[Squamous cell carcinoma of the lip: a report of 30 cases]

Squamous cell carcinoma [SCC] is one of the most common malignant tumors of the lips [90%]. The prognosis of these SCC seems to be poor thus here periorificial localization. To present the epidemiological, clinical, pathological, therapeutic features and out come of SCC of the lips. We conducted a retrospective study performed in the dermatology department of the La Rabta hospital of Tunis over a 11-year-period [2000-2010] recording patients with histologically confirmed SCC of lips. Thirty patients were included [26 men and 4 women] with an average age of 63 years. The most frequent risk factors were smoking and chronic sunlight exposure. The occurrence of the labial SCC on a precursor lesion was noted in 11 cases. It occurred more frequently on the lower lip [80%]. Tumor was ulcero-vegetant in 21 patients. Twenty patients had a commune SCC, 19 of them were well-differentiated. Surgery was indicated in 18 cases and 10 patients were treated by exclusive radiotherapy. Lymph nodes metastases were noted in 2 cases. No visceral metastasis was observed. During the period of follow-up [20.12 months], two patients died. The diagnosis of SCC of the lips is late and the treatment often mutilating. The improvement of the prognosis depends not only on the early diagnosis and the treatment of the precursors, but also on the photo protection and alcohol and smoking eviction

[Gastric MALT lymphoma: anatomo-clinical data and outcome of early stage H.pylori-associated gastric MALT-lymphoma resistant to treatment]

To describe the clinical, endoscopic and histological particularities of early stage HP associated gastric MALT lymphoma resistant to anti Hp treatment and identify predicting factors of resistance. We retrospectively studied 12 patients with primary low grade gastric localized MALT lymphoma treated with anti HP treatment and diagnosed at La Rabta Hospital from 1999 to 2009. The ultrasonography was normal in 5 patients between the 6 responding patients. Perigastric lymph nodes were found in non responders [33.3%]. Hp eradication was achieved in 66% of patients not responding while Hp was eradicated in 100% of responders. The two non-responding patients with failure of eradication of Hp had a strain resistant to Clarithromycin Hp. Predicting factors of failure of anti HP: HP resistance to antibiotics, the proximal head, and the presence of perigastric lymph nodes. Recently, chromosomal aberrations and immune-histochemical markers have been implicated as factors of non response to anti Hp

[Pseudo tumoral gastric amyloidosis: about a rare case report]

Amyloidosis is an abnormal extracellular deposition of insoluble proteins, which is associated with an involvement of the gastrointestinal tract in 50 to 70% of cases. In primary amyloidosis [light chain amyloidosis], localized gastric involvement is a rare finding which can mimick malignancy. To elucidate the clinical, histological and therapeutic features of pseudo tumoral gastric amyloidosis via a rare report along with a review of related literatures. We report the case of 56-year -old man, admitted with upper digestive outlet obstruction. Linitis plastica with lymph node involvement was suspected by gastroscopy, barium meal and endoscopic ultrasonography but was not confirmed by gastric biopsies. The patient was treated with total gastrectomy with lymph node dissection. Pathological examination demonstrated gastric and lymph nodes amyloidosis and no malignant tumor was found. We propose that amyloidosis should be considered in the differential diagnosis of gastric tumors

[Descriptive epidemiology of extrapulmonary hydatid cysts: a report of 265 Tunisian cases]

Hydatidosis is a parasitic endemic disease in Tunisia. The liver and lung are the most common sites of involvement; however, it can develop anywhere in the body. The aim of the present study was to analyse the epidemiological features of extrapulmonary hydatid cysts and compare our results with those reported in literature. Aretrospective study of 265 extrapulmonary hydatid cysts collected over the 18-year period from 1990 to 2007 was undertaken. There were 101 male and 164 female patients [sex ratio M/F= 0, 61] ranging in age from 2 to 84 years [mean age = 38, 7]. In our series, hydatid cysts involved mainly the kidney [24, 1%], the central nervous system [22, 6%], the liver [19, 6%] and the spleen [11, 3%]. The other less frequent sites included the peritoneum [n = 9], heart [n = 9], bone [n = 6], adrenal gland [n = 4], epiploon [n = 4], orbit [n = 4], ovary [n = 3], prostate [n = 2], bladder [n = 2], breast [n = 2], Douglas' cul-de-sac [n = 2], diaphragm [n = 1], testis [n = 1], broad ligament [n =1], mediastinum [n = 1], nasal cavity [n = 1], soft tissue [n = 1], abdominal wall [n = 1], parotid gland [n = 1], psoas muscle [n =1], synovia [n = 1], thymus [n =1] et le pancreas [n = 1]. In contrast to literature, our results show that hydatid cysts of the kidney and of the central nervous system are more frequent than hepatic location which occupies the 3rd rank

[Central nervous system dysgerminoma. A clinicopathological study of 3 cases]

Intracranial germ cell tumors are rarely seen and typically localize in the pineal or suprasellar region. The largest category of germ cell tumors is dysgerminoma. To describe clinicopathological features and immunohistochemical profile of dysgerminomas. We report three cases of central nervous system dysgerminomas. There were two young women and a man who were 6, 11 and 23 year-old. They presented with symptoms of insipidus diabetes [n=3] with association to visual field defects in the third case. Radiological findings showed a supra seller lesion in two cases. Double localization in the pineal and suprasellar regions was seen in the third case. Histologic examination and immunohistochemical study of surgical specimen were consistent with primary central nervous system dysgerminoma

[Infantile desmoplastic fibroma of the maxilla]

Infantile desmoplastic fibromatoses are benign fibrous tissue tumours, non -metastasizing but locally aggressive and with high likelihood of recurrence. Many cases occur in young children between 18 months and 3 years and commonly present as painless mass of the submandibular region. The maxilla is rarely involved. Through this report and a review of literature, we are going to study clinical, pathological and prognostic characteristics of this affection. We report here a case of an aggressive desmoplastic fibroma arising in a 20-months-old infant originating in the left anterior maxillary wall. Clinical examination of the face revealed a non tender, firm, expansion of the left maxilla of 2.5 cm of diameter. The diagnosis of DF of the maxilla was made on the basis of histological features on biopsy specimen. No other location of the fibromatosis was found. The child had a favourable course. DF is an intraosseous, non metastasizing and locally aggressive fibrous tumour. Although its benignity it could engage vital prognosis since it can extend into vital organs