[Ear nose sarcoma. Report of 3 cases]. / Les Sarcomes à localisation ORL. (A propos de 3 Observations).

BACKGROUND: Head and neck sarcoma are very rare malignant tumors which can occur on any different ENT localization. AIM: The authors report tree different variety of ENT sarcoma diagnosed and treated at the oto-rhino-laryngological department of military hospital of Tunis. We intend to remind of clinical and histological particularities, therapeutic modalities and finally to evaluate the follow-up. METHODS: From 2001 to 2007, three cases of head and neck sarcomas were diagnosed in ENT department of military hospital of Tunis. RESULT: the study concerned a women (22 years old) and two men 36 and 76 years old. It deals with an orbital rhabdomyosarcoma, a carcinosarcoma of submandibular gland and a maxillary chondrosarcoma. In each case, diagnosis was validated by the immunohistochemistry. All patients had surgical removal of their tumor. External irradiation or/and chemotherapy was also indicated for all cases. CONCLUSION: ENT sarcomas are aggressive neoplasm. Long-term survival is bad with high potentialities of local recurrence and distant metastases.

Les tumeurs parotidiennes : a propos de 43 cas

Les tumeurs des glandes salivaires sont rares; dominees en frequence par les tumeurs parotidiennes. Elles sont caracterisees par une grande heterogeneite morpho-histologique. Cliniquement; elles se manifestent le plus souvent par une masse parotidienne non specifique. A l'examen histologique; les formes benignes sont les plus frequentes dominees par l'adenome pleomorphe. Le traitement de ces tumeurs demeure chirurgical en premier lieu. Neanmoins; la complication majeure de cette chirurgie reste la paralysie faciale pouvant etre transitoire ou permanente. Le but de cet article est d'analyser chez 43 patients suivis et traites d'une tumeur parotidienne les differents aspects epidemio cliniques; radiologiques et histologiques de ces tumeurs

[Primary sino-nasal lymphomas. Apropos of 25 cases]. / Lymphomes primitifs nasosinusiens. A propos de 25 cas.

PURPOSE: To report on the epidemiological and therapeutic features of a series of Tunisian patients treated for primitive sinonasal lymphoma. PATIENTS AND METHODS: Our retrospective study concerns patients with histologically proven primitive sinonasal lymphoma diagnosed and treated at our institution from 1975 to 1997. Initial work-up included: clinical plus ENT examination, WBC, ESR, LDH, abdominal ultrasonography, bone marrow biopsy and facial CT-scan taken since 1985. All slides are reviewed and reclassified using the Kiel system. Treatment is based on radiotherapy with or without chemotherapy (mainly with the CHOP protocol). RESULTS: We collected 25 patients (22 males and three females, sex-ratio = 7) with a mean age of 48 years (18 to 78). Mean delay of consultation is 4 months and patients consulted mainly for nasal obstruction (65%), more rarely epistaxis (40%) or rhinorrhea. ENT examination showed a fungating nasal fossa tumor in 20% of cases, predominantly unilateral (80%), associated to cervical nodes in 25% of cases. High-grade lymphomas represented 60% of the cases, and 60% of the patients were stage IE. All stage IEs have been treated by exclusive radiotherapy while more advanced stages received combined chemo- and radiotherapy (eight patients). The five-year actuarial survival rate was 69% for the whole population, with a better prognosis for localized stage and low-grade lymphomas. DISCUSSION: Radiotherapy remains a standard treatment for sinonasal lymphomas, permitting us to cure localized stages. In extended stages (more than IE), combined chemoradiotherapy seems to be a good option, especially in case of bulky tumors as observed for the other nodal and extra-nodal head and neck lymphomas.