[Favorable evolution after medical treatment in three cases of emphysematous pyelonephritis: about 3 cases]

La pyélonéphrite emphysémateuse est une infection nécrotique du rein caractérisée par la présence de gaz au sein du parenchyme rénal, des cavités excrétrices ou des espaces péri rénaux. Il s'agit d'une forme grave pouvant engager le pronostic vital. La prise en charge reste controversée: entre l'attitude chirurgicale et le traitement purement médical, il existe une place pour le drainage percutané. Nous rapportons 3 cas de PNE traité par des antibiotiques seuls avec une bonne évolution, nous montrons à travers que le traitement médical pourrait suffire.

[Kaposi's sarcoma of the penis in a HIV-seronegative patient]

Sarcomas of the penis account for less than 5% of all tumors of the penis. They are dominated by Kaposi's sarcoma that mainly affects HIV-positive patients. However, recent studies have shown a relationship between Kaposi's sarcoma and HHV-8 infection (Human herpes virus-8), which explains why this sarcoma occurs in non-immunocompromised and HIV-seronegative patients. We here report the case of a 72-year old patient, with no previous medical history, reporting of gradual onset of tumor-like granulation tissue of 3 years duration at the level of the gland, without secondary location. Given the patient's clinical condition, epidermoid carcinoma or sarcomatoid carcinoma of the penis were suspected. Initial biopsy was negative, the second was in favor of Kaposi's sarcoma, confirmed by immunohistochemistry. The patient underwent chemotherapy.

[Urethral ectropion may hide a carcinoma!]

The incidence of female urethral cancer is rare and accounts for 0.02% of all women's cancers. It is dominated by epidermoid carcinoma, which most commonly develops in the distal portion of the urethra, extending to inguinal lymph nodes. The diagnosis is confirmed in the distal forms on the basis of uretrocystoscopy with biopsy. Abdominopelvic MRI allows to determine tumor extension as well as its infiltration into tissues and peri-urethral organs. As in superficial tumors of the distal urethra, simple circumferential resection of the urethra associated with resection of the adjacent portion of the anterior surface of the vagina is sufficient. We here report the case of a 59-year old diabetic and hypertensive female patient presenting for irritative lower urinary tract symptoms, associated with vulvar mass. Clinical examination showed mucosal ectropion extending from the urethral meatus associated with extensive local inflammation. The patient underwent wide excision of the ectropion which was diagnosed as squamous cell carcinoma. Abdominopelvic MRI was normal.

[Retroperitoneal leiomyoma: report of 2 cases]

Les tumeurs bénignes du muscle lisse sont fréquentes dans le tractus gastro-intestinal et génito-urinaire, et rares au niveau rétro péritonéal. Leur prévalence parmi les tumeurs rétropéritonéales primitives a été estimée entre de 0,5 à 1,2%. Une situation qui conduit à des erreurs de diagnostic. On rapporte dans cet article deux cas de léiomyome rétropéritonéal (LRP) retrouvés chez des femmes âgées entre 47et 54 ans. L'imagerie a mis en évidence une masse rétro-péritonéale, ce qui a motivé une exérèse totale de la tumeur. L'examen anatomopathologique de la pièce opératoire a posé le diagnostic de léiomyome rétro-péritonéal. L’évolution sans récidive était bonne.