No abstract

No abstract

Background: Ovarian fibroma is a very unusual epithelial tumor representing less than 1% of all ovarian tumors. It can be asymptomatic and discovered during surgery or be associated with a pleural effusion preferentially located on the right side and a more or less abundant free ascites in the framework of the so-called Meigs syndrome. The challenge of management then lies in distinguishing benign from malignant since clinically, radiologically, and biologically everything points towards malignant which requires radical surgical treatment. We report here the case of a 69-year-old postmenopausal patient with a clinical form of Meigs' syndrome that strongly suggested ovarian cancer. Case presentation: We hereby report here the case of a 69-year-old patient, menopausal, gravida 4 para 3 with 3 live children delivered vaginally and one miscarriage. She presented with ascites, hydrothorax, and a solid tumor of the ovary. Serum CA 125 and HE 4 levels were very high. ROMA score was highly suggestive of malignancy. A hysterectomy with adnexectomy was performed. It was only the histological evidence of ovarian fibroma and the rapid resolution of its effusions that confirmed Meigs syndrome. Conclusion: Meigs syndrome is an anatomical-clinical entity that associates a benign tumor of the ovary, ascites, and hydrothorax. Highly elevated CA 125 and HE-4 tumor markers often point clinicians toward a malignant tumor and compel radical surgical treatment. This case report reminds us once again that only histology confirms the diagnosis of cancer.

Background: Non-puerperal uterine inversion (NPUI) is a rare gynecological affection whose scarcity makes its diagnosis challenging. Uterine inversion may be -acute- most seen in obstetrics as a complication of the third stage of labor or- chronic- due to uterine benign or malign tumors. Case report: We proffer two cases of non-puerperal uterine inversion presenting to our emergency department complaining of a protruded mass through the vagina outside the introitus. The first one outlays the second reported case - to our knowledge- in a patient without sexual experience of a uterine inversion due to a leiomyosarcoma, presenting in an acute state, leading to hemorrhagic shock. The second case occurs after recurring uterine inversions due to a known submucosal myoma. Both diagnoses relied on physical examination where not being able to palpate the uterus was the cornerstone of clinical suspicion. Using ultrasound as imaging investigation was pivotal to confirming the diagnosis and an etiology, uterine tumors. For different reasons, both patients underwent transvaginal hysterectomy. Conclusion: NPUI is a complicated clinical condition where the diagnosis is often exacting. If accurately and timely managed, it has an excellent prognosis. It’s very important to define the tumor’s histopathological profile before choosing one of the underlining known surgical and non-surgical procedures. However, taking into consideration fertility and the patient’s desire should be mandatory before deciding on any course of action.

Background: Congenital toxoplasmosis results from vertical transmission of the Toxoplasma gondii parasite from mother to fetus after a primary maternal infection. The risk of fetal contamination is higher the later the term of maternal infection. Conversely, the risk of severe fetal infection decreases with term; third trimester infections are most often asymptomatic at birth.