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Biomedical subjects

M Zitouna

Publications and source records attributed to M Zitouna.

At least 19 recordsLinked to original sources

[Rhinocerebral mucormycosis: A case report].

Mucormycosis is a rare and acute fungal infection which is frequently lethal, usually observed in non-controlled diabetic patients. The infection usually begins in the nose but it can invade the lung, the digestive tract, and the skin. Rhinocerebral mucormycosis accounts for 40 to 49% of mucormycosis cases. We report the case of a 53-year-old diabetic man, with chronic renal failure, presenting with rhinocerebral mucormycosis. Our patient was treated by an association of amphotericin B and surgical debridement. This observation provides on opportunity to recall clinical, histopathological, and therapeutic aspects of rhinocerebral mucormycosis.

Brain Diseases↗

[Three cases of cutaneous blastomycosis].

Blastomycosis is a rare mycotic infection in Africa. Isolated cutaneous disease is extremely rare. We report three cases of cutaneous blastomycosis confirmed by istologic and mycologic examination. No visceral involvement was found. Blastomycosis is rare in Tunisia. The most common site of involvement is the lung. The three cases reported presented with skin involvement only, suggesting a cutaneous inoculation of Blastomyces dermatitidis. The diagnostic criteria of cutaneous blastomycosis are discussed.

Adolescent↗

[Pseudotumoral gastric amyloidosis].

INTRODUCTION: Localized gastric amyloidosis is rare. It should be considered in differentiation of gastric tumors, in which biopsy is the only means to confirm the diagnosis. CASE REPORT: A 56-year old male patient presented dysphagia and vomiting. A plastic linitis was suggested by endoscopic ultrasonography. Total gastrectomy and clearance of perigastric lymph nodes were performed. The postoperative pathological diagnosis determined the lesion to be localized gastric amyloidosis and no malignant tumor was found. No sign of recurrence has been found one year after surgical resection. DISCUSSION: Currently, surgical resection of pathological tissue and circumambient lymph nodes may be a preferable therapeutic strategy for the localized amyloidosis to prevent possible complications.

Amyloidosis↗

[Malignant cerebellar ganglioglioma. A case report and review of the literature].

Ganglioglioma is usually a well differentiated slowly growing mixed neuronal and glial neoplasm corresponding to WHO grade I or II. However, some gangliogliomas are considered to be WHO grade III because they exhibit anaplastic features in their glial component. Finally there are exceptionally rare cases of newly diagnosed gangliogliomas with grade IV changes in the glial component. We report a case of a 25-year-old woman with a family history of neurofibromatosis who presented initially with a World Health Organization grade IV anaplastic ganglioglioma (a mixed ganglion cell multiform tumor glioblastoma). Despite aggressive management, the patient died of disease in a relatively short period. Histologically, two cell populations were noted: a predominant glial component consisting in a multiform glioblastoma and ganglion cells supporting a diagnosis of ganglioglioma. Immunohistochemical analysis clearly distinguished the two tumor cell populations. Although other cases of grade III gangliogliomas and twelve cases of grade IV gangliogliomas have been reported, the present case is exceptional in that, to our knowledge, it is the second case of a patient who presented initially with a composite grade IV ganglioglioma and who was clinically followed up to the time of death. This case allows direct comparison between the histological findings in a multiform glioblastoma and a ganglioglioma. It also documents the aggressive biologic behavior of this complex neoplasm.

Adult↗

[Bone metastasis from a glioblastoma: An unusual course!].

Extraneural diffusion of glioblastoma is very unusual. Extracranial metastases generally occur after craniotomy or a long survival time. Metastases usually involve the lungs, pleura, lymph nodes and occasionally the bone. We report herein a case of bone dissemination occurring 18 month after the initial diagnosis and treatment of supratentorial glioblastoma.

Adult↗

Intracerebellar granulocytic sarcoma. A case report.

Granulocytic sarcoma is a form of extramedullary leukaemia. The intraparenchymal localisation is extremely rare. We report a case of cerebellar granulocytic sarcoma occuring in a 43 years old woman without any precedent medical history. The diagnosis of granulocytic sarcoma was established by neoplastic cells findings through morphological and immunohistochemical studies. The patient died few days after surgery. There are still no conclusive treatment strategies for this entity; however, early antileukemic chemotherapy seems to lower the probability of developing systemic disease and thus prolong survival.

Adult↗

Imaging features of spinal epidural cavernous malformations.

Cavernous angioma or cavernoma is a vascular malformation that may affect any area in the neuraxis. Epidural location is very rare and therefore seldom considered in the differential diagnosis of spinal cord compression. We report two cases of epidural cavernous angiomas. The first case is a solitary and purely epidural dorsal cavernous angioma without foraminal expansion or bone modification causing spinal cord compression in a 35 year old woman. The second case is a solitary epidural dorsal cavernous angioma with foraminal extension causing spinal cord compression in a 56 year old woman. Histological confirmation is available for both cases. We describe the MRI features of this lesion insisting on its differential diagnosis on imaging.

Adult↗

[Idiopathic granulomatous hypophysitis: clinical apppearance and imaging].

Idiopathic granulomatous hypophysitis is a chronic inflammation of the pituitary gland. It is a rare occurrence and is diagnosed only on pathologic examination. We report a case of a 23-year-old female patient presenting with polyuria and polydipsia associated with a pituitary failure and hyperprolactinemia. MRI study showed a space occupying lesion of the pituitary gland with a marked enhancement after gadolinium injection. Pituitary biopsy was consistent with the diagnosis of idiopathic granulomatous hypophysitis. The aim of this work is to discuss the different clinical and radiological aspects of the disease with a special emphasis on differential diagnosis.

Adult↗

[Endometrial adenofibroma].

We report a case of papillary adenofibroma of the uterine corpus in a 31 year-old woman who was initially examined for vaginal bleeding. Pelvic examination showed a large polypoid mass protruding through the cervix canal. A pelvic ultrasound revealed a polypoid cystic mass apparently arising from the uterus. A polypectomy was performed. The tumor was composed histologically by begin epithelial and mesenchymal components. Uterine adenofibroma is a extremely rare tumor which considered to be a mixed tumor of Müllerian origin. This lesion appears to be clinically and histologically benign but must be differentiated from other malignant lesions of the uterus, particularly from the adenosarcoma.

Adenofibroma↗

[Primary localized bronchopulmonary amyloidosis].

A 56-year-old patient with an uneventful history was hospitalized for investigation of recent dypnea. The physical examination was normal and chest X-ray showed localized interstitial lesions in the upper right lobe. Endoscopy showed evidence of diffuse infiltration of the bronchial mucosa and narrowing of the lumen. Transbronchial histology showed evidence of bronchopulmonary amyloidosis. There were no signs of extrapulmonary localizations. Search in other organs was negative demonstrating the primary nature of the lung disease. Primary bronchopulmonary amyloidosis is rarely encountered.

Amyloidosis↗

[Tumors of the ceruminous glands].

Tumors of ceruminous glands, called "ceruminoma" are rare. They arise from the ceruminous glands of the external auditory canal. They realise a group of glandular tumors diversified in histologic pattern and prognosis. Three patients with ceruminous gland tumors are reported: one case of ceruminous adenoma, one case of adenocarcinoma and adenoid cystic carcinoma in the third one.

Adenocarcinoma↗

[Ileal perforation in 3 cases of Behçet disease].

Digestive manifestations are uncommon in Behçet's disease. The authors reported 3 male patients between 20 and 30 years with Behçet's disease who developed surgical abdomen. Emergency surgical intervention found perfored ileal ulceration. Histological study of resection piece showed mainly intestinal angitis with periphlebitis, venous thrombosis and obliterant endarteritis.

Acute Disease↗

[Analysis of placenta accreta risk factors. 8 case reports].

The authors report 8 cases of placenta accreta during a 7-year period between March 1986 and January 1992. There were 72,399 deliveries at the Rabta Tunis Maternity and Neonatalogy Centre during this same period, i.e. a rate of 0.11%. Risk factors were dominated by multiparity (7 cases), uterine scars (7 cases) and placenta praevia (5 cases). Associated rupture of the uterus was seen in 2 cases. There was no ultrasonographic diagnosis of placenta accreta before delivery. The diagnosis invariably made at the time of delivery was confirmed histologically in all cases. Hysterectomy was performed in 7 cases and a partial resection of the uterine horn in 1 case. Maternal mortality was nil. There was perinatal mortality in 4 cases, linked twice to prematurity and twice to hypoxia secondary to severe hemorrhage. Analysis of these 8 cases and a review of the literature form the basis of a discussion of the epidemiological profile and clinical and paraclinical characteristics of this condition and an evaluation of foeto-maternal prognosis.

Adult↗

[Malignant rhabdoid tumor of the central nervous system. Apropos of a case with immunohistochemical and ultrastructural studies, and review of the literature].

The authors report a new case of cerebral malignant rhabdoid tumour in an eight year old girl. The diagnosis was confirmed on immunohistochemical and ultrastructural examinations showing cytoplasmic perinuclear inclusions composed of whorled filaments of vimentin. Base on a review of six cases reported in the literature, they analyse the clinical, histological, immunohistochemical and ultrastructural features of this exceptional central nervous system neoplasm. Different histogenetic hypotheses are discussed.

Brain Neoplasms↗