Mature cystic teratoma is the most common type of ovarian germ cell neoplasm, but occasionally, it can undergo malignant transformations, especially in postmenopausal women. These secondary malignant neoplasms are most commonly squamous cell carcinomas. The absence of clinical and radiological specificity of this transformation means that the diagnosis remains purely histological. Data is insufficient regarding the appropriate management given their rarity. However, the treatment is multidisciplinary and is based on surgery and a platinum-based chemotherapy regimen. We report the case of a 53-year-old postmenopausal female patient with malignant transformation of the ovarian teratoma who was treated surgically and whose outcome was favorable. The diagnosis of the teratoma was evoked on imaging, while the diagnosis of squamous cell carcinoma was revealed on histology. Malignant transformation is an uncommon complication of mature ovarian teratomas. No clinical, radiological, or biological sign is specific; therefore, resection of any ovarian mass, even asymptomatic, is required.
Ovarian fibromas are uncommon, accounting for 4% of ovarian tumors. The clinical examination, ultrasonographic, and tumor marker data remain the best preoperative approach currently available for ovarian tumors. However, the diagnosis remains histological. We hereby present the uncommon case of unilateral ovarian fibroma in a 55-year-old woman who presented with pelvic chronic pain the past 2 years. Underwent a bilateral adnexectomy through laparotomy and pathologic examination confirmed the diagnostic of ovarian fibroma. Our case is to illuminate the diagnosis of ovarian fibroma as a rare diagnosis and it should be considered in the differential diagnosis of solid ovarian masses.
Introduction: Idiopathic granulomatous mastitis (IGM) is an uncommon and persistent inflammatory breast disease with no identified cause. It affects women of reproductive age who have previously breastfed. Diagnosis of IGM is difficult because clinical and radiological features might mimic breast cancer. We report an unusual case of IGM in a breastfeeding mother mimicking breast cancer. Observation: A 32-year-old female patient, with no particular pathological history, has been presenting for 3 months mass of the right breast with erythema. A few weeks later, she presented a suppuration and ulceration of the right breast. The breast examination revealed a painless and poorly marginated mass, mobile in relation to the muscle plane and adherent to the skin at the junction of the external quadrants measuring 40*40mm. Breast ultrasound showed a heterogeneous hypoechoic irregular mass in the outer quadrants with surrounding edema, and dilatation of the milk ducts, classified as BI-RADS 4. Histologically, there was an epithelioid and gigantocellular granulomatous reaction of the mammary parenchyma, with a polymorphic inflammatory infiltrating of lymphocytes, plasma cells, and neutrophils. The patient received corticosteroids, bromocriptine, amoxicillin and clavulanic acid associated with topical care of the lesion. The evolution was favorable with the regression of the mass after 18 months. Discussion: IGM is an uncommon and benign condition that is frequently misdiagnosed. It mostly occurs in young women during the genital period. IGM does not have any pathognomonic mammographic characteristics. Breast ultrasound can show a nodular hypoechoic image with irregular contours with a long axis parallel to the skin. IGM is characterized by lobulocentric non-caseating granulomas made up of epithelioid histiocytes mixed with Langhan's multinucleate giant cells on histological examination. The treatment of IGM is not well established. The management of the disease is based on its clinical form. IGM is a gradual and recurrent disease that has a major impact on the quality of life and requires close surveillance. Conclusion: IGM is an uncommon and persistent inflammatory disorder of the breast that can be difficult to diagnose. Breast cancer is the predominant differential diagnosis, with the possibility of an association. Increased awareness of this disorder will lead to more accurate and timely diagnosis and treatment.
Background: Vasa praevia is an uncommon but very serious condition that is characterized by the presence of vessels belonging to the fetal circulation in the amniotic membranes surrounding the internal cervical os below the fetal presenting part. These vessels are at risk of rupture in active labor, or when the membranes spontaneously or artificially rupture, which can result in an acute fetal exsanguination and death. The prenatal diagnosis is thus of paramount importance, allowing a prophylactic cesarean section and therefore avoids severe Benckiser’s hemorrhage responsible for very high neonatal mortality.
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