Background: The diagnosis of dermal primary and metastatic melanocytic tumors is often problematic. Recently, a new entity has been proposed, cutaneous melanocytoma with CRTC1‐TRIM11 fusion (CMCT). Case presentation: We report the 11th case of cutaneous melanocytoma harbouring the CRTC1-TRIM11 fusion. The patient is a 35‐year‐old female patient, with no particular history, who presented in the dermatology department for a 1.5cm nodular lesion on the dorsal aspect of the left foot. The lesion evolved for more than one year. She underwent tumour resection for clinical suspicion of malignant melanoma. Pathological examination of the resected specimen after H&E stain revealed a dermal symmetrical proliferation made of spindle cells showing a melanocytic differentiation proved by expression of Melan A, S100 protein and SOX10. FISH study helped exclude a clear cell sarcoma. RNA sequencing showed the CRTC1-TRIM11 fusion.Conclusions: Since only 11 cases have been documented, and because of the overlap with the clear cell sarcoma, the characterization of CMCT is still not fully satisfactory.
Introduction : Rheumatoid arthritis is a chronic, systemic and inflammatory joint disease that primarily affects the joints and can be associated with a variety of extra-articular manifestations. The aim of this study is to determinate the frequency and the factors associared with those extra-articular manifestations.Materials and methods: Cross-sectional study of hospitalized cases of rheumatoid arthritis in our department between January 2012 and January 2018. We studied the prevalence of the extra-articular manifestations and associated factors. The analysis was done by the software EPI INFO 3.5.4.Results : 294 cases of rheumatoid arthritis included. The average age was 53.2 years +/- 12.3 with female predominance F / M = 6.1. The diagnosis lag time was 10.7 +/- 6.9 years. Half of our patients (50.7%) had systemic manifestations. In order of frequency, we distinguish: Osteoporosis (39.6%), Sjögren's syndrome (22.1%), pulmonary involvement (16.1%), dermatological manifestations (8.8%), cardiac involvement (8.8%), ocular involvement (3.1%) carpal tunnel syndrom (1.3%) and vasculitis (1.3%). The extra-articular manifestations were associated with several factors on bivariate analysis : advanced age (p = 0.014), longer duration of disease (p = 0.006), deformities (p = 0.000), seropositivity (p = 0.02), high titers of rheumatoid factor (p = 0.03), destruction (p = 0.02), bone erosions (p = 0.012) and non-use of biotherapy (p = 0.04). Factors whose association was statistically significant, after multivariate logistic regression analysis, were: advanced age (p = 0.04, OR = 1.02 [1.001-1.043], and longer duration of disease (p = 0.02 OR = 1.04 [1.005-1.082]).Conclusion : In our Moroccan context, half of patients with rheumatoid arthritis had extra-articular manifestations. Older patients with longer disease evolution are the most involved.
We present a case of traumatic neuroma of the common bile duct in a 53-year-old woman who presented with jaundice,5months after cholecystectomy. Physical examination revealed jaundice, epigastric pain and scratching lesions. Gamma glutamyl transferase (GGT) at 109 U/L, Alkaline phosphatase at 175U/L. CA19-9 was at 500U/mlMagnetic resonance cholangiopancreatography revealed a T1 and T2hyperintense lesion of peri-hilar fat. An increase in intensity was noted after useof gadolinium.Exploratory laparotomy was performed with the presumptive diagnosis of cholangiocarcinoma. Pathologic analysis of the surgical specimen revealed Haphazard mature nerves, consistent with a bile duct neuroma. Follow-up of the patient showed no post-operative complications or signs of recurrence.
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