[Polymorphous low grade adenocarcinoma: about two cases]

Polymorphous low-grade adenocarcinoma [APBG] is a variant of malignant tumour of minor salivary glands usually arising in the palate. Our aim is to discuss morphology, evolution and differential diagnosis of this rare tumour. The first case interested a 65-year-old-woman admitted for a two-months-history of a right submaxillary swelling. Examination found a tumour of the right side of the palate. A biopsy concluded to a pleomorphic adenoma. Giving that the mass enlarged, a surgical resection carrying off the thyroid with a bilateral neck dissection was performed. Diagnosis was an APBG partially resected with lymph node metastasis. The patient received adjuvant radiotherapy. Local recurrence appeared 28 months after treatment. The second case interested a 57-year-old-woman who consulted for a 12-year-history of a swelling of the lower lip. Clinical examination showed a painless nodule measuring 2 cm located in the mucosal side of the lower lip. An excisional biopsy was performed. Pathologic examination concluded to an APBG completely resected. The patient had no evidence of disease with a follow-up of 54 months. APBG is characterised by a morphologic diversity and a cytologic uniformity that may cause a diagnostic dilemma especially with adenoid cystic carcinoma and pleomorphic adenoma. Its aggressiveness is assessed by its local infiltrative growth pattern requiring a wide surgical excision

[Parathyroid macroadenomas]

Macroadenomas of the parathyroids represent a frequent entity and their treatment is mainly surgical. Post surgical hypocalcemia is the most post operative complication. In our study, we evaluated the clinical, biological and evolutive characteristics of the macroadenomas with a size more than 3 cm. Eight patients were operated in the ORL departement of Sfax for macroadenomas among 34 patients operated for parathyroid adenomas between 1992 and 2004. All our eight patients were women and their mean age was 52 [extremes 31 and 70] and all of them had symptoms that were suggestive of primary hyperparathyroidism. The mean size of the adenomas was 4 cm [from 3 to 5 cm] and all them were benign tumours. When compared to patients who had tumors of less than 3 cm, we found that brown tumors were more frequently encountered [3 cases; p<0.05], phosphocalcic levels more abnormal and post surgical hypocalcemia significantly more frequent. All the glands were considered as benign