[Cervico-facial hydatidosis. Report of 17 cases]. / L'hydatidose cervico-faciale. A propos de 17 cas.

BACKGROUND: Cervico-facial hydatid cyst is rare. It accounts for 1 % of echinococcosis locations. AIM: To describe the epidemiological, clinical and therapeutic aspects of cervico-facial hydatid cysts based on our clinical experience and data in the literature. METHODS: A retrospective study was made concerning 17 patients with cervico-facial hydatid cyst treated surgically over a 25-year period from 1982 to 2006. RESULTS: Mean patient age was 27 years (range 2-79). Hydatid cyst localization was: cervical muscle (7 cases), thyroid gland (5 cases), parotid gland (2 cases), cervico-thoracic (1 case), larynx (1 case) and cheek (1 case). Hydatic origin of the cyst was suspected for 6 patients (35.3 %) preoperatively. Surgical treatment was used in all cases and adapted to each case. Diagnosis was always confirmed by macroscopic aspects and pathology. CONCLUSION: Hydatid cysts are rarely found in the cervico-facial region, even in highly endemic zone. The manifestation of symptoms depends on the location and the size of the cyst. Positive diagnosis can be difficult during preoperative period. Exclusively surgical treatment is indicated, ideally for total pericystic resection without rupture.

Tissue quantification of radioiodine thyroid uptake in humans by an isotopic imaging technique on slides.

BACKGROUND: Thyroid metabolism involves iodine, which allows us to use radioactive iodine for diagnostic and therapy purposes. The efficiency of radioiodine therapy depends on several parameters; the ability of thyroid tissue to uptake radioactive iodine is one of them. OBJECTIVE: The objective of this work is to quantify the radioactive iodine uptake on thyroid tissue. METHODS: In this work, we developed a method to quantify the in vivo uptake of iodine-131 on sections of thyroid glands removed by thyroidectomies. We performed an analysis of histological sections of the thyroid tissue by beta imaging. We had the opportunity to quantify the fixed radioactivity and to analyze its distribution in the thyroid gland, thanks to the good spatial resolution available with the type of detector used. RESULTS: The results gave a high image resolution showing the heterogeneity of iodine-131 fixation by the thyroid tissue. We were able to quantify the tissue radioactivity in mega Becquerel (MBq) per volume unit. CONCLUSION: This work has shown that the direct quantification of the thyroid tissue uptake is possible using the beta imaging system.

Inflammatory myofibroblastic tumor of the thyroid in its sclerosing subtype: the first case report.

Inflammatory myofibroblastic tumor (IMT) is a rare entity. It is usually found in the lung and upper respiratory tract. Its location in the thyroid is exceedingly rare. Only seven cases of IMT of the thyroid were reported in the literature, mostly after the age of 50 years. The predominant histological pattern in all previously reported cases is that of marked plasma cell infiltrate. We report the detailed clinico-pathological and immunophenotypical features of a case of IMT of the thyroid in an 18-year-old girl with a family history of goiter. Our case is unique because it is the first and only known case of IMT of the thyroid in its alternative sclerosing subtype.

[Fungal necrotizing external otitis]. / Otites externes nécrosantes d'origine mycosique.

OBJECTIVE: Fungal necrotizing otitis externa is rare, although its frequency has increased over the last few years. We report four cases, which to our knowledge make up the largest series published and discuss the main diagnostic problems and the management of this infection. OBSERVATIONS: Our study investigated two men and two women, all diabetics, aged between 69 and 74 years. All four patients were first treated for bacterial necrotizing otitis externa. Diagnosis was reviewed after a lack of response to antibiotic therapy. Aspergillus flavus and Candida parapsilosis were the fungal agents isolated in each of the two patients. Diagnosis was established based on the pathological specimen for one patient. The last patient was treated without identifying the causal fungus. Two patients developed facial paralysis during disease progression. Treatment was based on intravenous amphotericin B and oral itraconazole. Three patients are now free of disease after a three- to six-month course of antifungal therapy; one patient was not followed up. CONCLUSION: Fungal necrotizing otitis externa should be suspected in cases where there is no response to antipseudomonal antibiotic therapy. Deep biopsies from the external auditory canal or the mastoid are usually needed to confirm the diagnosis.

[Diagnostic and surgical strategy for parathyroid adenoma]. / Stratégie diagnostique et chirurgicale de l'adénome parathyroïdien.

From a retrospective study carrying on 8 patients operated for sporadic parathyroid adenoma, we underline the place of medical imagery which allowed the detection of parathyroid adenoma in 7 cases. For all our patients the exploration of thyroid space was bilateral, seeking parathyroid glands. The authors discuss the stages and the various processes of the surgical strategy for parathyroid glands' exploration.

[Primary non-Hodgkin's lymphoma of the thyroid. A case report and review of the literature]. / Lymphome non hodgkinien primitif de la thyroïde. A propos d'une observation et revue de la littérature.

The authors report an observation of a non-Hodgkinien primitive lymphoma of the thyroid, developed on Hashimoto's thyroiditis. The 61 years old woman was operated on a total thyroidectomy for a multinodular goiter with dysphagia. The non-Hodgkinien high-grade lymphoma infiltrated the perithyroidal tissues. The extension' assessment was negative and the lymphoma was classified stage IE. The treatment was supplemented by 6 cures of standard chemotherapy CEOP. Based on this observation and on a literature' review, we will discuss the clinical and therapeutic characteristics of this thyroid cancer.

Therapeutic approaches to complicated cholesteatoma of the external auditory canal: a case of associated facial paresis.

Spontaneous cholesteatoma of the external auditory canal (EAC) is an uncommon condition that is difficult to diagnose. In a patient with such a possibility, serious clinical investigation along with radiologic and histologic exploration should be performed early on because a delay in treatment can lead to severe complications. Given the rarity of EAC cholesteatoma, no therapeutic consensus has emerged. The type of management depends on the extensiveness of invasion and bone erosion and the status of the neighboring structures. The primary therapeutic objectives are to eradicate the cholesteatoma and then to fill in the residual cavity, which in our opinion can be best accomplished with a muscle flap and EAC reconstruction. Postoperative follow-up should be carried out to look for infections, stenosis, and recurrence. We report a new case of spontaneous EAC cholesteatoma, and we review its diagnostic and therapeutic challenges.