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Hedfi M, Ben Ismail I, Zenaidi H, Bouslama S, Zoghlami A. Primary Ewing sarcoma of the liver: Diagnosis, management, and prognosis: A case report and literature review. Clin Case Rep 2022; 10:e6508. [PMID: 36381031 PMCID: PMC9647335 DOI: 10.1002/ccr3.6508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 09/04/2022] [Accepted: 10/08/2022] [Indexed: 11/11/2022] Open
Abstract
Ewing's sarcoma tumors (ES) are a rare entity exceptionally localized on the liver. We report a case of an ES of the liver in a 26‐year‐old man who presented with abdominal pain. The diagnosis was confirmed with a histopathological examination of the left hepatectomy specimen and adjuvant chemotherapy was received.
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Affiliation(s)
- Mohamed Hedfi
- Department of General Surgery, Zaghouan Regional Hospital University of Tunis El Manar Tunis Tunisia
| | - Imen Ben Ismail
- Department of General Surgery, Trauma and Burns Center University of Tunis El Manar Tunis Tunisia
| | - Hakim Zenaidi
- Department of General Surgery, Zaghouan Regional Hospital University of Tunis El Manar Tunis Tunisia
| | - Sirine Bouslama
- Department of Pathology, Zaghouan Regional Hospital University of Tunis El Manar Tunis Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Trauma and Burns Center University of Tunis El Manar Tunis Tunisia
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2
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Ben Ismail I, Sghaier M, Zenaidi H, Zoghlami A. Intracystic Haemorrhage of a Simple Liver Cyst Secondary to Vitamin-K Antagonist Overdosage. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03381-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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3
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Ben Ismail I, Zenaidi H, Sghaier M, Rebii S, Zoghlami A. Cholecystitis in a midline gallbladder: A rare ectopic location. Int J Surg Case Rep 2022; 93:106969. [PMID: 35364394 PMCID: PMC8968061 DOI: 10.1016/j.ijscr.2022.106969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/15/2022] [Accepted: 03/24/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction The ectopic gallbladder is an uncommonly encountered anomaly that surgeons should be aware of. Its diagnosis is difficult but can be elucidated with the use of computed tomography and MRCP. Presentation of case We present a case of a 64-year-old patient who presented with abdominal pain, inflammatory epigastric mass and fever. Computed tomography (CT) revealed the presence of a para-umbilical gallbladder with signs of acute cholecystitis. Laparoscopic exploration revealed that the gall bladder was not present in its usual fossa but was seen attached to the midline anterior abdominal wall with extensive adhesion between it and the omentum. Given the complexity of the cholecystectomy via the laparoscopic approach, a conversion to a midline incision was performed. The IOC confirmed the absence of anatomical variants of the biliary tree. Discussion An ectopic gallbladder is a difficult entity to diagnose as it can create clinical confusion by tampering with the common clinical presentation of cholecystitis. MRCP is currently one of the most effective preoperative examination methods as it detects the coexistence of biliary tract variation. Laparoscopic surgery is a safe procedure to be performed in the ectopic gallbladder. Conclusion Ectopy of the gallbladder is a rare congenital abnormality that should be kept in mind to avoid errors or delays in management. Ectopic gallbladder is an extremely rare condition. Ectopy of the gallbladder may lead to clinical misdiagnosis, imaging misinterpretation and technical challenges. Pre-operative imaging is needed to detect the coexistence of biliary tract variation.
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Ben Ismail I, Rebii S, Zenaidi H, Zoghlami A. Acute pancreatitis secondary to ansa pancreatica: Two new cases and review of the literature. Clin Case Rep 2022; 10:e05381. [PMID: 35136610 PMCID: PMC8807883 DOI: 10.1002/ccr3.5381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 04/24/2021] [Accepted: 12/24/2021] [Indexed: 11/07/2022] Open
Abstract
We described two cases of acute pancreatitis secondary to ansa pancreatica. The first patient was diagnosed on MRCP and improved after standard treatment of AP. In the second case, ansa pancreatica was diagnosed on IOP. At the second episode of AP, sphincterotomy of the minor papilla was performed.
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Affiliation(s)
- Imen Ben Ismail
- Department of general surgeryUniversity of Tunis El ManarTrauma centerBen ArousTunisia
| | - Saber Rebii
- Department of general surgeryUniversity of Tunis El ManarTrauma centerBen ArousTunisia
| | - Hakim Zenaidi
- Department of general surgeryUniversity of Tunis El ManarTrauma centerBen ArousTunisia
| | - Ayoub Zoghlami
- Department of general surgeryUniversity of Tunis El ManarTrauma centerBen ArousTunisia
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5
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Ben Ismail I, Zenaidi H, Jouini R, Rebii S, Zoghlami A. Pedunculated hepatic focal nodular hyperplasia: A case report and review of the literature. Clin Case Rep 2021; 9:e04202. [PMID: 34136232 PMCID: PMC8190514 DOI: 10.1002/ccr3.4202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 02/21/2021] [Accepted: 04/12/2021] [Indexed: 11/24/2022] Open
Abstract
Focal nodular hyperplasia (FNH) is a common asymptomatic benign hepatic tumor encountered in middle-aged women. However, pedunculated FNH is exceedingly rare and more frequently associated with complications. That is why surgical management is mandatory in this form.
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Affiliation(s)
- Imen Ben Ismail
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
| | - Hakim Zenaidi
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
| | - Raja Jouini
- Department of PathologyHabib Thameur HospitalUniversity of Tunis El ManarTunisTunisia
| | - Saber Rebii
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
| | - Ayoub Zoghlami
- Department of General SurgeryTrauma Center Ben ArousUniversity of Tunis El ManarTunisTunisia
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6
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Ben Ismail I, Rebii S, Zenaidi H, Zoghlami A. Laparoscopic Cholecystectomy for Acute Cholecystitis in a 30-Week Pregnant Woman with True Left-Sided Gallbladder. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02712-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Hedfi M, Zenaidi H. Appendicite sur appendice diverticulaire: à propos d’un cas. Pan Afr Med J 2021; 40:253. [PMID: 35251447 PMCID: PMC8856982 DOI: 10.11604/pamj.2021.40.253.32464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022] Open
Abstract
Diverticulum of the appendix is defined as the existence of diverticulum (s) arising from the cecal appendix resulting in polymorphic clinical manifestations characterized by infection of the appendix and the periappendicular region. We here report the case of a 28-year-old female patient without a significant medical history, presenting to the Emergency Department with fever, right iliac fossa pain associated with vomiting. Clinical examination showed a temperature of 38.5°C, clear susceptibility of the right iliac fossa with positive Blumberg sign and right rectal pain on touch. Differential diagnoses of urinary tract infection were excluded based on negative cytobacteriological examination of the urine. Other diagnoses, such as Crohn´s disease and colon cancers, were also excluded based on patient´s history and context. The diagnosis of acute appendicitis was made and the patient underwent coelioscopy that revealed internal laterocecal appendix with phlegmon and two diverticules at the tip and body of the appendix (A: a coelioscopic view of the appendix phlegmon, seat of the diverticulum). Appendicectomy was performed (B: macroscopic view of the appendix showing the diverticula) without incident. Histological examination showed acute appendicitis with uncomplicated diverticulitis. The postoperative course was uneventful.
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Affiliation(s)
- Mohamed Hedfi
- Service de Chirurgie Générale, Hôpital Régional de Zaghouan, Zaghouan, Tunisie
- Auteur correspondant: Mohamed Hedfi, Service de Chirurgie Générale, Hôpital Régional de Zaghouan, Zaghouan, Tunisie.
| | - Hakim Zenaidi
- Service de Chirurgie Générale, Hôpital Régional de Zaghouan, Zaghouan, Tunisie
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Ben Ismail I, Zenaidi H, Rebii S, Zoghlami A. Tricky diagnosis of a primary gluteal hydatid cyst. ANZ J Surg 2020; 91:1625-1626. [PMID: 33290633 DOI: 10.1111/ans.16475] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/20/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Imen Ben Ismail
- Department of General Surgery, Trauma and Burns Center, The University of Tunis El Manar, Ben Arous, Tunisia
| | - Hakim Zenaidi
- Department of General Surgery, Trauma and Burns Center, The University of Tunis El Manar, Ben Arous, Tunisia
| | - Saber Rebii
- Department of General Surgery, Trauma and Burns Center, The University of Tunis El Manar, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Trauma and Burns Center, The University of Tunis El Manar, Ben Arous, Tunisia
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9
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Zenaidi H, Ismail IB, Rebii S, Zoghlami A. Predictors of Failure of Nonoperative Management in Spleen Trauma. J Emerg Trauma Shock 2020; 13:319-320. [PMID: 33897154 PMCID: PMC8047952 DOI: 10.4103/jets.jets_60_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/25/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hakim Zenaidi
- Department of General Surgery, Traumatology and Severe Burns Center, Ben Arous, University of Tunis El Manar, Tunis, Tunisia
| | - Imen Ben Ismail
- Department of General Surgery, Traumatology and Severe Burns Center, Ben Arous, University of Tunis El Manar, Tunis, Tunisia
| | - Saber Rebii
- Department of General Surgery, Traumatology and Severe Burns Center, Ben Arous, University of Tunis El Manar, Tunis, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Traumatology and Severe Burns Center, Ben Arous, University of Tunis El Manar, Tunis, Tunisia
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10
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Ben Ismail I, Zenaidi H, Rebii S, Yahmadi A, Zoghlami A. Chilaiditi's sign: A rare differential diagnosis of pneumoperitoneum. Clin Case Rep 2020; 8:3102-3104. [PMID: 33363889 PMCID: PMC7752635 DOI: 10.1002/ccr3.3346] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 08/14/2020] [Accepted: 08/18/2020] [Indexed: 11/29/2022] Open
Abstract
Chilaiditi sign is a rare condition typically mistaken for pneumoperitoneum. CT scan can confirm the diagnosis. Its management is conservative that is why it should be well known by surgeons to avoid unnecessary exploratory laparotomies.
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Affiliation(s)
- Imen Ben Ismail
- Department of General Surgery Trauma and Burns Center Ben Arous Tunisia
| | - Hakim Zenaidi
- Department of General Surgery Trauma and Burns Center Ben Arous Tunisia
| | - Saber Rebii
- Department of General Surgery Trauma and Burns Center Ben Arous Tunisia
| | | | - Ayoub Zoghlami
- Department of General Surgery Trauma and Burns Center Ben Arous Tunisia
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Abstract
Gallbladder agenesis (GA) is a rare congenital malformation characterized by the absence of the gallbladder and cystic duct due to an anomaly in the embryonic development. It is commonly associated with other congenital abnormalities, and the isolated form is extremely rare. Its clinical presentation is variable. Actually, GA is more often incidentally diagnosed. Magnetic resonance cholangiopancreatography (MRCP) is considered to be the diagnosis method of choice since it avoids unnecessary and risky surgery in symptomatic patients. Here we report the case of a radiologically incidentally discovered gallbladder agenesis in a 68-year-old patient.
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Affiliation(s)
- Imen Ben Ismail
- Department of General Surgery, University of Tunis El Manar, Traumatology and Severe Burns Centre, Ben Arous, Tunisia
| | - Saber Rebii
- Department of General Surgery, University of Tunis El Manar, Traumatology and Severe Burns Centre, Ben Arous, Tunisia
| | - Hakim Zenaidi
- Department of General Surgery, University of Tunis El Manar, Traumatology and Severe Burns Centre, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, University of Tunis El Manar, Traumatology and Severe Burns Centre, Ben Arous, Tunisia
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12
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Zenaidi H, Ismail IB, Rekik F, Aziz M, Rebii S, Zoghlami A. Large pedunculated colonic lipoma: a rare cause of colorectal intussusception in adults. Pan Afr Med J 2020; 36:200. [PMID: 32952844 PMCID: PMC7467618 DOI: 10.11604/pamj.2020.36.200.24606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 07/02/2020] [Indexed: 12/03/2022] Open
Abstract
Colo-rectal intussusception is rare in adults and is often secondary to malignant lesions, rarely benign lesions such as colonic lipomas can also be the cause. We present the case a 60-year-old man who presented to the emergency department with acute abdominal pain. On physical examination, the abdomen was distended with diffuse tenderness. CT scan of the abdomen revealed a colo-rectal intussusception secondary to a rectal lipoma with parietal pneumatosis of the invaginated loop. An emergency laparotomy was performed. Intraoperatively the radiological findings were confirmed. A rectosigmoid resection (Hartmann's procedure) taking off the lipoma and the invaginated segment of the colon was performed and the patient had an unevent full recovery. Histopathology confirmed a 6cm sub-mucosal lipoma without evidence of malignancy. As the diagnosis of a benign disease in patients presenting with colonic intussusception can only be made on pathological examination, this entity should be managed as a malignant lesion due to the high incidence of malignancy.
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Affiliation(s)
- Hakim Zenaidi
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Imen Ben Ismail
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Fatma Rekik
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Mouelhi Aziz
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Saber Rebii
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia
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Ben Ismail I, Zenaidi H, Khanchel F, Rebii S, Zoghlami A. Actinomycosis: A rare etiology of chronic appendicitis in elderly. Int J Infect Dis 2020; 100:180-181. [PMID: 32800856 DOI: 10.1016/j.ijid.2020.08.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 08/03/2020] [Accepted: 08/09/2020] [Indexed: 10/23/2022] Open
Affiliation(s)
- Imen Ben Ismail
- University of Tunis El Manar, Department of General Surgery, Trauma Center Ben Arous, Tunisia.
| | - Hakim Zenaidi
- University of Tunis El Manar, Department of General Surgery, Trauma Center Ben Arous, Tunisia.
| | - Fatma Khanchel
- University of Tunis El Manar, Department of Pathology, Habib Thameur Hospital, Tunisia.
| | - Saber Rebii
- University of Tunis El Manar, Department of General Surgery, Trauma Center Ben Arous, Tunisia.
| | - Ayoub Zoghlami
- University of Tunis El Manar, Department of General Surgery, Trauma Center Ben Arous, Tunisia.
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Abstract
Acute gastric volvulus is a rare condition complicating 4% of hiatus hernias. It is a more or less complete rotation of the stomach around a transverse or longitudinal axis. It can lead to perforations due to ischemic gastric wall necrosis with very poor prognosis (30% of mortality). We here report the case of an 89-year old female patient with chronic bronchopathy, presenting with epigastralgias associated with vomiting which had progressed for 03 days. Physical examination showed febrile patient at 38.5 with dyspnea (SpO2 88% at room air). Her appearence suggested infection, the abdomen was soft, tender at the level of the epigastrium. Laboratory test showed SBI (WBCs= 22000, CRP= 80). Abdominal CT scan showed hiatus hernia associated with significant gastric distension with wall defect in the anterior face of the stomach associated with pneumatosis in the gastric wall. The patient underwent surgery using a median approach, which showed voluminous hiatus hernia containing the greater curvature of the stomach. Distended stomach was restored to its normal intra-abdominal position. The anterior face of the greater tuberosity was the seat of several areas of necrosis. Total gastrectomy with manual oesojejunal anastomosis associated with Roux-en-Y gastric bypass was performed. The postoperative course was complicated by acute respiratory distress syndrome (ARDS). The patient died on day 8 after emergency hospital admission. Gastric volvulus is a rare condition, which can lead to extremely severe consequences. CT scan allows for thoracic lesion assessment and to study stomach vitality. The treatment of choice is based on surgery.
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Affiliation(s)
- Imen Ben Ismail
- Service de Chirurgie Générale, Centre de Traumatologie et des Grands Brulés Ben Arous, Faculté de Médecine de Tunis, Université Tunis El Manar, El Manar, Tunisie
| | - Hakim Zenaidi
- Service de Chirurgie Générale, Centre de Traumatologie et des Grands Brulés Ben Arous, Faculté de Médecine de Tunis, Université Tunis El Manar, El Manar, Tunisie
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15
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Abstract
Groove pancreatitis (GP) is a rare form of chronic pancreatitis involving the groove area bound by the pancreatic head, the duodenum, and the common bile duct. The diagnosis of this entity is challenging since it can mimic pancreatic carcinoma. We herein report the case of groove pancreatitis diagnosed in a 37 year old men, with a past history of chronic alcohol consumption. The patient was admitted for several times over the past three years because of recurrent alcohol-induced pancreatitis. The diagnosis of groove pancreatitis was made on the basis of CT, MRI and EUS findings. A medical treatment was initially attempted. In the absence of improvement in clinical symptoms, a pancreatico-duodenectomy was performed with satisfying results at 24 months follow up. Pancreatico-duodenectomy is the treatment of choice in groove pancreatitis since it leads to total resolution of clinical symptoms.
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Affiliation(s)
- Imen Ben Ismail
- Department of general surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Hakim Zenaidi
- Department of general surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Abdelwahed Yahmadi
- Department of general surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Saber Rebii
- Department of general surgery, Trauma and Burns Center, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- Department of general surgery, Trauma and Burns Center, Ben Arous, Tunisia
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Zenaidi H, Ben Ismail I, Jouini R, Maalej Y, Zoghlami A. Appendicular mass: a rare form of Yersinia pseudotuberculosis. ANZ J Surg 2020; 90:2098-2100. [PMID: 32618049 DOI: 10.1111/ans.16137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/20/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Hakim Zenaidi
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
| | - Imen Ben Ismail
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
| | - Raja Jouini
- Department of Pathology, Habib Thameur Hospital, University of Tunis El Manar, Tunis, Tunisia
| | - Yassine Maalej
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- Department of General Surgery, Trauma and Burns Center, University of Tunis El Manar, Ben Arous, Tunisia
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Abstract
•Hydatid disease is an endemic infection in the Mediterranean region, and Tunisia is one of the most affected countries. •The involvement of the female genital tract is uncommon, and the occurrence in the fallopian tube is extremely rare. •In reproductive organs, the involvement is always secondary. Primary involvement of the fallopian tube is rarely reported.
Hydatid disease is endemic in Tunisia. The involvement of the female genital tract is uncommon, and the occurrence in the fallopian tube is exceptional. We present a case of a 42-year-old woman who had complained of a 4-month history of lower abdominal pain. The abdominal ultrasonography and CT scan showed a multiloculated cystic lesion in the left adnexa. The exploratory laparotomy found a cystic mass developing in the left fallopian tube. Left salpingectomy was performed. The pathological examination confirmed the diagnosis of hydatid cyst disease. No recurrence was detected at the 2-year follow-up. Tubal hydatid cyst is an extremely rare condition that should be considered in the differential diagnosis of any cystic lesion in patients from endemic areas.
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Affiliation(s)
- Imen Ben Ismail
- University of Tunis El Manar, Department of General Surgery, Trauma Center, Ben Arous, Tunisia
| | - Hakim Zenaidi
- University of Tunis El Manar, Department of General Surgery, Trauma Center, Ben Arous, Tunisia
| | - Saber Rebii
- University of Tunis El Manar, Department of General Surgery, Trauma Center, Ben Arous, Tunisia
| | - Ayoub Zoghlami
- University of Tunis El Manar, Department of General Surgery, Trauma Center, Ben Arous, Tunisia
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Imen BI, Zenaidi H, Abdelwahed Y, Sabeur R, Ayoub Z. Management of isolated retroperitoneal Castelman's disease: A case report. Int J Surg Case Rep 2020; 70:24-27. [PMID: 32361607 PMCID: PMC7200444 DOI: 10.1016/j.ijscr.2020.03.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 03/14/2020] [Accepted: 03/27/2020] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Castleman's disease (CD) is a rare disorder characterized by benign angio follicular lymphoid hyperplasia, with gentle behavior. Its etiology and prevalence are unclear. It is usually found in the mediastinal area and it is rare to see this tumor in the retroperitoneum. PRESENTATION OF CASE A 53 year old male with a retroperitoneal hypervascular calcified mass densely adherent to the psoas muscle that was accidentally encountered on a CT scan. Provisional diagnosis of retroperitoneal liposarcoma was made and the patient underwent an exploratory laparotomy. The histologic examination of the surgically resected specimen disclosed « a hyaline type of Castleman's disease ». DISCUSSION Castleman's disease, is a rare heterogenous group of lymphoproliferative disorders that arises mostly in the mediastinum. The retroperitoneal localization is very rare. Clinically, CD can be subdivided into a localized form (unicentric disease) and a generalized form (multicentric disease) according to the number of lymph nodes involved. A careful histological and immunohistochemical examination of the tumor tissue after surgery is the only way for tumor diagnosis. CONCLUSION Castelman's disease is a rare entity that has often benign and non invasive behavior, but remains a diagnostic challenge. There is no reliable diagnostic method and its definitive diagnosis is based on histopathology report. For treating the unicentric variant, radical surgical resection is considered to be the gold standard.
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Affiliation(s)
- Ben Ismail Imen
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Hakim Zenaidi
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Yahmadi Abdelwahed
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Rebii Sabeur
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
| | - Zoghlami Ayoub
- Department of General Surgery, Trauma and Burns Center, Ben Arous, Tunisia.
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