Superficial Angiomyxoma of the Vulva: A Case Report

Superficial angiomyxoma is a rare benign mesenchymal tumor that mainly occurs in the genital region. We report the case of a 51-year-old woman with a painless vulvar mass, well circumscribed on ultrasound. On gross finding, it was a polypoid and bilobed mass, partially encapsulated. On histological examination, it was a proliferation of non-atypical spindle cells with an abundant, myxoid stroma and numerous medium-sized blood vessels. The diagnosis was superficial angiomyxoma. The clinical features do not often lead to the diagnosis of superficial vulvar angiomyxoma. It is based on histological examination and immunohistochemistry is helpful to differentiate it from other myxoid tumors.

Undifferentiated Uterine Sarcoma: A Rare Cause of Pelvic Pain in Young Woman

We report a case of undifferentiated uterine sarcoma occurring in a 20-year-old woman presenting as a pelvic pain with a mass discovered at the physical examination. The tumor ruptured into the abdominal cavity. A total hysterectomy was performed. On the pathological examination, the uterine corpus presents a proliferation of markedly atypical spindle cells admixed with round cells and pleomorphic cells. The tumor deeply infiltrated the myometrium. The tumor was very necrotizing. There were more than 50 mitoses per 10 fields at high magnification. The isthmus was invaded by the tumor. The diagnosis of undifferentiated uterine sarcoma was confirmed by immunohistochemistry. The tumor shows negativity for the following markers: CKAE1/AE3, h-caldesmon, α-SMA, progesterone receptors, desmin, CD 10, alpha foeto-protein, CD 3 and CD 20.

Invasive Mole of the Uterus: A Case Report

Invasive mole is a rare subgroup of gestational trophoblastic disease characterized by the invasion of molar tissue into the myometrium or uterine vasculature. In this paper, we report the third case of invasive mole described in the Malagasy literature. A 33-year-old woman was referred to the Soavinandriana Hospital, her complaint was persistent vaginal bleeding during 2 months, occurring at 3 months of pregnancy with biological anemia without hemodynamic repercussions. The human chorionic gonadotropin (HCG) level was 385,931 mIU/ml. A haemostasis hysterectomy was performed. Histological examination showed an enlarged uterus and endometrial cavity containing edematous chorionic villi with trophoblastic proliferation invading the myometrium. The diagnosis was an invasive mole, stage I, FIGO score 6. Chemotherapy was prescribed but was not honored. After 45 days of follow-up, the serum βHCG level decreased to 1803 mIU/ml, without clinical symptoms. The patient then lost sight. Persistent vaginal bleeding after pregnancy may be the only clinical symptom of an invasive mole and should raise suspicion. Histological examination establishes the diagnosis. As this is an unusual cause of vaginal bleeding, our case should remind physicians that when faced with this symptom, the possibility of an invasive mole should be considered in order to make an early diagnosis for less aggressive treatment.

Primary Bilateral Adenocarcinoma of the Fallopian Tube: A Case Report

Primary fallopian tube carcinoma is an uncommon malignancy that accounts for 0.14% to 1.8% of gynecological cancers. The clinical symptom is not specific and preoperative diagnosis is easy to miss or delay because of a lack of specific symptoms. We reported a case of bilateral adenocarcinoma of the Fallopian tubes, was occurred in a 51-year-old postmenopausal woman and diagnosed with bilateral salpingectomy for suspicious of suppurative salpingitis. The diagnosis is not always suspected preoperatively. They are assimilated to salpingitis in the early stage, or to ovarian tumors in the advanced stage. The diagnosis is made postoperatively, after an anatomopathological examination. Its etiology is still poorly understood.

Appendicular Abscess Revealing Gastrointestinal Stromal Tumor of the Appendix

Gastrointestinal stromal tumor (GIST) is a rare tumor of the digestive tract, but it is the most common of the mesenchymal tumors. The location is often gastric and small intestine. GIST of the appendix is extremely rare. We report one case in a 48-year-old man. He complained of severe pain in the right iliac region. The clinical presentation was typically like acute appendicitis. Abdominal ultrasound was performed and suspected an appendicular abscess. Surgical excision of the appendix was performed and histological diagnosis was “gastrointestinal stromal tumor of the appendix”.

Endometriosis of the Sigmoid Colon Mimicking Malignant Lesion

Endometriosis is defined as the presence of endometrial tissue outside the uterus. It is a benign pathology involving 15% of women of reproductive age. The sigmoid site represents 7% of endometriosis but it is the most frequent area in the digestive tract. We report two cases of colonic endometriosis in which the initial diagnosis suspected a malignant disease. Respectively, the patients were 31 and 48 years old. The first patient complained about abdominal pain with symptoms of intestinal obstruction and was classified after radiological examination as an intrasigmoid tumor with bladder adhesion. The second patient was undergone for a radiological examination because of a bowel obstruction syndrom and a mass in the sigmoid colon was suspected. In both cases, sigmoid colon resection was performed and histological diagnosis was sigmoid endometriosis. Sigmoid endometriosis is rarely diagnosed before surgical excision. Suspicious bowel obstruction and malignant origin lead to large surgical excision. Histological examination is important to establish the diagnosis.

Primary Breast Tuberculosis Mimicking Carcinomatous Mastitis: A Case Report

The breast is a rare localization of extra-pulmonary tuberculosis, even in highly endemic countries. It is most often primitive. The clinical and radiological features are sometimes misleading. It poses diagnostic problems especially with cancer. We report a case of breast tuberculosis having clinical and radiological presentations as a breast carcinoma. Through this observation and a review of the literature, we provide an update on the epidemiological characteristics and the means of diagnosis of this lesion. It was a 52-year-old woman with inflammatory lump of the left breast, adherent to the skin. Ultrasonography and mammography revealed a homogeneous, poorly demarcated nodule of approximately 4 cm of diameter, classified ACR4. Surgical excision was performed. The histological diagnosis was breast tuberculosis. The diagnosis of tuberculous mastitis is made on bacteriological and pathological examinations. Histological examination helps for diagnostic confirmation while excluding a malignant lesion of the breast.