Primary hydatidosis of the central nervous system: a retrospective study of 39 Tunisian cases.

OBJECTIVE: To analyze epidemiological characteristics, clinical symptoms, radiological aspects, treatment and outcome of central nervous system hydatidosis and compare our results with those reported in literature. PATIENTS AND METHODS: In our retrospective study, we reviewed 39 cases of primary central nervous system hydatid cysts operated on in our hospital between 1998 and 2007. RESULTS: There were 20 male and 19 female patients (sex-ratio M/F=1.05) between 2 and 68 years of age (mean=26.5 years). Thirteen of the patients were children (33.3%) with a mean age of 6.8 years and 26 were adults (66.7%) with a mean age of 36.3 years. The location of hydatid cysts was intracranial in 27 cases (69.2%) and spinal in 12 cases (30.8%). Headache and motor deficits were the predominant symptoms in patients with intracranial hydatidosis whereas back pain and spinal cord compression syndrome were the most frequent clinical presentations in patients with spinal hydatidosis. All patients underwent surgical resection of the cyst. Pathologic findings were consistent with hydatid cyst in all cases. During the follow-up period which ranged between 12 months and 5 years, 12 patients had recurrence (30.7%). Only one patient with intracranial hydatid cyst died postoperatively due to anaphylactic shock. CONCLUSION: Despite all the advances in imaging techniques and therapeutic methods, central nervous system hydatidosis remains difficult to cure and patient outcomes are not satisfactory especially in case of spinal involvement due to the high incidence of recurrence.

Primary orbital hydatid cyst in an elderly patient.

BACKGROUND: Orbital hydatidosis is rare, accounting for only 1% of all hydatid cysts. Herein we report a case and review the sparse literature. METHODS: Case report and review of pertinent literature. RESULTS: A 74-year-old farmer presented with progressive proptosis and loss of vision of the left eye. Evaluation revealed a hydatid cyst of the orbit. Orbital hydatidosis is usually unilateral and unaccompanied by cysts elsewhere in the body. Most affected are children and young adults. Although there is no gender predominance, orbital hydatidosis may affect the left eye preferentially. Onset is usually insidious over several months. Serologic testing is unreliable, and imaging by computed tomography or magnetic resonance imaging is now standard. Surgical resection is curative, but albendazole must be administered postoperatively if there is spillage intraoperatively. CONCLUSIONS: Hydatid cysts should be included in the differential diagnosis of unilateral proptosis in patients from regions where echinococcosis is endemic.

Hydatid cyst of the cranial vault.

Only 0.5 to 2% of hydatid cysts are localized in the skeleton and of these, 3 to 4% are found in the skull. In this paper, the authors report a case of primary hydatidosis involving the cranial vault revealed by a bulging mass of the forehead and symptoms of raised intracranial pressure that occurred in a 22-year-old woman who came from a rural area. Through this case and literature review, the authors analyse the epidemiological, clinical and radiological aspects of skull hydatidosis. They conclude that hydatid cyst should be considered in the differential diagnosis of any soft tissue swelling or osteolytic lesion in the scalp of patients living in endemic areas.

[Central nervous system dysgerminoma: a clinicopathological study of 3 cases]. / Dysgerminomes du système nerveux central: étude anatomo-clinique de 3 cas.

BACKGROUND: 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. AIM: to describe clinicopathological features and immunohistochemical profile of dysgerminomas. CASE REPORT: 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.

[Paraganglioma of urinary bladder: report of two cases]. / Le paragangliome vesical: a propos de deux observations.

BACKGROUND: Extra-adrenal pheochromocytoma is a rare entity. Its occurrence in the urinary bladder has only been reported less than 200 times. AIM: Report 2 news cases CASES REPORT: Here we present two case reports of bladder paraganlioma with an update of the diagnostic techniques, treatment modalities and follow-up of patients with this disease. The common presentation of paraganglioma of the urinary bladder is painless haematuria, headache, palpitation and anxiety. Treatment of this lesion requires the same preparation as for any other site of pheochromocytoma. Partial cystectomy ensures radical and effective treatment. Long-term surveillance is necessary as recurrences or metastases have been described 20 and 40 years after treatment.

[Salivary gland biopsy : experience of La Rabta Hospital's pathology departement]. / Biopsie des glandes salivaires accessoires : experience du laboratoire d'anatomie pathologique de l'hopital la Rabta de tunis.

BACKGROUND: The minor salivary glands biopsy is a very common diagnostic procedure in oral medicine rather its efficiency has not been statistically proved. AIM: Assessment of Rabta pathologic department experience METHODS: 297 biopsies have been studied with special attention to the suspected diagnosis before biopsy and the final histologic result. RESULTS: The minor salivary gland biopsy confirmed the initial diagnosis in 78 cases. Although if the minor salivary gland biopsy is in most cases not contributively, it is a very simple procedure which gives the diagnosis of Gougerot-Sjogren disease, amylosis and sarcoidosis.

Endometrial adenofibroma: a rare entity.

Endometrial adenofibroma is an uncommon mullerian mixed tumor composed of benign epithelial and mesenchymal components. This tumor must be distinguished from other malignant lesions of the uterus, particularly adenosarcoma. The authors report three cases of endometrial adenofibroma and discuss their clinical and histopathologic features. The tumors were diagnosed in patients 31, 55 and 63 years of age. In all three cases polypoid lesions of 13, 2 and 5 cm, respectively, were found in the uterine cavity. A polypectomy was performed in two cases; one patient underwent hysterectomy. Follow-up was available for two patients who are today alive and well.