[Surgical treatment of secondary hyperparathyroidism in chronic renal failure. Report of 57 cases]. / Traitement chirurgical de l'hyperparathyroidie secondaire des insuffisants renaux: a propos de 57 cas.

AIM: The aim of this study was to report the experience of the department of general surgery (Aile III) Ibn Rochd Hospital in surgical management of hyperparathyroidism in patients with end-stage renal disease (ESRD). METHODS: Fifty seven patients (24 M, 33F) with hyperparathyroidism underwent surgical parathyroidectomy from 1998 to 2004. Surgical indication was established according to clinical or biological assessment. Fifty nine operations were performed (57 first-hand cervicotomies and resumptions in too cases). RESULTS: Histological examination of parathyroid gland specimens disclosed adenoma in 33 patients and hyperplasia in 14 patients. The follow-up was normal in 52 patients, marqued by cervical hematoma in 2 cases and death was deplored in 4 patients. The post-operative calcium level was in the normal range in 43 cases, low comparatively to the baseline in 12 cases and high in 2 cases. The PTH levelwas normal in 55 patients and high in two patients. Long-term outcome was evaluated in 36 patients mean follow-up (18 months). A good evolution was noted in all patient referring to clinical, biological and radiological investigations. CONCLUSION: That, in our context, surgical parathyroidectomy still an appropriate approach for the treatment of hyperparathyroidism in patients with end-stage renal disease.

[Non-functional retroperitoneal paraganglioma]. / Paragangliome rétropéritonéal non fonctionnel.

Non functional retroperitoneal paragangliomas are rare tumors: less than 50 cases are reported in the literature. They are usually asymptomatic and can attain big dimensions. The authors report a case diagnosed by histological examination of the operative specimen. Malignant tumors more frequent than the benign tumors present with a regional extension and delayed metastases. The treatment is completed by surgical excision. Radiotherapy and chemotherapy can be used for palliation of symptoms.

CT features of a voluminous gastric trichobezoar.

We report on the case of a 15-year-old girl with a voluminous gastric trichobezoar imaged by CT. The absence of any attachment of the mass to the gastric wall and the presence of air within the mass are very suggestive for diagnosis.

[Cancer of the breast in men. Apropos of 50 cases]. / Cancer du sein chez l'homme. A propos de 50 observations.

Breast cancer, rarely encountered in men, accounts for 0.2 to 1.5% of the cancer morbidity in men and 1 to 5.7% of all breast cancers. The aim of this work is to analyse the different epidemiological, therapeutic and outcome features of this disease in men using a retrospective multicentric approach to 50 cases reported in Casablanca from 1980 to 1992. The mean age of the patients was 60.6 years. No significant risk factor was found. The mean delay to consultation was 22.5 months. Diagnosis was made at an advanced stage as, the tumour was located behind the nipple in 98% of the cases and ulcerated in 52%. Laterality was almost identical. Invasive galactophoric adenocarcinoma was found in 86% of the cases. Treatment was usually Patey mastectomy with positive nodes in 84%. Complementary treatment included radiotherapy in 60%, chemotherapy in 36% and hormonotherapy in 1 case. Recurrence was observed in 71% of the patients who has achieved complete remission. Surviceal in evaluable cases was 59 and 25% at 2 and 5 years respectively. The results in this series was less satisfactory that it is generally reported in the literature which suggests the need for better codification and management.

[Therapeutic approach in a case of papillary cancer of the thyroid gland. Apropos of 22 cases]. / Notre attitude thérapeutique devant un cancer papillaire pur de la thyroïde. A propos de 22 cas.

The authors report about a series of 22 papillary carcinomas of the thyroid gland. Among the operated patients, 6 underwent loboisthmectomy, 9 total thyroidectomy. For papillary carcinoma, a frequent cancer (1.3% of all cancers) dominating in women, the survival rate is virtually the same if the lesion is treated with maximal or conservative surgery. The results obtained with minimalist conservative procedures (decrease in morbidity, no recurrence) reinforces the authors' attitude, even more so as it corresponds to the data found in the literature.