[Primary malignant tumors of the sternum]

Primary tumors of the sternum are rare and account only 0.5% of all primary bone tumors. They are often malignant, osteolytic and aggressive. They often present difficulties in management. To determine clinical, pathological and therapeutic characteristics for primary malignant tumors of the sternum. We report a series of six cases of primary malignant tumors of the sternum, collected in our institution between 1993 and 2009. There were 4 men and 2 women with a mean age of 69, 5 years. Parietal swelling was the most frequent symptom. Imaging showed a sternal lytic lesion. Three tumors were treated surgically. Associated treatments were neoadjuvant chemotherapy [1 case] and postoperative radiotherapy [1 case]. A medical treatment [radiotherapy alone or chemotherapy] was performed in 3 cases. These tumors were divided as below: 3 plasmacytoma, 1 chondrosarcoma, 1 osteosarcoma and 1 large B cell lymphoma. The management of primary malignant tumors of the sternum is multidisciplinary. It depends on the histological type, the possibility of surgical treatment and the distant and local aggressiveness

[Pulmonary atinomycosis: a great clinical polymorphism]

Pulmonary actinomycosis is a rare bacteriological disease, caracterized by local suppuration and an extensive fibroinflammatory process, with a possible pseudotumoral outcome. To report a new observation of a pulmonary actinomycosis. A 52-year-old patient, smoker, admitted in our department for infectious pneumopathy complicated by purulent pleurisy. Clinical and radiological findings were not contributive.Fiberoptic had evocate the diagnosis of bronchopulmonary cancer. Evolution had been marqued by abondant hemoptysia indicating right low lobectomie. The diagnosis of actinomycosis was obtained by the pathology of the surgical resection. Diagnosis of pulmonary actinomycosis can be difficult because it can mimic the presentation of lung carcinoma.If the diagnosis is no late established, and if the patient is correctely treated medically, the prognosis still excellent

[Non penetrating cardiac trauma]

Traffic accidents are a very important leading cause of death in young adults in our country and the most cause of non penetrating cardiac trauma. Cardiac contusions represent the most common form of non penetrating cardiac trauma but a wide spectrum of cardiac injury ranging from, cardiac valve is not usually foremost in the minds of physicians dealing with acutely injured patients because initial screening is usually focused on other classic and common injuries. There is actually no controversies surrounding the fact that transoesophageal echocardiography is becoming the corner stone and the most useful modality of the evaluation of severe chest trauma with suspicion of cardiac injury. This paper describe the most important blunt cardiac injuries and emphasizes indirectly the need for early diagnosis that becomes an easy one, if the physician keeps in mind such a possibility in all traumatised patients. Another concern is to point out the importance of appropriate therapeutic approach that may significantly improve outcomes in patients with blunt cardiac trauma

[Acquired isolated factor VII deficiency and bronchogenic carcinoma. a case report]

An acquired factor VII deficiency was identified in a 63-year-old man with bronchogenic carcinoma. Initial studies indicated a normal activated partial thromboplastin time and a prolonged prothrombin time. The factor VII level was 6%. No evidence of a factor VII inhibitor or inactivator was demonstrable. However, on account of the initial normal laboratory test of emostases, the partial correction of the prothrombin time with 50% normal plasma in vitro and the family history, the congenital deficiency in factor VII was ruled out. Whatever the mechanism involved, this factor VII deficiency was related to malignancy