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Biomedical subjects

M Ayed

Publications and source records attributed to M Ayed.

At least 19 recordsLinked to original sources

Sarcomatoid renal cell carcinoma in a young adult.

Sarcomatoid renal cell carcinoma (SRCC) is an uncommon, aggressive renal cell carcinoma (RCC) accounting for 1.2% to 12.3% of renal cell carcinomas. SRCC may arise from any RCC subtype as it probably results from the de-differentiation of any renal epithelial malignancy. SRCC is characterised by a rapid progression and high metastatic rate. Currently there is no specific effective treatment for it. We report a new case of a 32-year-old man presented with two months backache. Ultrasound revealed a 7.5 cm heterogeneous mass at the inferior pole of the left kidney. A nephrectomy was performed. Histological study diagnosed a sarcomatoid renal cell carcinoma. The patient was doing well 6 months after initial surgery and then was lost to follow-up.

Actins↗

[Extra-adrenal pheochromocytoma: report of 4 cases].

Extra-adrenal pheochromocytoma is rare. The diagnosis must be evoked in signs of pheochromocytoma with absence of tumor of the adrenal. We report four cases of ectopic pheochromocytoma while specifying their clinical particularities and diagnosis procedure.

Adolescent↗

[Treatment of urinary incontinence in epispadias at the beginning of the third millenium].

The treatment of urinary incontinence in epispadias is delicate. Urinary continence is generally obtained after onerous and repetitive surgery. Different publications show a variable results. After the study of the results of our series (nine cases) and the results published in the literature, we propose a clarification on the therapeutic modalities of urinary incontinence associated to this malformation.

Child↗

[The female urethral diverticula: apropos of 21 cases].

PURPOSE: Our goal is to study the clinical, radiological and therapeutic particularity of the female urethral diverticula via a retrospective study of 21 cases. PATIENT AND METHODS: Twenty one females, with a mean age of 37 years (range 15 to 62 years) presenting an urethral diverticula, were treated between 1988 and 2000. Clinical examination made diagnosis in all cases. Cystorethrography shown a direct image of diverticula in 100% of cases and intravenous Pyelography in only 24% of cases. The urethral diverticula was excised via a transvaginal approach in all cases. RESULTS: Eighteen patients had favourable immediate outcome. Three patients presented an urethrovaginal fistula treated surgically in one case and by bladder drainage in one case. The last patient refused treatment and she was lost to follow-up. After a median follow-up of 54 months (range 18 to 120) only three patients have some urinary urgency that was treated by anticholinergics. CONCLUSION: Female urethral diverticula is a rare disease, the diagnosis is easy and only surgical excision gives good results.

Adolescent↗

[Perineo-transpubic approach to the management of posterior urethral post-traumatic rupture].

OBJECTIVE: To study the place of the perineal-trans-pubic approach in the treatment of the posterior urethral post-traumatic rupture operated late, and to evaluate its results. PATIENTS AND METHODS: Twenty-four patients whose had a total posterior urethral post-traumatic rupture were treated in our department in a stage of urethral strictures. All patients underwent perineal transpubic urethroplasty. In this study we detailed a technique description of the approach and a clinical evaluation of our results. RESULTS: This technique allows having a direct approach of the posterior urethra, to perform a tension free end to end urethral suture. The backward is about 3 years. We assessed 3 cases of recurrent urethral strictures. The cases of erectile dysfunction assessed were mainly related to the initial pelvic trauma. Finally this approach had not orthopaedic squall in all cases. CONCLUSIONS: Comparing to others, the perineal transpubic approach is the best one to manage the posterior urethral injuries treated with late. It gives a satisfactory results with a few disadvantages.

Adolescent↗

[Giant retroperitoneal liposarcoma: report of a case].

Liposarcoma is a rare and primary malignancy developed from mesenchymal tissue. We report the case of a 32-year-old woman who had a complete exeresis of a 15 cm retroperitoneal myxoid liposarcoma. Three months later, a 9 cm local recurrence was excised and radiotherapy was performed. In 2000, a local recurrence and an intestinal localisation of the liposarcoma were observed. The retroperitoneal tumor could not be removed and she had an intestinal resection followed by chemotherapy. With the literature data, we review the pathological, therapeutic and prognostic aspects of this tumor.

Adult↗

Hydatid cyst of the kidney: diagnosis and treatment.

Renal echinococcosis is relatively uncommon compared to liver and lung localizations. Kidney involvement represents 4% of confirmed cases of hydatid disease. We reviewed the clinical findings of a personal series of renal hydatidosis with emphasis on diagnostic and therapeutic issues. A total of 178 renal cysts were collected over a period of 33 years from 1963 to 1996. Clinical, radiologic and laboratory data are analyzed. Radiologic exploration has had an interesting evolution, with the appearance of ultrasonography and computed tomography. Diagnostic accuracy has been greater since the availability of ultrasonography and immunologic studies. Their contribution to the diagnosis of renal hydatid disease is important. We try, with our experience of ultrasonography in the matter of renal hydatid cysts, to underline the role of this exploration. The treatment of hydatid cyst of the kidney is surgical. Renal-sparing surgery, cystectomy plus pericystectomy, is possible in most cases (75%). Nephrectomy (25% of cases) must be reserved for destroyed kidneys resulting from aged cysts opening into the excretory cavities and complicated by renal infection. Whether conservative or radical, the first surgery performed is cystectomy, with germinate membrane removal after controlled evacuation and opening of the cyst, making the subsequent steps of surgery easier.

Adolescent↗

[Kidney oncocytoma. Report of 7 cases].

Renal oncocytoma has some particularities in diagnosis and prognosis. We report a retrospective study performed between 1987 and 1999 at the department of Urology of Charles Nicolle's Hospital. Seven oncocytoma are found out of 120 renal carcinoma. Features at sonography or CT scan or arteriography can not suggest oncocytoma. The diagnosis is made at the pathology examination. Renal oncocytoma is a benign tumor. Conservative surgery will be performed as possible.

Adenoma, Oxyphilic↗

[Retroperitoneal ganglioneuroma. Report of a case].

Retroperitoneal ganglioneurom is a primitive, rare and benign tumor originating in the neural sheath. We report the case of a 27-years old man. An abdominal sonography had revealed accidentally a 60 mm, well demarcated tumor. The left renal vein was compressed an forced back. This tumor was located in front of and internal to the left kidney. The CT scan confirmed this tumor. A left subcostal laparotomy was done. The tumor was soft and movable. A total exeresis was performed. The pathology examination had conclude in a benign ganglioneuroma. The follow-up was six years and half. Retroperitoneal ganglioneuroma is a benign tumor with a good prognosis. The treatment is surgical.

Adult↗

[Xanthogranulomatous orchitis. Report of 7 cases].

The xanthogranulomatosis orchiepididymititis is a benign and a rare disease. Its etiology is unknown. It creates diagnosis, therapeutic and etiological problems. The diagnosis is hardly made because of the variability of the clinical findings. The confusion is mainly made with a malignant tumor, and sometimes with a simple orchiepididymitis. Orchidectomy is usually performed. We report seven cases of orchiepididymitis characterized by their antibiotherapeutic resistance, the destruction of the testis which needed a surgical removal. The diagnosis is established after the histological study of the testis. The etiology is not yet known. The authors study the clinical evolution and therapeutic characteristics of our serial comparing with the literature data.

Adult↗

[Retroperitoneal schwannoma. Case report].

Retroperitoneal schwannoma is a rare tumor originating in the neural sheath. We report the case of a 48 year-old women. She had a ten year history of lumbal pain. The abdominal sonography had revealed a left retroperitoneal tumor that compresses the left renal cavities. The abdominal CT scan visualized a 56 mm, homogenous, well demarcated, retroperitoneal mass with a low attenuation. This mass with multiple enhanced septa is separated from the left adrenal gland. The diagnosis of a cystic lymphangioma is made. We perform surgical exeresis of the tumor by a left lumbal laparotomy. The pathology examination concludes in an altered schwannoma with Antoni B patterns. Retroperitoneal schwannoma is a primary neural benign tumor with a good prognosis. The management is surgical.

Back Pain↗

[Thrombosis of the renal transplant vein].

In this study, three cases have been reported of renal transplant vein thrombosis, which is a rare complication associated with renal transplant. The positive diagnosis is frequently made at a later date, and is established by Doppler ultrasonography. The prognosis is poor. Only an early diagnosis and immediate surgical investigation can possibly save the transplant. To reduce the incidence of renal transplant vein thrombosis, donors should be carefully screened for potential risk factors; the transplant technique should be completely mastered; and postoperative anticoagulant treatment, including further studies in this regard, may help to prevent this complication in at-risk patients. At present, however, the graft generally has to be removed.

Child↗

[Retroperitoneal neuroblastoma in the adult: case report and review of the literature].

Retroperitoneal neuroblastoma is a rare embryonic tumor of the sympathetic nervous system that is specific to the child. In this study, the case is reported of an infant who underwent median laparotomy at the age of 14 months for a tumor which occupied the left half of the abdomen. The lesion was large, hard, and not very mobile. It was considered to be unresectable, and the histological findings after biopsy showed it to be a neuroblastoma. Radiotherapy was then initiated, which successfully reduced the tumor size. A second investigation at the age of three years detected an unresectable tumor of 5 cm. A further biopsy was performed, and the histological findings showed the lesion to be a partially developed ganglioneuroblastoma. The patient has been followed up regularly by ultrasonography which has shown no increase in tumor size. She is now 20 years old, and is asymptomatic. The last computed tomography scan visualized a 62-mm retroperitoneal mass with no metastases. Surgery was decided against in favor of regular monitoring. This case is particular due to the prolonged survival of the patient, regression of histological stage, and reduction in size of the tumor after radiotherapy. It is remarkable that the diagnosis of neuroblastoma was made when the patient was 14 months old, and that she is still alive at 20 years old.

Adult↗

[Isolated, spontaneous hematoma of the kidney. Report of 2 cases].

Spontaneous hematoma under the renal capsula is a rare pathology. The authors report two cases with one male and one female aged respectively of 50 and 63 years. The symptomatology is presented by right renal aches associated with repetitive and total hematuria in male and atypical abdominal aches in female. The radiological explorations (IVP, renal sonography and Computered Tomography) had conclude in a renal cancer in the two cases. The diagnosis is made by the pathologic study. Some etiology may be searched such as malignant tumor, an angiomyolipoma, vascular abnormalities and disturbance to the hemostasis. If no etiology is find, a nephrectomy or a simple supervision can be discussed.

Adult↗

[Therapeutic aspects of renal abscess. Report of 50 cases].

INTRODUCTION: Renal abscess often raises therapeutic problems. Based on their experience and a review of the literature, the authors propose a treatment plant for renal abscess. MATERIAL AND METHODS: The authors report 50 cases of renal abscess treated between January 1988 and September 1999 in the Department of Urology of Charles Nicolle Hospital in Tunis. The diameter of the abscess was less than or equal to 4 cm in 19 cases, between 4 and 10 cm in 29 cases and greater than 10 cm in 2 cases. Renal ultrasound and intravenous urography are an integral part of the initial morphological assessment. All patients were treated by intravenous antibiotics for a mean duration of 28 days. Complementary percutaneous drainage of the abscess was indicated in 25 patients. Surgical treatment was indicated in 13 patients in the presence of a large perirenal collection or severe sepsis, or following failure of percutaneous drainage. RESULTS: Antibiotics alone were proposed in only 17 patients with an abscess less than 4 cm in diameter and 90% of these patients were cured. Percutaneous treatment was performed in 25 patients with an 80% success rate; the other patients underwent open surgery. One patient died after surgery in a context of septic shock despite salvage nephrectomy. The other patients has a favourable outcome. CONCLUSION: The treatment of renal abscess is based on antibiotics alone or combined with a percutaneous or surgical drainage procedure depending on the size of the abscess and the clinical course. The authors describe their decisional flow-chart.

Abdominal Abscess↗

[Intrauterine device migrating to the bladder].

Transuterine migration of an intrauterine contraceptive device (IUCD) is a rare complication. The authors report a case of IUCD which migrated into the bladder and subsequently became calcified. This 34-year-old woman had been fitted with an IUCD for 4 years. She presented an unwanted pregnancy and signs of disabling cystitis at the end of pregnancy. The diagnosis of migration of the IUCD into the bladder with secondary calcification was suggested on the plain abdominal x-ray and on ultrasound and was confirmed by cystoscopy. Ballistic lithotripsy of the bladder stone with endoscopic extraction of the IUCD was then performed.

Adult↗

[Retrovesical and retroperitoneal extrarenal hydatid cyst: descriptive study of 9 cases].

OBJECTIVE: To determine the clinical, radiological and surgical features of retrovesical, retroperitoneal hydatid cyst and to discuss the aetiology and pathogenesis. MATERIAL AND METHODS: Nine cases of hydatid cyst operated in the urology department of Charles Nicolle hospital in Tunis between 1982 and 1998 were reviewed: five retroperitoneal sites and 4 retrovesical sites. RESULTS: Retrovesical and retroperitoneal sites represent about 10% of all operations for hydatid cyst in our department. The mean age of our patients was 49.8 years. The clinical presentation was dominated by voiding disorders in the cases of retrovesical hydatid cyst (4 cases) and the appearance of a lumbar or abdominal mass with or without associated abdominal pain in the cases of retroperitoneal hydatid cyst (5 cases). The positive diagnosis was based on abdominopelvic ultrasonography, completed by computed tomography in 3 patients. All patients were treated by wide cyst resection with a favourable course and no recurrence. CONCLUSION: Retrovesical and retroperitoneal hydatid cysts are rare, but not exceptional in a country with a high endemic rate, such as Tunisia. The diagnosis can be confirmed by radiological investigations. Implantation of the hydatid larva is essentially haematogenous. However, secondary implantation in the pouch of Douglas of protoscolex derived from rupture of an intraperitoneal cyst can also be responsible for some retrovesical sites.

Adult↗