Necrotizing fasciitis is a rapidly spreading soft tissue infection characterized by extensive necrosis of the deep and superficial fascia. It is a polymicrobial infection in approximately 70% of cases. The infection is serious and fatal due to decompensation of underlying defects and septic shock. The occurrence of this clinical entity in healthy subjects is rare. We report through this observation a case of necrotizing fasciitis with vulvar origin in a 76-year-old patient with a serious medical history.

Cancerization of a cystic teratoma into sebaceous carcinoma is an extremely rare phenomenon. The clinical and radiological aspects are not very specific. We report a case discovered in a 77 year old female patient. Confirmed by anatomopathological examination after excision of the tumor.

Introduction/Background Study of genetic alterations practical interests Understanding the molecular mechanisms of carcinogenesis Genetic risks (hereditary) Inherited mutations: BRCA1, BRCA2, PALB2... Biomarkers in clinical oncology screening diagnostic assistance prognosis prediction of response to treatment Development of new therapeutic approaches (targeted therapies) Methodology Biomarkers : Ability of the test to measure the biomarker with reliability and reproducibility Clinical utility Treatment decision can be based on test result (prospective study with test/objective) Clinical validity Ability of test to correlate with prognosis and/or response prediction (statistical significance) Molecule (protein or gene (DNA or RNA)) that influences tumor cell behavior and can predict prognosis and/or sensitivity/resistance to a specific treatment. Results PERSONALIZED MEDICINE PREVENTIVE STRATEGY personalized screening (example: predisposition to cancer) Prognostic criterion: -Which patient will do well without further treatment (natural history) example: chemo in breast cancer if risk of relapse Predictive criterion: -Which patient will do well with which type of treatment (example: hormone receptor positive and hormone therapy ) Therapeutic target: What molecular abnormality of the tumor can be targeted (example: HER2 overexpression and anti-HER2)? Biomarkers: genomic signatures -early breast cancer RH+/HER2- Prognostic value demonstrated Clinical validity: confirmed in large retrospective cohorts: Clinical utility: prospective evaluation of prognostic value and impact on therapeutic decisions (indication for adjuvant chemotherapy): Predictive criteria Predictive of what? Predictive of treatment efficacy Assumes that the treatment 'works' in certain subgroups and not in others: 'interaction' between the predictive factor and the treatment effect. Examples: Hormone receptors and hormone therapy HER2 and anti-HER2 Conclusion biomarkers Thanks to the development of molecular biology and high-throughput analysis, more and more markers are available to predict treatment efficacy. The 'mapping' of gene anomalies (overexpression, gene mutations) to predict efficacy or resistance to a given targeted therapy is the basis of personalized medicine in oncology. A large number of targeted therapies are thus inseparable from their 'companion' test, a predictor of their possible effect... The measurement of certain predictive 'biomarkers' can be repeated over time (iterative biopsies and/or 'liquid' biopsies) Disclosures The authors declare no conflict of interest.

Angiomyofibroblastoma is a rare benign mesenchymal tumor. Angiomyofibroblastism is a generally painless tumor, most patients consult for the genes caused the tumor in cases where they are large. We report a case of vaginal location of 3 cm in a 67 years old patient discovered during investigation of abnormal uterine bleeding. The patient benefited complete excision of the tumor, surgical hysteroscopy and hysterectomy by surgical laparoscopy. Angiomyofibroblastoma can be associated with a uterine pathology whose intake in charge cannot be dissociated from it.

Intoxication is a frequent reason for consultation in the emergency department, and may be voluntary, with the aim of self-medication, or accidental. However, intoxication in pregnant women is poorly described in the literature, with the majority of reports concerning case histories. This study analyses the epidemiological data on intoxication in pregnant women in the mother and child intensive care unit, describes the various clinical and toxic aspects, describes the management methods and assesses the maternal-fetal prognosis of intoxication in pregnant women.

Introduction/Background The incidence of dysplasia during pregnancy is estimated at 1%, and that of cervical cancer at one in 10,000. Cervical cancer is one of the most frequently observed cancers during pregnancy.the objectives are twofold and sometimes antagonistic: to achieve a level of care that is closer to that of non-pregnant patients, and if possible, to maintain the pregnancy. but recent publications report cases of pregnancy preservation. This must not be to the detriment of the carcinological result. Methodology Patient aged 39, with a history of recurrent post-coital metrorrhagia for 04 years, neglected by the patient, admitted to the emergency department for delivery of a full-term pregnancy, with clinical examination revealing an ulcerating-bourging tumour of the uterine cervix. a caesarean section was performed, and cervical sampling confirmed the diagnosis of squamous cell carcinoma Results The median age of parturients found in the literature was 38 years with extremes of 35 and 42 years and the average clinical size of lesions was 3 cm in diameter in our patient the size of the lesion was 06 cm, Anatomopathological examination showed squamous cell carcinoma. The disease was classified according to the FIGO 2009 classification as IIIB. Treatment consisted of RCC (concomitant radiochemotherapy) after the emergency caesarean section. Conclusion In parturients who have had little or no screening for more than two years, a Pap smear should be taken at the start of pregnancy to detect cervical abnormalities and to make patients aware of the benefits of screening. For dysplastic lesions in the absence of colposcopically-proven invasion, treatment can be deferred to the post-partum period, with close monitoring. In the case of invasive lesions, the work-up should be completed by MRI to better define the size of the lesion. Management will depend on term, stage of lesion and lymph node involvement. Disclosures Authors declare no conflict of interest.

Fbrothecomais a benigntumor of the sexcords of the ovary, from the fibrothecal group. These are rare tumorsthatgenerallyoccur in postmenopausewith a good prognosis and rare cases of fibrothecoma cancer have been reported. We report a case of fibrothecoma in a patient in genitalactivitywithouthistory in the obstetrics and gynecologydepartment CHU Hassa II Fez Morocco. The interest of this case isits occurrence in a patient withgenitalactivity.

Thanatophoric dysplasia is a lethal skeletal dysplasia characterized by marked underdevelopment of the skeleton and short-limbed dwarfism [1]. The child will present with a short neck, narrow chest, and prominent abdomen. Other anatomical features include a relatively enlarged head with frontal prominence, prominent eyes, hypertelorism, and a depressed nasal bridge. Diagnosis is typically established by ultrasound in the second trimester of pregnancy. In this study, we report a case of this rare entity, emphasizing its anatomical characteristics, anomalies, and clinical profile, along with a relevant literature review.

Ovarian non-Hodgkin's lymphoma is an extremely rare tumor. It accounts for 1.5% of ovarian cancers and 0.5% of non-Hodgkin's lymphoma (NHL). It is most often a secondary location of a disseminated lymphomatous disease. We report on a patient managed in the department for this condition.

A lymphoma presenting as an ovarian mass with an initial manifestation is unusual and can cause confusion for the clinician, as its presentation may resemble that of other much more common tumors. Malignant lymphoid cells may appear in the ovary either as a primary neoplasm or as a secondary manifestation of an occult or known disseminated disease. The most common presenting signs or symptoms of malignant lymphomas involving the ovaries are abdominal or pelvic pain or a mass. We report a case of bilateral primary Burkitt lymphoma of the ovaries in a 14-year-old girl presenting with abdominal distension, abdominal pain, hematemesis, and melena. Ultrasound and CT imaging suggested a provisional diagnosis of ovarian tumor. The diagnosis of Burkitt lymphoma was established by histopathological examination of a biopsy from a digestive thickening. The tumor was classified as Burkitt lymphoma with pleural, intestinal, peritoneal, nodal (coelio-mesenteric), renal, ovarian, and bone involvement with medullary infiltration.

Intra uterine device migration is a relatively rare event. The migration of the IUD in the surrounded viscera can be managed by endoscopy approach. Objectives: We reported our experience to determine the epidemiologic characteristics of patients that presented migrated IUD, to report clinical aspects and describe the laparoscopic management. Method: The study includes 10 patients reported to obstetrics and Gynecology I department of UHC Hassan II FES in the last 4 years (2018-2021). In all the patients a gynecological examination, ultrasound evaluation abdomen and pelvis were done to locate the misplaced IUD. If the device was found to be intrauterine, hysteroscopy was done to locate and retrieve device. In those patients in whom the IUD was confirmed to be extrauterine diagnostic laparoscopy was done. Results: The average of age was 34.5 years. Majority of patients were primipara (53.3%) and 46.6% were multipara. As far as timing of insertion is concerned 6 (60%) were postpartum, 4 (40%) were postmenstrual. The average of time interval between insertion and removal is 3, 12 years. Of the 10 misplaced intrauterine devices 4 were found partially embedded in uterine wall and 6 of the misplaced 1UD’s were found deeply embedded in the uterine cavity. After their location they were removed hysteroscopically One patient reported with 8 weeks pregnancy and misplaced IUD. The device was confirmed to be intrauterine on transvaginal sonography. She had full term normal delivery and IUD was removed after 6 weeks hysteroscopically. None of our patient had an extra uterine migration that required a laparoscopy.

Introduction: A relatively new type of ectopic pregnancy is cesarean scar pregnancy (CSP). This is related to the increasing number of cesarean deliveries and to the advances in imaging. There are 2 types of CSP; CSP with progression to cervicoisthmic space or uterine cavity (type I, endogenic type) or with deep invasion of scar defect with progression towards bladder and abdominal cavity (type II, exogenic type). The endogenic type of CSP could result in a viable pregnancy; yet with a high risk of bleeding at the placental site. The exogenic type could be complicated with uterine rupture and bleeding early in pregnancy. As early diagnosis and treatment is important for the best outcome, every pregnant woman with history of cesarean delivery should be screened early in the first trimester of pregnancy. Diagnosis can be achieved with ultrasound and Doppler imaging. To date there have been only 5 randomized studies on CSP and evidence based management remains unclear. Until then, treatment should be individualized according to many factors including clinical presentation, β-hCG levels, imaging features, and the surgeon’s skill. We report a case of cesarean scar pregnancy successfully managed in our university hospital center.

Background: Invasive mole is a subtype of gestational trophoblastic disease (GTD) that usually develops from malignant transformation of trophoblastic tissue after evacuation of the mole. Invasive mole occurs mainly in women of childbearing age, whereas it is extremely rare in postmenopausal women. Observation: This is a 42-year-old cholecystectomized G3P2 patient who was referred for suspected GTD and whose pelvic echo and abdominal-pelvic CT scan revealed a hypervascularized image filling the uterine cavity, invading the myometrium to the serosa without invasion. The patient underwent total interannexal hysterectomy and chemotherapy with satisfactory clinical and biological follow up. Conclusion: Our case highlights the difficulties of diagnosing invasive moles in the absence of a significant history of gestational trophoblastic disease. This study reviews the diagnostic methods, histological features and therapeutic recommendations.

Sertoli Leidig tumors are rare tumors, representing less than 0.5% of ovarian tumors. It is the moderately and poorly differentiated forms which are the most common. We report a case in a 25-year-old female patient with right ovarian localization. The patient underwent right adnexectomy surgery which removed the tumor. The management of these tumors is not good, it is a tumor with a relatively good prognosis due to early diagnosis with a lesion still limited to the ovary.

Breast cancer is a serious worldwide public health problem and is currently the most common cancer overall. Its endocrine therapy is related to the expression of the steroid hormones, estrogen receptor (ER), and progesterone receptor (PR). Breast cancers can be presented under multiple profiles of steroid hormones: ER(−)/PR(+), ER(+)/PR(−), double-positive/negative ER, and PR. 2–8% of all breast cancers express only PR (ER−/PR+) which is an abnormal phenotype, with less known about their behaviors and outcomes. Our study was performed on a large and well-characterized database of primary breast cancer from 2012 to 2019, up to 1159 cases. These cases were divided according to ER and PR expression, as we put all of our focus on ER-negative/PR-positive group, more specifically ER−/PR+/HER2+ and ER−/PR+/HER2− gene expressions, to highlight their features and find a pattern that links HR (hormone receptors) profiles and breast cancer subtypes. Out of the informative cases, 94 patients (8%) had ER−/PR+ breast cancers, while 676 (58.4%) had ER+/PR+, 88 (7.6%) had ER+/PR−, and 164 (14.2%) had ER−/PR− tumors. The ER−/PR+ group was statistically correlated with a high risk of recurrence and death in midway between the double-negative and double-positive HR. According to HER2 status, a low DFS was observed in patients ER−/PR+/HER2−, which is closer to the DFS of TNBC cases but worse than ER+/PR any. On the other side, the ER−/PR+/HER2+ showed also a poorer DFS closer to the HER2+ subgroup in between TNBC and ER+/PR any. The clinicopathological features of the ER−/PR+/HER2− and ER−/PR+ HER2+ have distinguished the patients into two groups with a difference in some clinicopathological characteristics: both groups had closer OS estimation, which was worse than ER−/PR any and better than TNBC and HER2. The ER−/PR+/HER2− seems to increase the risk of recurrence than ER−/PR+/HER2+ when compared to ER+/PR any. On the other hand, the ER−/PR+/HER2+ seems to increase the risk of death more than ER−/PR+/HER2− in comparison with ER+/PR any. Our results support that ER−/PR+ tumors really exist and are rare and clinically and biologically distinct subtypes of breast cancer. In addition, our analysis, which was based on dividing the groups according to HER2 expression, has revealed the existence of two distinct groups; this gave the ER−/PR+ subgroup a heterogeneity characterization. Moreover, this breast cancer subtype should not be treated as a luminal tumor but rather according to the HER2 expression status.

Background: Breast cancer is a major public health problem worldwide. It's the most common cause of death from cancer in women, it considers a heterogeneous disease, shows variable morphological and biological features, they have different clinical behavior, and prognoses, and respond to therapy differently despite similarities in histological types, grade, and stage. The classication aims for an accurate diagnosis and prediction of behavior, however, histological classication isn't enough in this era of personalized medicine, this results in « overtreatment » of many patients, so, molecular proling allows tumors to be dened by the expression pattern or genomic alteration of thousands of genes. A Methods: retrospective, descriptive and analytic study was performed among 1040 women with invasive breast carcinoma, which was diagnosed in the department of surgical pathology at University Hospital Center of Hassan 2 of Fez in Morocco, during a period ranging from 2012 to 2019. The prevalence of different molecular subtypes of breast carcinoma was estimated, in addition, clinicopathological features such as age, tumor size, tumor grade, lymph node involvement, hormonal receptors prole, and HER2 status have been compared. The mean age of diagnosis was Results: 49.5 years (DS12,5 years, 17-88 years), among these, 637 (55%) were under 50 years. NOS invasive breast carcinoma was the histological type the most common in 1030 (89%), with an SBR II in 60% of cases. The Mean tumor size was 2.8cm. Axillary lymph nodes (LN) were metastatic in 60% of cases. 76% of cases showed positive staining for estrogen receptors, 75,5% for progesterone receptors, and 18,5% for HER2/neu. Luminal A subtype was found in 22% of patients while Luminal B was present in 62,5% of patients, HER2 enriched in 5%, and triple-negative (TN) in 10,5 % of cases. There is signicant difference between the 4 subclasses by age (P=0.02), SBR grading (p<0,0001), tumor size (p=0,05), lymph node metastasis (0,0001). There are more young women in HER2 enriched and luminal B subtypes than in luminal A and TN subtypes, while the rate of older women is increased in luminal A subtypes. The proportion of patients with histological grade III in the TN subtype and HER2 subtype, is signicantly increased (P<0.0001) while grade I is signicantly increased in the luminal A subtype. LN metastasis in the luminal B and Her2 cancers are more signicant than in luminal A and TN. Disease-free survival (DFS) among older women above 50 years is signicantly greater among young women under 40 years ( p=0,021). Regarding SBR grading, and DFS, we found that survival was signicantly highest for patients with grade I, followed by those with grade II and then grade III (P<0.0001). According to molecular subtypes, we noted that DFS was signicantly highest for patients with luminal-A subtype, followed by those with luminal B subtype, then HER2 and TN cancers (P<0.0001). The Conclusion: present study shows the particularities of women breast carcinoma in our countryo, through our results, we found that BC is diagnosed at a younger age, a decade earlier than in developed countries, and we found a predominance of luminal B subtype in contrary with others studies suggesting that there are clinico-biological differences, as well as disparities in the expression proling in our population. This highlights the importance of early screening and the need to improve women's awareness of breast cancer in our region and additional research is needed to understand these results in hopes of adopting more effective therapies.

Introduction :La frequence des malformations uterines est estimee entre 0,5 et 4 %. Ces anomalies peuvent avoir des repercussions sur levolution de la conception. Patients et observation :Nous rapportons trois cas de RCIU associee a un oligoamniossecondaire a des malformations uterines decouvertes en per operatoire type : uterus pseudo unicorne dans 02 cas et un uterus bicorne bi cervicalpour le troisieme cas. Discussion :Lincidence des anomalies uterines congenitalesdans une population fertile est de 3,2 %.On retrouve dans 38% des cas une malformation de larbre urinaire associee. Toutes ces anomalies peuvent avoir des repercussions sur levolution de la conception a type de fausses couches precoces et tardives, de grossesse extra-uterine, de menace daccouchement premature, daccouchement premature, de pathologies vasculaires gravidiques et de retard de croissance intra-uterin. Laugmentation de lincidence des presentations dystociques est en effet decrite par de nombreux auteurs. Dautres auteurs rapportent que Les nouveau-nes de meres avec uterusmalforme avaient un poids moyen de naissance plus faible. Conclusion : Lesmalformations uterines congenitales sont relativement frequentes et souvent asymptomatiques. Ces malformations uterines ont un impact sur la croissance fœtale avec taux elevee de RCIU.

Quick Response Code Abstract: Congenital anomalies of the kidney and urinary tract are common findings on fetal ultrasound. To review the antenatal sonographic findings and postnatal followup of fetuses with renal agenesis and normal amniotic fluid volume. Prenatal ultrasonography seems to be highly reliable in diagnosing these anomalies. Prognosis is favorable in the absence of additional extra urinary. Malformations, We report the case of a 30-year-old woman, second gesture, on 31 weeks of pregnant; referred for the management of suspected renal agenesis unilateral ;obstetrical ultrasound showing an empty right renal pelvis, left kidney seen.