup>, 2016 to December 31<sup>st</sup>, 2019. During the study period, we collected 14 cases of primary digestive lymphoma representing 16% of all lymphomas. We noted a female predominance with a sex ratio of 0.75. The mean age of the patients was 35.64 years with extremes of 3 and 78 years. The clinical signs were dominated by occlusive syndrome (57.14%), abdominal pain (21.44%), digestive hemorrhage (7.14%), intestinal invagination (7.14%) and lingual swelling (7.14%). Regarding the location, the ileum was the most frequently affected (42.85%), followed by the stomach (14.29%), the ileo-caecal area (14.29%), the sigmoid (14.29%), the colon (7.14%) and we also noted a lingual location (7.14%). The most frequent histological type was diffuse large B cell lymphoma (42.86%) followed by MALT lymphoma (35.71%), Burkitt’s lymphoma (14.29%) and diffuse small cell lymphoma (unclassified) (7.14%). We did not observe a significant association (p > 0.05) between the site involvement and the histological subtypes. Among the 14 cases, 3 were confirmed by immunohistochemistry. Primary lymphomas of the gastrointestinal tract include several anatomic entities with different presentation and prognosis. Pathological examination is essential for diagnosis. Immunohistochemical examination is a valuable aid for immunophenotyping despite its difficult access in Madagascar. A multidisciplinary collaboration is necessary for an optimal management of these rare lymphomas.
