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L'atteinte hépatique est fréquente au cours de l'hyperthyroïdie. Elle est le plus souvent asymptomatique. Une hyperthyroïdie révélée par un ictère est rarement décrite dans littérature. Nous vous rapportons une observation à Dakar (Sénégal). Il s'agissait d'un patient de 52 ans qui avait consulté notre service pour un ictère associé à un prurit. Les explorations biologiques montraient une augmentation des alanine aminotranférases (1,1 N), des aspartate aminotranférases (1,5 N), des phosphatases alcalines (3 N), des gamma glutamyl transférases (1,3 N) et de la bilirubinémie (22 N). L'échographie abdominale était normale. Une cause toxique ou médicamenteuse, un obstacle sur les voies biliaires, une hépatite virale ou auto immune ainsi qu'une cholangite biliaire primitive ont été exclu. Le dosage des hormones thyroïdiennes montrait une élévation de la T4 libre à 24 ng/dL (9-20 ng/dL) et un taux plasmatique indétectable de TSH inférieure à 0,01μUI/mL (0,35-4,94 UI/mL). Les anticorps anti récepteurs de la TSH étaient positifs à 7,04 UI/L (N < 1,75 UI/L). L'échographie thyroïdienne objectivait un goitre diffus homogène hypervasculaire. Le diagnostic d'une atteinte hépatique secondaire à une maladie de Basedow sans dysfonction cardiaque était retenu. L'évolution clinique et biologique était favorable sous carbimazole. L'ictère peut être révélatrice d'une hyperthyroïdie. La recherche des signes cliniques et biologiques d'une hyperthyroïdie est obligatoire devant un ictère inexpliqué.

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Biliary cystadenoma is a multilocular cystic benign tumor which arises in the intrahepatic biliary system. Diagnosis is often difficult and based on imaging, however histology remains the only argument for diagnosis certainty. We report a case of biliary cystadenoma in a 69-year-old female. Observation: it was a 69-year-old female with history of RHUPUS syndrome (Lupus + Rheumatoid arthritis) under low-dose corticosteroid therapy. She presented with pain in the right hypochondrium with permanent moderate intensity for 3 months associated to altered performance status. Physical examination showed a hepatomegaly, cervical subluxation, and pulmonary condensation syndrome. Hepatobiliary ultrasound showed presence of multiple septate cystic formations occupying segments 1, 7, 8, 5 of the left liver. Abdominal CT scan and hepatic MRI were in favor of biliary cystadenoma but could not rule out biliary cystadenocarcinoma with certainty. Conclusion: biliary cystadenoma is a benign cystic tumor of the liver. The differential diagnosis with cystadenocarcinoma is most often difficult and usually requires histological analysis for diagnostic certainty.

Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron deficiency anemia and a cervical esophageal web. It is one of the risk factors of the esophageal cancer. Objectives: To report the epidemiological, clinical, paraclinical and histological characteristics of patients with Plummer-Vinson syndrome associated with esophageal cancer. Patients and Methods: This was a retrospective study carried out at the digestive endoscopy center of Aristide le Dantec hospital in Dakar from January 2008 to December 2015. We included all patients with Plummer-Vinson syndrome associated with esophageal cancer. Results: We included 7 patients. The mean age was 36 years (24 -65 years). There were 5 women and 2 men. The mean diagnostic period was 9 months (6 months -15 years). The main clinical manifestations were dysphagia (100%), weight loss (100%) and clinical anemia (71.4%). The biology showed a mean hemoglobin level of 8.8 g/dl (6 -11 g/dl), serum iron at 30.8 μg/dl (11 -52 μg/dl) and ferritinemia at 6.2 ng/dl (1.5 -25 ng/dl). The upper digestive endoscopy revealed a stenosis web of the cervical esophagus in all patients. An endoscopic dilatation was performed in all cases. After dilation, the endoscopy showed a tumor of the middle third of the esophagus in 4 cases and of the lower third in 3 cases. It was about of a squamous cell carcinoma in the tumors of middle third and of an adenocarcinoma in those of the lower third. Conclusion: At Aristide le Dantec hospital of Dakar, PVS is sometimes associated with an epidermoid carcinoma or an adenocarcinoma of the esophagus. The improvement of the prognosis depends on the early realization of an upper gastrointestinal endoscopy (UGI) in case of any dysphagia and the monitoring of the patients.