[ tracheal adenoid cystic carcinoma]

Adenoid cystic carcinoma [CACC], also called cylindroma, are rare epithelial malignant tumors, their favorite seat is at the salivary glands [95% of cases], they represent 20 to 40% of tracheal carcinoma and 0,1% of respiratory tract cancers. Bronchial localization is rare, estimated only between 0.3 and 2%. This is a retrospective study ranging from 1997 to 2006 concerning five patients treated in the thoracic surgery department, for tracheal tumor and whose final histological diagnosis was in favor of adenoid cystic carcinoma [ACC]. All the patients had inspiratory dyspnea. Bronchoscopy showed a smooth tracheal tumor, the biopsy revealed a ACC. Four of our patients underwent resection of the tumor-by-end anastomosis and one patient was deceased prior to surgery. Adjuvant radiotherapy was indicated in one case. The short term, outcome was good, but local recurrence with lung and cervical lymph node metastases appeared after 6 years in one patient. The adenoid cystic carcinoma of the trachea is a rare tumor. Its diagnosis and surveillanse based on bronchial Bibroscopy combined with biopsy. CT better evaluates the scope and extent of the peri tracheal tumor. The therapeutic management is based mainly on surgery combined with radiotherapy. adenoid cystic carcinoma of the trachea are rare malignant tumors issues to think about before a lesion at this level

[Inflammatory pseudo-tumor of the chest]

The inflammatory pseudotumor are rare benign tumors that are the subject of a recent interest, motivated in part by the discovery of a chromosomal abnormality, and secondly, by the existence of rare malignant forms. We report a retrospective study spread over 8 years [1999- 2006] during which we have reported 6 cases of inflammatory pseudotumor. The diagnosis was based on clinical, radiological and histological findings. The incidence of ITP was 1.14% among tumors, patients' age ranged between 14 and 58 years and the sex ratio was 5 women for every man. One patient had a history of treated pulmonary tuberculosis and a history of sarcoma of the thigh treated was reported in one case. Clinical signs were dominated by hemoptysis, chest pain and cough with purulent sputum. The clinic and paraclinical objectified, a heterogeneous left process basal [one case], an excavated lesion of the right hemi thorax [two cases], right upper lobe mass [two cases] and endotracheal process [one case]. All patients underwent surgery for diagnostic and therapeutic reasons and confirmation was based on a pathological examination of surgical specimens. The immediate postoperative course was uneventful and no recurrence was noted. The etiology of these tumors is unclear, the clinical, radiological, and the preoperative cytohistologie can not put a definitive diagnosis, so that the surgery is performed for diagnostic and therapeutic reasons. Careful monitoring is necessary to prevent any recurrence or malignant transformation which is rare but certainly formidable. Through these observations and a literature review, the authors propose an update on the clinical, paraclinical and therapeutic aspects of these cases

[ intrathoracic desmoid tumors]

The desmoid tumors are rare benign fibrous tumors, its intra-thoracic localization is exceptional. Authors report three cases of intra-thoracic tumors, 2 of them were operated. The cases were 3 females, aged 27 to 32 years old, with a mean age of 29,6 years. The symptomatology was silent, in all of them, dominated by chest pain, one case had a palpable mass. The radiological examination did not show a suggestive evocative aspect. The diagnosis depends on the histological findings 2 cases have been operated, and despite the carcinologic resection, relapse occurred in one patient after 9 months. Due to the tumor extensive and infiltrative character its illdefined limits, the third case had only a radiochemotherapy treatment. Our series shows the importance of a well knowledge of these rare tumors, before any therapeutic surgical treatment decision

[ fibrous osseous dysplasia]

The fibrous osseous dysplasia is a rare congenital condition characterised by the replacement of the medullary canal spongy os by a fibrous tissue proliferation. we reported a case of a young girl, 21 years old, who suffered from thoracic pain since more than one year, with apparation of the axillary arch which progressivaly increase in volume since six months. Examination revealed a fixed hard tumefaction, the thoracic radiography showed two souffle osteolytic images near the medium arc of the fifth left rib and fourth right rib. The osseous scintigraphy revealed an hyperfixation touching the right hemiface. The cranio-facial scan showed an interesting aspect of [frosted glass] of the clivus. The remodeling mark dosage of the osseous alkaline phosphatase was of 2321U/L. A mass biopsy was done which confirmed the diagnosis. the combination of costal and clivus fibrous dysplasia which had been never reported in literatures and the difficult therapeutic decision in front of this polystotic picture makes our case a particular case

[Pulmonary hydatidosis]

Objective: pulmonary hydatidosis is a common health problem observed in Morocco. In this study, our surgical experience was reported according to indications and results of the disease

Materiel and methods: all 1589 patients who were operated on pulmonary hydatidosis between 1993 and 2002 were investigated retrospectively

Results: There were 890 men [56%] and 699 women [44%]. The diagnosis was established on the basis of associated clinical signs and radiological finding. Cystectomy was the most common operation performed 607 [38, 2%], followed by 220 wedge resection [13, 8%], 503 segmentectomy [31, 6%], 392 lobectomy [24, 6%], 19 bilobectomy [1, 19] and 13 pneumonectomy [0, 81%]. Recurrence was determined in 49 patients. Mortality was 0, 3% [5 patients], and morbidity was observed in 286 patients [18%]. The complications were: infection of the incision [2, 8%], pneumothorax [11%], empyema [1, 7%] and hemothorax [1, 5%]. Mean hospitalisation stay was 8-12 days

Conclusion: surgical outcome of the pulmonary hydatidosis is perfect with a low mortality and morbidity rates. In order to prevent the transmission of the disease, all the necessary precautions should be taken