Pregnancy in an abnormal uterus is a high-risk situation in obstetrics. Uterus bicornis unicollis with a rudimentary horn is often discovered incidentally. The aim of this report is to warn obstetricians about recurrent abdominal pain in the second trimester of pregnancy without any cause identified. Pregnancy can proceed in the rudimentary horn. We presented a case of a rupture of the rudimentary horn which occurred at 25 weeks of amenorrhea in an unmarried 19-year-old primigravida. The rudimentary horn was removed after performing an emergency laparotomy for an intraperitoneal hemorrhage with signs of shock. This abnormality is often revealed by uterine rupture, which usually occurs in the second trimester of pregnancy. Conclusion: We emphasize the importance of early diagnosis of this uterine abnormality, before pregnancy if possible. Undiagnosed, this condition evolves towards uterine rupture during pregnancy and requires emergency surgery with excision of the rudimentary horn.
Malignant melanomas or lymphoma of the skin are malignant tumors of the skin and/or the mucous membranes whose uterine metastases are rare. The secondary uterine localizations, although rare, must be evoked in front of a pelvic tumoral syndrome, or diffuse metastases and a personal past history of melanoma, even after a long time of remission. In our observation, the evolution of the tumor in the pelvis extended to the muscular structures of the uterus and the sigmoid colon of a 72 year old patient, what made it an exceptional case. The diagnosis of these secondary localizations is a diagnosis of elimination, almost always post-operative, made on the histopathological and immunocytochemical study of the surgical specimen, supported by cytogenetics, even molecular biology. The treatment is based on chemotherapy.
The ovary is an organ that can be the site of metastases for many cancers. In general, malignant ovarian tumors are primary; however, cases of extra gynecological metastatic tumors (breast, colon, stomach, and pancreas) have been reported. In most cases, the primary cancers of these ovarian tumors are gastrointestinal or gynecological, the lung being very rarely involved. We report a rare case of ovarian metastases of bronchial cancer discovered during an extensional assessment. The histological examination coupled with immunohistochemistry concludes that ovarian metastasis of small cell lung carcinoma. In addition to chemotherapy such as Taxol-Hycamtin, the management required cerebral radiotherapy for a cerebral metastasis detected.
Spontaneous uterine rupture following a history of surgical treatment of an interstitial tubal ectopic pregnancy (EP) is a rare clinical form. This uterine rupture occurring after a wedge resection of the uterine horn, is a serious obstetric complication involving maternal and fetal vital prognosis and obstetric fate of patients in the absence of immediate management. Our observation concerned a 32-year-old gestant, G3P1 (without living children), with a history of interstitial EP dating back to 3 years during which a uterine wedge resection was performed. For this patient, a prophylactic caesarean was recommended between 36 and 37 weeks of amenorrhea. The patient presented during her prenatal follow-up at 37 weeks and 6 days, a complete uterine rupture involving the right uterine horn with the death of a fetus weighing 2900g. The rupture extended throughout the uterine horn, with the right uterine pedicle intact and the right fallopian tube absent. A conservative treatment of the uterus was decided since the patient had no living children. The purpose of our observation is to recall the risk of uterine rupture after cornual uterine excision hence the importance of performing during a EP if possible, a salpingectomy at the level of the uterine horn and if necessary coagulate the intramural portion of the tube. And also in case of uterine wedge resection, to hasten the prophylactic caesarean section as soon as sufficient maturity of the fetus to reduce the incidence of this pregnancy complication.
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