Fibroadenomas are the most common breast disease that occurs usually in young. The coexistence of an invasive ductal carcinoma and a fibroadenoma in the ipsilateral breast is extremely rare. We present the case of a 52 years woman, presented to us for an upper-outer breast lump. Breast imaging concluded to tow contiguous lesions, one of them was suspicious. She had a conservative surgery. Histology concluded to a fibroadenoma and an invasive ductal carcinoma.

Warty squamous cell carcinoma (WSCC), is a rare variant of squamous cell carcinoma that occurs mostly in younger women, but can occur in old women. It is due to human papillomavirus (HPV) infection. This rare entity has been described in several organs such as vulva, cervix, and penis. To the best of our knowledge WSCC of vagina associated with the third-degree of uterine prolapse has never been reported in the literature. We present an exceptional case of WSCC of vagina occurred in a 77-year-old woman with long disease duration. The physical exam found a large ulcer-budding lesion of the middle and lower third of the vagina that depends on the left vaginal wall. The full work-up concluded to stage IVA of FIGO classification, due to the bladder involvement. The patient underwent a hysterectomy, bilateral salpingo-oophorectomy, bilateral pelvic node dissection, left partial cystectomy with left ureteral reimplantation and total vaginectomy, followed by adjuvant radiotherapy. The patient had no recurrence during 8 years of regular follow-up. WSCC can express locally aggressive behavior, such we reported; despite it appears to be less aggressive than the typical well-differentiated squamous cell carcinoma. That leads to individualize WSCC from other verruciform neoplasms.

Pure Ductal carcinoma in situ (DCIS) of the man is extremely rare. The incidence is approximately 1% of all malignancies in men and 5% to 7% of male breast cancer (1). It is usually associated with invasive carcinoma. We reported three cases on DCIS in men. The aim of our study is to further emphasize the importance of this disease for men and to evaluate the management of this rare tumor. Case PresentationsCase 1 A 58-year old man consulted for a left breast mass that has been evolving for 3 months. There was no remarkable personal history or family history of breast's disease. He had a remarkable history of smoking with 38 packages per year. On physical examination, we found a mobile, well-defined mass, measuring 20 mm × 20 mm without axillary lymph node. The right breast was unremarkable. Mammography and ultrasound showed a circumscribed nodule without calcifications in the left breast. This was considered as ACR 3 of the classification of the American College of Radiology (ACR) (Figure 1). We performed a core needle biopsy. The histological findings showed a DCIS. The patient underwent a mastectomy with sentinel node. Macroscopically, the tumor was greyish to white and measured 17 mm in its greater axis. The definitive histopathological assessments showed DCIS with papillary and cribriform patterns (Figure 2). The nuclear grade was intermediate, and there was no necrosis. Cells were polarized. The margins were free, with a clearance of 15 mm. No invasive cancer was present. The nuclear grade was I of Van Nuys. Van Nuys Prognostic Index score (VNPI) was 6 (Table 1). Sentinel lymph node sampling brought back three lymph nodes which were all negative. The immunohistochemical examination of estrogen (ER) and progesterone (PR) receptors were negative for both. The patient was noted to be doing well until now, and he is regularly followed up, with a total duration of follow-up of 10 years.A written informed consent was obtained from the patient.

Pancreatic metastases are rare, accounting for 2%–3% of pancreatic tumors. The pancreas represents an unusual metastatic site of synovial sarcoma (SS) outside the usual localizations (regional nodes, lung, bone, and liver). The diagnosis is evoked by the personnel medical history of SS and imaging then confirmed by histological examination of the guided pancreatic biopsy. Its therapeutic management is mainly surgical with extensive removal of the lesion. So far only four cases have been reported in the English literature. We reported the case of a male aged 30-year-old who was admitted to our Institute for a local recurrence of SS of the left thigh which was initially treated by surgical excision. The patient underwent a wide surgical excision followed by chemotherapy and radiotherapy. About 15 months later, he experienced a pancreatic metastasis of his SS. He had a caudal splenopancreatectomy with partial resection of the transverse colon followed by chemotherapy. This report highlights the diagnostic difficulties of this rare localization and therapeutic challenge.