Complete Rupture of Polytetrafluoroethylene-covered Endoprosthesis after Exclusion of a Popliteal Aneurysm.

Popliteal artery aneurysm (PAA) is the most commonly reported peripheral artery aneurysm. The usual treatment is exclusion bypass with a saphenous vein. However, the availability of medium size covered stent graft is an attractive option. By performing this procedure percutaneously, we can shorten the hospital stay of the patient. Favourable early and long-term results have been reported; however, little is known about the durability of the procedure. Given the mobile location of the stent-graft close to the knee joint, graft damage can be expected. We describe a case of complete rupture of a Viabahn(®) endoprosthesis which was inserted to exclude a PAA.

Excavated pulmonary nodules: an unusual clinical presentation of lung metastasis in two cases.

BACKGROUND: Excavated pulmonary metastasis are rare. We present two cases of excavated pulmonary nodules proved to be metastases from osteosarcoma and gallblader lymphoma. CASE PRESENTATION: The first one is 39-year-old man in whom cholecystectomy made the diagnosis of primary non-Hodgkin's lymphoma of the gallbladder. He presented in chest CT scan excavated nodules that had been biopsied and confirmed the diagnosis of non hodgkin lymphoma. He underwent 8 courses of chemotherapy CHOP 21 with complete remission. The second one is an 21 years old man who presented a right leg osteoblastic osteosarcoma with only excavated pulmonary nodules in extension assessment. He had 3 courses of polychemotherapy API (doxorubicin, platinum, and ifosfamide) with partial response. Unfortunately, he died following a septic shock.Review of the literature shows that excavated pulmonary nodules as metastasis are rare but we should consider this diagnosis every time we are in front of a cancer. Chest computed tomography is the best diagnosis imaging that could make this diagnosis. Differential diagnosis between benign and malignant bullous lesions is important because surgical excision affects survival in some malignancies. CONCLUSIONS: Although pulmonary nodules are the most common cancer metastasis, a differential diagnosis of a concurrent primary malignancy should always be considered every time we have excavated lesions, even in patients with known malignant disease. Thorough chest evaluation is important, as multiple primary malignancies may occur concomitantly.

Nasopharyngeal carcinoma in adolescents: a retrospective review of 42 patients.

The aim of the present study was to evaluate the characteristics and outcome of adolescent patients with nasopharyngeal carcinoma (NPC) disease. The study concerned 46 pediatric NPC patients treated during the period 1999-2002 at the National Institute of Oncology, Rabat. The median age of the patients was 16 years. The male/female ratio was 2.8/1. Histologically, all patients had undifferentiated carcinoma. A total of 93% presented nodal metastasis. Four (9%) had distant metastasis. All patients received neoadjuvant multiagent chemotherapy containing cisplatin, followed by radiotherapy. Kaplan-Meier curves were used to evaluate prognostic factors. The log-rank test was used to evaluate the differences between the groups. While none of the patients had locoregional failure, nine patients (29%) developed distant metastasis. The disease-free survival and overall survival (OS) rate for the entire group were 73 and 41%, respectively. Responders to chemotherapy had superior OS (P < 0.001). We suggest that combined modality management using multi-agent chemotherapy and RT as an effective treatment of NPC disease which will achieve satisfactory locoregional control and OS of NPC pediatric patients. Response to chemotherapy was an important prognostic factor.