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.
Granulosa cell tumors belong to the group of stromal and sex cord tumors of the ovary. The adult type is the most common type and usually occurs during the perimenopausal period while the juvenile type mostly affects young women. This is a report of a 26 years old woman who presented an adult type of granulosa cells tumor, with review of the literature. She complained abdominal pain and distension associated with abundant ascites and underwent a right adnexectomy. The pathology examination diagnosed an adult granulosa cell tumor. The two entities of granulosa cell tumors (juvenile and adult types) are distinguished by their characteristic morphological aspects on histological examination allowing diagnostic orientation.
Among the disorder sexual development which regroups several pathological entities, true hermaphroditism or Ovotestis disorder remains a rare variety. We report a case of true hermaphroditism, diagnosed at the age of 15 years. Despite the presence of sexual ambiguity at birth, the female gender has been declared. The presence of a female genital tract and secondary sexual characteristics has led the choice of scrotal excision. The surgical procedure, the histological study bestow the positive diagnosis and allowed to revise the sexual ambiguity.
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.
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