[Budd-chiari syndrome a rare complication of hepatic echinococcosis; about 3 cases]

Hydatid disease is a parasitic infestation due to the development of echinococcus granulosus in the organism. This disease is particularly frequent in Tunisia where echinococcosis is endemic. Liver is the most common organ to be involved by hydatidosis and several complications have been described. Vascular complications secondary to hepatic echinococcosis such as Budd-Chiari syndrome have rarely been reported. We present herein, three rare cases of hydatid cyst complicated by Budd-Chiari syndrome. The cyst occupied at least two segments of the hepatic dome in all patients and his diameter was 12, 5 cm, 21 cm and 12, 5 cm respectively. According to the Gharbi classification, the cysts were type III in one case and type IV in the two others. The Budd-Chiari syndrome was chronic in one patient and asymptomatic in the two others. His diagnosis was established by abdominal US in two cases, completed by US Doppler and CT angiogram in one patient and by CT angiogram in the other. The diagnosis was established only by CT angiogram in the later case. The Budd-Chiari syndrome was due to compression of two hepatic veins in one case, compression of inferior vena cava in one case and compression of one hepatic vein and inferior vena cava in one case. Laparotomy was performed in all patients. The surgical procedure consisted in resection of the protruding hepatic tissue after puncture aspiration of the cyst in the three cases. The postoperative period was complicated by abscess formation in residual cavity, requiring drainage and by development of ascitis, in one case. Hydatid cyst should be remembered amongst the causes of Budd-Chiari syndrome in countries where the disease is endemic. Conversely, this vascular complication should be looked for routinely in patients with hydatid disease of the liver

[Internal iliac artery aneurysms in behcet's disease, two cases report]

Behcet's disease is a vasculitis more frequent in Japan, in the Middle East and in some Mediterranean countries. It is characterized by a classical triad of recurrent uveitis, oral and genital ulcerations. It is a systemic vasculitis affecting predominantly the venous system. Arterial manifestations in Behcet's disease are less common especially aneurysms who may in some cases quickly involve the vital prognosis. We report two cases of Behcet's disease with arterial internal iliac aneurysms complicated in the two patients by a rupture

[Dermatofibrosarcoma protuberans a facial localisation]

The dermatofibrosarcoma protuberans is a rare but not exceptional tumor of the skin. It is misdiagnosed, often after multiple surgical debulking with cosmetic damage. The authors report the case of a 59 years old woman presenting a voluminous dermatofibrosarcoma protuberans located in the parotid area and not associated with facial palsy and trismus. The treatment consisted in a large surgical debulking of the sarcomatous tumor, the covering skin and the superficial lobe of the parotid. The surgeon used local flaps to repair the cosmetic damage. The post operative follow-up was of 1 year without complications and recurrence. Dermatofibrosarcoma protuberans is a cutaneous tumor characterized by local malignancy. It is seen mainly in adults regardless to sex and it is rarely seen in head and neck. This tumor has a rare propensity to metastasise and high relapse and sarcomatous transformation rates, A large debulking is the only solution to avoid a local recurrence

[Focal xanthogranulomatous pyelonephritis success of the conservative treatment about a case report]

Focal xanthogranulomatous pyelonephritis is an atypical form of chronic renal infection, It is frequently misdiagnosed preoperatively because of its resemblance to malignancy. We report on a fifty years old woman who presented with a right kidney mass. The CT scan showed a solid aspect mass with a lithiasis of the upper ureter. The diagnosis of local xanthogranulomatous pyelonephritis was suspected by clinical and radiological findings and confirmed by histopathologic examination of percutaneous biopsy specimens of the lesion. Successful treatement of the patient was achieved with leaving on the lithiasis and antibiotic therapy dosing eight weeks. Three months later the CT scan was completely normal. The conservative treatment of focal xanthogranulomatous pyelonephritis makes possible to avoid a needless nephrectomy usually on young patients. However a close follow-up must be undergone on these patients because of the possible association of focal xanthogranulomatous pyelonephritis and renal cell carcinoma of the kidney

Adenoid cystic carcinoma of paranasal sinus - about 2 cases

Adenoid cystic carcinoma [ACC] is a fairly uncommon malignant disease that accounts for about 1.3% of all paranasal sinus cancers, and occurs most commonly in the minor salivary gl and s of the head and neck. ACC grows slowly. However, it frequently recurs and metastasizes to distant organs such as lung or bone after treatment, and the prognosis is poor. Locally advanced lesions are usually managed best by resection and postoperative radiotherapy

Pancreas hydatic cyst: a case report

Echinococcal involvement of the pancreas is extremely rare. The clinical presentation is polymorph and the diagnosis is rarely evocated before surgery. We report a 60-year-old woman presenting with epigastric pain. Abdominal examination found an epigastric mass. Radiologie explorations [Abdominal ultrasound and a computed tomography scan] revealed a pancreatic cyst located in the corpus and in the tail. The diagnosis of hydatid cyst was made at laparotomy. The cyst was treated by aspiration and injection of hypertonic saline solution followed by cystectomy. Three years later, the patient was asymptomatic without recurrence of hydatic cysts. Epidemiological, clinical, biological and radiological data should allow better detection of hydatid cysts of pancreas. Surgical treatment depends on the location of the cyst in the pancreas

Pseudotumoral lateral and far lateral lumbar disc herniation - about a case report

Far lateral lumbar disk herniation [FLH] is a rare clinical and radiological entity. It can sometimes mimic other diagnosis such as tumor or radicular cyst. We report a case of a lumbar FLH with vertebral scalloping in a 48-year-old patient. The aim of this work is to insist on the utility of imaging modalities [Ct-scan and MRI] in positive and differential diagnosis of pseudotumoral FLH

[Abdominal cystic lymphangiomas-Report of three cases]

Cystic lymphangioma are rarely observed in the abdomen. Their incidence varies between 2 and 10% of all localisations. The diagnosis is based on histopathological exam but can be suspected by radiology. Laparoscopic removal of the cyst is possible offering many adantages. We report the case of abdominal cystic lymphangioma occurring in women respectively 60, 65 and 68 years aged. Abdominal pain was the main symptom. Diagnosis was suspected before surgery in two cases thanks to the radiological findings. In these two patients, the cyst was removed under laparoscopic surgery. The third patient was operated by laparotomy. The diagnosis was established on histopathological study. With a mean follow up of 36 months, there were no signs of recurrence

[New advances in the management of gastric marginal zone B cell lymphoma]

The stomach is the most common site involved in primary gastrointestinal lymphoma. Helicobacter pylon [HP] plays a decisive role in the pathogenesis of gastric marginal zone B cell lymphoma of mucosa associated lymphoid tissue. Eradication therapy has become widely accepted as initial treatment of localized low grade MALT lymphoma. Further studies are needed to determine the most adapted treatment in non-responding patients. A long-term endoscopic follow-up is recommended due to the increased risk of gastric adenocarcinoma in spite of Helicobacter pylon eradication

[Pathogenesis of intestinal amebiasis]

Amebiasis is the infection of the human gastrointestinal tract by Entamoeba histolytica, a protozoan parasite that is capable of invading the intestinal mucosa and spread to other organs mainly the liver. Identification of proteins associated with virulence, including a lectin that mediates adherence to epithelial cells, a pore-forming peptide that lyses host cells and secreted proteases that degrade host tissues, is one of major recent accomplishment in the field of amebiasis research. This review focuses mainly on the parasitic mechanisms that may be related to invasive intestinal amebiasis