[Blastomycosis in Morocco: imported mycosis]. / La blastomycose au Maroc: une mycose d'importation.

Blastomycosis is a rare case. We report a first Moroccan case. A 41-year-old male presented with a 6-month history of dyspnea, fever and significant chest pain associated with night sweats and weight loss. The physical examination disclosed a firm painful paravertebral mass. The chest radiograph demonstrated a left apical opacity. The thoracic scan showed parenchymal infiltration of the apico-dorsal segment of the left upper lobe with vertebral and costal lytic lesions. Surgical biopsy showed granulomatous inflammation with giant-cell intracytoplasmic inclusions. Fungal studies yielded Blastomyces dermatitidis which responded excellently to ketoconazole. Outcome has been excellent at 3.5 years months follow-up. The clinical and radiographic presentation of blastomycosis is non-specific and can be mistaken for a neoplasm. Delay in diagnosis is common.

[Intracranial hydatid cysts in children: a report of 9 cases]. / Kystes hydatiques cérébraux de l'enfant (à propos de 9 cas).

PURPOSE: To illustrate the value of cross-sectional imaging (CT, MRI) for the diagnosis and follow-up of intracranial hydatid cysts in children. MATERIALS AND METHODS: Retrospective study of 9 cases of intracranial hydatid cysts in children seen over a period of 8 years. Precontrast and postcontrast 5 mm thick axial CT images were obtained in 7 cases. Noncontrast sagittal, axial and coronal T1W and T2W images were obtained in 2 cases. RESULTS: Mean patient age was 7.5 years. Intracranial hypertension was the main presenting clinical symptom. A single supratentorial cyst with significant mass effect upon the ventricular system and midline structures was observed in all cases. All patients underwent surgery with good outcome in all cases. CONCLUSION: CT is the imaging modality of choice for diagnosis and postoperative follow-up of intracranial hydatid cysts in children. MRI is most helpful for further characterization when multiple or atypical cysts are present to optimize management.

[High-resolution CT of temporal bone trauma: review of 38 cases]. / L'apport du scanner dans les traumatismes du rocher: à propos de 38 cas.

PURPOSE: Temporal bone trauma is frequent but difficult to assess due to the diversity of clinical presentations and complex anatomy. We have sought to assess the different types of fractures and complications on high-resolution CT. Materials and methods. Descriptive retrospective study over a 24 month period performed in the ENT radiology section of the Mohammed VI university medical center in Marrakech. A total of 38 cases of temporal bone trauma were reviewed. All patients underwent ENT evaluation and high-resolution CT of the temporal bone using 1mm axial and coronal sections. RESULTS: Mean patient age was 33 years (range: 14-55 years) with male predominance (sex ratio: 36/2). Clinical symptoms were mainly otorrhagia and conductive hearing loss. Oblique extra-labyrinthine fractures were most frequent. Two cases of pneumolabyrinth were noted. Management was conservative in most cases with deafness in 3 cases. CONCLUSION: High-resolution CT of the temporal bone provides accurate depiction of lesions explaining the clinical symptoms and helps guide management. MRI is complimentary to further assess the labyrinth and VII-VIII nerve complex.

[Paratesticular desmoplastic small round cell tumour: case report with literature review]. / La tumeur desmoplastique à petites cellules rondes paratesticulaire: à propos d'une observation avec revue de la littérature.

Desmoplastic small round cell tumors are rare aggressive cancers of adolescence and early adulthood. It has recently been separated from other small round cell tumors because of its pathological characteristics and clinical features. They are usually intra-abdominal tumors affecting young people and have classically been associated with a bad prognosis. However, in recent years there have been reports on desmoplastic small round cell tumors affecting other body regions, including the paratesticular area. We report the case of a 27-year-old male who consulted on a progressive enlargement of the right hemiscrotum. He referred no previous urological symptoms and had no systemic symptomatology. Physical examination revealed a round elastic firm 1-cm mass of the epididymis, which was excised. A computed tomography scan showed a para-aortic mass of 1cm. Histological and immunohistochemical diagnosis confirmed a desmoplastic small round cell tumor. The patient received chemotherapy. Today, 6 months after diagnosis the patient remains well and free of disease. Recent reviews on desmoplastic small round cell tumors affecting the paratesticular area have shown a better prognosis for tumors of this origin compared to abdominal ones. We should include this lesion among the differential diagnosis of paratesticular tumors, mainly in children and adolescents.

[Iris metastasis from lung cancer]. / Métastases iriennes d'un adénocarcinome bronchique.

A 47-year-old man with a history of lung adenocarcinoma presented a red and painful right eye with loss of visual acuity after the 5th course of chemotherapy. The ophthalmologic exam showed visual acuity at 3/10 and diffuse iris nodular lesions in the same eye. The fundus was not visible. The controlateral eye was normal. The ocular scan showed iris tumors without choroidal metastasis. Systemic medical evaluation demonstrated no other metastases. The patient died 1 year later.

[Idiopathic granulomatous mastitis: apropos of 8 cases and review of the literature]. / Mastite granulomateuse idiopathique: à propos de huit cas avec revue de la littérature.

AIM OF THE STUDY: The authors report eight cases of idiopathic granulomatous mastitis in which the epidemiological, clinical, diagnostic, therapeutic and prognostic features are discussed. MATERIAL AND METHODS: Retrospective study of eight cases registered among 2,000 breast anatomopathological study during 5-years period. RESULTS: The mead age was 44.3 years. Breast lump measuring 2.5 to 15 cm in size was noted at clinical examination. Mammography noted nodular opacities and ultrasonography showed hypoechoic nodules. Histological findings were consistent on granulomatous inflammation centred on mammary lobules. The inflammatory infiltrate was including leukocytes, lymphocytes, plasma cells as well as epithelioid and giant cells without caseous necrosis in the granuloma. DISCUSSION AND CONCLUSION: Idiopathic granulomatous mastitis is a rare entity. This entity can clinically mimic other breast mastitis disease. Diagnosis is assessed by histological analysis This disease can be treated with drugs and surgical excision of the lump. The prognostic of this chronic disease is favourable.

[Chondrosarcoma of the hand. Diagnostic and therapeutic discussion (three case reports)]. / Le chondrosarcome de la main. Discussion diagnostique et thérapeutique (à propos de trois cas).

Chondrosarcoma of the hand is very rare. We report three observations which enable us to make a review of its pathology. There were two men and one woman aged 72, 38 and 63 years respectively. Localisation was phalangeal in two cases and metacarpal in one case. Two cases were central and one peripheral. Radiographs were characterised by the presence of lytic areas with intralesional calcifications and soft tissue extension. Histological diagnosis was made by biopsy in two cases and after amputation of the finger for lesional spread in one case. Treatment consisted of amputation of the finger in two cases. In the case of metacarpal localisation, wide resection of two rays was followed by recurrence after ten months which required amputation of the hand. We agree with other authors who believe that chondrosarcoma in the hand is due to malignant change in a pre-existing chondroma. Conservative treatment is difficult due to the small size of the hand which allows easy spread of the tumour from compartment to compartment.