Moncef Zitouna

University of Tunis El Manar, Tunis-Ville, Tūnis, Tunisia

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Publications (262)69.17 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: IntroductionSarcoidosis is a granulomatous disorder of unknown cause, characterised by noncaseating granulomas affecting multiple organs. Gastrointestinal tract involvement in sarcoidosis is rare. The stomach, particularly the antrum is the most common extra-hepatic organ to be involved. We report four cases of gastro-intestinal sarcoidosis.
    La Revue de Médecine Interne 04/2010; 31(4):262-267. DOI:10.1016/j.revmed.2009.12.003 · 1.07 Impact Factor
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    ABSTRACT: Cutaneous vasculitis has been mainly associated with hematologic cancer. The association of solid neoplasms with cutaneous paraneoplastic vasculitis is rare. We report a case of cutaneous leucocytoclastic vasculitis that revealed a gastric adenocarcinoma. A 72-year-old man presented with an acute diffuse polymorphic eruption, with erythematous, vesicular, and necrotic lesions predominating on the lower limbs, which had developed within the past 8 days. The medical history revealed abdominal pain and weight loss over the previous 6 months. A skin biopsy noted typical leucocytoclastic vasculitis. A workup including GI tract investigations revealed an antral adenocarcinoma. Complete excision of the gastric tumor was followed by resolution of the skin lesions. No tumor recurrence or cutaneous vasculitis was noted during 2 years of follow-up. To our knowledge, the association of leucocytoclastic vasculitis with gastric cancer has never been reported previously. The failure of vasculitis to respond to conventional therapy should suggest an underlying malignancy.
    Acta dermatovenerologica Alpina, Panonica, et Adriatica 03/2010; 19(1):21-3.
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    ABSTRACT: Testicular lymphoma was first reported by Malassez and Curling in 1866. Primary testicular lymphoma constitutes only 1 - 7% of all testicular neoplasms and less than 1% of all non Hodgkin lymphoma. The authors report a new case of primary testicular lymphoma and highlight its diagnostic and therapeutic challenge. We report the case of a 26-year old man without a particular past medical history, who presented with a painful right testicular swelling that he has noticed for several weeks. Radiological findings consisted in multiple hypoechoic masses that corresponded in histological examination to a diffuse intratubular lymphomatous infiltration situated away from the spermatic cord, the epididymis, ductuli efferentes and rete testis. Immunohistochemical study showed positivity for leukocytic common antigen (CD45), B-cell marker (CD20) and bcl 6. The patient underwent full staging for lymphoma showing no evidence of extra-testicular involvement by lymphoma and no lymph nodes. The diagnosis of stage I primary testicular large B-cell lymphoma of germinal center B-cell-like group was made. The patient is now treated by chemotherapy. Primary testicular lymphoma is a rare tumour whose diagnosis is based on histological findings. There are non consensual etiological or predisposing factors. Treatment modalities consist in surgical excision, chemotherapy and radiation therapy but the accurate procedures are not standardized. Factors that have been linked to more favorable outcomes include younger patient age, localized disease, presence of sclerosis at pathologic analysis, smaller tumour size, lower histological tumor grade and lack of epididymal or spermatic cord involvement. Keywords Testicular lymphoma; Germinal center; B-cell
    Journal of Clinical Medicine Research 02/2010; 2(1):47-9. DOI:10.4021/jocmr2009.12.1284
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    ABSTRACT: Sarcoidosis is a granulomatous disorder of unknown cause, characterised by noncaseating granulomas affecting multiple organs. Gastrointestinal tract involvement in sarcoidosis is rare. The stomach, particularly the antrum is the most common extra-hepatic organ to be involved. We report four cases of gastro-intestinal sarcoidosis. Retrospective study of a series of four cases. All patients had gastric sarcoidosis. It involved the duodenum, ileum and gall bladder in a patient with a history of an acute pancreatitis probably due to sarcoidosis. This patient presented with obstructive intestinal manifestations, weight loss and exsudative enteropathy. Two patients presented with mild abdominal pain and the last patient was admitted for upper gastrointestinal bleeding. The endoscopy was normal in one case and showed an antral congestion in another case. Gastric ulcers were found in the patient with a history of upper gastro-intestinal bleeding. A pseudo-linitic aspect was noticed in the patient with obstructive manifestations. The duodenum and the ileum were normal. This patient had an antrectomy and was treated with corticosteroids. Surgery evidenced a perforated duodenal ulcer, which was obstructed by the gall bladder. The patient with gastrointestinal bleeding received proton pump inhibitor and corticosteroids. These two patients improved gradually. The two other patients recovered spontaneously. The stomach is the most commonly affected organ in gastrointestinal sarcoidosis. Gastric sarcoidosis can mimic a malignant lesion owing to narrowing of the gastric lumen or can be revealed by upper gastrointestinal bleeding. Duodenum, small bowel and colon involvement is uncommon but may be underestimated in the absence of systematic biopsies.
    La Revue de Médecine Interne 02/2010; 31(4):262-7. · 1.07 Impact Factor
  • D El Euch · M Mokni · S Haouet · S Trojjet · M Zitouna · A Ben Osman
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    ABSTRACT: Chromoblastomycosis is a chronic subcutaneous fungal infection caused by dematiaceous saprophytic moulds. We report a case of chromoblastomycosis due to Fonsecaea pedrosoi observed in man from the Baja region of Tunis. He presented since one year an erythemato-squamous atrophic plaque localised at the abdomen area. Clinical remission was obtained after cryotherapy and terbinafine.
    Médecine tropicale: revue du Corps de santé colonial 02/2010; 70(1):81-3.
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    ABSTRACT: Cryptococcus neoformans is a ubiquitous yeast that causes opportunistic infections mainly involving the central nervous system. Cryptococcoma is a rare entity characterized by a solid, tumor-like mass that is usually located in the cerebral hemispheres or cerebellum. Spinal involvement is rare with only 6 cases reported in literature. Bony involvement is also a rare occurrence that has been observed in only 5 to 10% of reported cases of infection by Cryptococcus neofomans. The purpose of this report is to describe a case of paraplegia due to cryptococcal spondylitis with spinal cord involvement in an HIV-seronegative patient with a history of systemic sarcoidosis. Diagnosis was achieved by histological examination of the surgical specimen.
    Médecine tropicale: revue du Corps de santé colonial 02/2010; 70(1):85-7.
  • Pathology 01/2010; 42(1):99-101. DOI:10.3109/00313020903434710 · 2.19 Impact Factor
  • La Tunisie médicale 01/2010; 88(1):66-7.
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    ABSTRACT: Only 0.5 to 2% of hydatid cysts are localized in the skeleton and of these, 3 to 4% are found in the skull. In this paper, the authors report a case of primary hydatidosis involving the cranial vault revealed by a bulging mass of the forehead and symptoms of raised intracranial pressure that occurred in a 22-year-old woman who came from a rural area. Through this case and literature review, the authors analyse the epidemiological, clinical and radiological aspects of skull hydatidosis. They conclude that hydatid cyst should be considered in the differential diagnosis of any soft tissue swelling or osteolytic lesion in the scalp of patients living in endemic areas.
    The Journal of Infection in Developing Countries 12/2009; 3(10):807-10. DOI:10.3855/jidc.48 · 1.14 Impact Factor
  • Annales de Pathologie 12/2009; 29(6):516-8. · 0.29 Impact Factor
  • Annales de Pathologie 12/2009; 29(6):516-518. DOI:10.1016/j.annpat.2009.10.027 · 0.29 Impact Factor
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    ABSTRACT: hidradenitis suppurativa (HS) is a chronic inflammatory, suppurating, fistulizing, and scar-producing disease of apocrine gland-bearing skin. The diagnosis is primarily clinical, based on the presence of both sinus tracts and abscesses with a characteristic distribution. Review of epidemiological, clinical, and prognostic characteristics of HS and discussion of the etiopathogenic aspects of this chronic problem. We retrospectively report all cases of HS followed at the Department of Dermatology between January 1985 and December 2008. Eleven patients (10 male and 1 female), with a mean age of 35.2 years (range 21 dash, vertical53 years) at HS diagnosis were followed for HS. The average age of disease onset was 23.9 years. The median delay between onset of symptoms and diagnosis was 144 months (range 1 dash, vertical408 months). Clinical features showed inflamed discharging papules or nodules, painful tender erythematous nodules, and double-ended comedones. The disease mainly affected the axillary, anal, perineal, and genital areas. Histologically, dermal features showed active folliculitis or abscess, sinus tract formation, fibrosis, and granuloma formation. Pathological associations (Darier's disease and Down syndrome) were noted in two patients. Treatment consisted of antibiotics in eight patients, retinoids (1 mg/kg/ day) in three patients, and surgery in three patients. The mean follow-up was 13 months (range 2 dash, vertical30 months). Recurrence of lesions was observed in all patients approximately 1 month after treatment withdrawal. The Down syndrome patient developed vaginal hydrocele of the testis as a complication of his staphylococcic ulcers. In all cases healing occurred with substantial scarring. An obvious male predominance was noted in our patients as well as a delay in the diagnosis of HS, which could be explained by non-recognition of the disease by non-specialists that see the patients at the primary-care level.
    Acta dermatovenerologica Alpina, Panonica, et Adriatica 12/2009; 18(4):165-72.
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    ABSTRACT: Synchronous occurrence of lymphomatous proliferations of B and T lineage in the same patient is a very rare event and still poorly understood. All the cases reported in the English language literature are described as single case reports. We report a case of 49-year-old man, with 2-year history of multiple myeloma, presented with a raised, erythematous and ulcerated nodule in the anterior aspect of his right thigh. Histologic examination of biopsy specimen showed a dense dermic infiltrate made of large balastic cells displaying anaplastic morphology with no epidermotropism. Immunohistochemical study showed that tumor cells stained positive with CD30, EMA and CD4, and negative for CD3, CD8, CD5, CD20, CD79a, CD138 and anaplastic lymphoma kinase 1 (ALK or Ki-1). Tangour M, Chelly I, Haouet S, Zitouna M, Kchir N. Multiple myeloma and cutaneous anaplastic large T-cell lymphoma in the same patient: Is there a causal relation?
    Journal of Cutaneous Pathology 11/2009; 38(3):298-300. DOI:10.1111/j.1600-0560.2009.01447.x · 1.58 Impact Factor
  • The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques 09/2009; 36(5):662-5. DOI:10.1017/S0317167100008222 · 1.53 Impact Factor
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    ABSTRACT: To analyze epidemiological characteristics, clinical symptoms, radiological aspects, treatment and outcome of central nervous system hydatidosis and compare our results with those reported in literature. In our retrospective study, we reviewed 39 cases of primary central nervous system hydatid cysts operated on in our hospital between 1998 and 2007. There were 20 male and 19 female patients (sex-ratio M/F=1.05) between 2 and 68 years of age (mean=26.5 years). Thirteen of the patients were children (33.3%) with a mean age of 6.8 years and 26 were adults (66.7%) with a mean age of 36.3 years. The location of hydatid cysts was intracranial in 27 cases (69.2%) and spinal in 12 cases (30.8%). Headache and motor deficits were the predominant symptoms in patients with intracranial hydatidosis whereas back pain and spinal cord compression syndrome were the most frequent clinical presentations in patients with spinal hydatidosis. All patients underwent surgical resection of the cyst. Pathologic findings were consistent with hydatid cyst in all cases. During the follow-up period which ranged between 12 months and 5 years, 12 patients had recurrence (30.7%). Only one patient with intracranial hydatid cyst died postoperatively due to anaphylactic shock. Despite all the advances in imaging techniques and therapeutic methods, central nervous system hydatidosis remains difficult to cure and patient outcomes are not satisfactory especially in case of spinal involvement due to the high incidence of recurrence.
    Clinical neurology and neurosurgery 09/2009; 112(1):23-8. DOI:10.1016/j.clineuro.2009.09.001 · 1.13 Impact Factor
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    ABSTRACT: Solitary fibrous tumours (SFT) of the central nervous system are rare neoplasms that usually present as dura-based masses and clinically resemble meningiomas. Histologically, they can be similar to haemangiopericytoma or fibrous meningioma. We present herewith a pathological study of eight patients with SFT and compare our results with the published data. All tumours diagnosed as SFT over a period of 15 years were retrieved from the files of La Rabta Hospital Department of Pathology, Tunisia. Routine histological sections were prepared from formalin-fixed, paraffin-embedded specimens. Immunohistochemical analysis was performed using antibodies raised against vimentin, CD34, CD99, Bcl-2 and MIB-1. The SFT group consisted of four males and four females with a mean age of 44 years. The tumours were supratentorial in six cases, tentorial in one case and located in the lateral right ventricle in the last case. All patients underwent surgery as initial treatment. Histologically, SFT were similar to their soft tissue counterparts. Two cases demonstrated increased cellularity, marked nuclear hyperchromasia and marked cellular pleomorphism. Only the later two cases recurred after 6 months of follow-up. Little is known about the biological behaviour of SFT, although most seem amenable to total resection.
    Pathology 09/2009; 41(7):649-54. DOI:10.3109/00313020903071439 · 2.19 Impact Factor
  • La Tunisie médicale 09/2009; 87(9):639-40.
  • La Tunisie médicale 08/2009; 87(8):555.
  • Annales de Dermatologie et de Vénéréologie 06/2009; 136(6-7):566-7. DOI:10.1016/j.annder.2008.10.047 · 0.92 Impact Factor
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    S Trojjet · I Zaraa · I Chelly · H Zribi · M Mokni · M Zitouna · A Ben Osman
    Annales de Dermatologie et de Vénéréologie 06/2009; 136(5):453-5. · 0.92 Impact Factor

Publication Stats

351 Citations
69.17 Total Impact Points


  • 2014
    • University of Tunis El Manar
      Tunis-Ville, Tūnis, Tunisia
  • 1990–2013
    • La Rabta Hospital Tunis
      Tunis-Ville, Tūnis, Tunisia
  • 2006
    • Hopital Habib Thameur
      Tunis-Ville, Tūnis, Tunisia
  • 1988
    • Institute National de Neurologie, Tunis
      Tunis-Ville, Tūnis, Tunisia