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.
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.
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.
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