Scarf pin inhalation: clinical characteristics and surgical treatment.

OBJECTIVE: Scarf pin inhalation is becoming a frequent accident among young Moroccan woman who wears islamic veil. The aim of the study is to highlight indications, principles and challenges of surgical removal of that particular foreign body. METHODS: Twenty-eight patients were hospitalized in Thoracic Surgery department of Ibn Sina Hospital at Rabat between January 2008 and June 2013 for surgical removal of a pin scarf after unsuccessful endoscopy. RESULTS: Mean age was 20 years. Inhalation was accidental in all cases. Average interval between inhalation and surgery was 10 days. Penetration syndrome was found in 82% of patients. Pin was located at the left tracheo-bronchial tree in 53.5% of cases and at the right one in 46.4%. All were operated by thoracotomy. Surgery was conservative in all cases, and postoperative course was uneventful. CONCLUSION: In case of failure endoscopic treatment, surgery remains the only alternative. It must be as conservative as possible. Short interval between inhalation accident and surgery prevents parenchymal resection.

Neoadjuvant chemotherapy in well-differentiated fetal adenocarcinoma: a case report.

BACKGROUND: Fetal adenocarcinoma of the lung is a rare subtype of pulmonary adenocarcinoma with a relative estimated incidence of 0.5% or fewer of all lung cancers. Because of its extreme rarity, there have been no controlled clinical trials investigating treatment regimens for fetal adenocarcinoma and, as a result, there are no guidelines for management. CASE PRESENTATION: We report a case of a well-differentiated fetal adenocarcinoma, which is a variant of pulmonary blastoma, that is a low-grade malignancy and associated with a good prognosis. A 29-year-old Moroccan man presented with a well-differentiated fetal adenocarcinoma staged T3N0M0, who received 3 cycles of neoadjuvant chemotherapy followed by surgery, with no recurrence at 2 years follow-up. CONCLUSION: Fetal adenocarcinoma is a rare suptype of adenocarcinoma. Surgical resection is the treatment of choice for resectable disease. The role of chemotherapy in the neoadjuvant setting or adjuvant setting is not well defined.

Pulmonary epithelioid hemangioendothelioma: a case report.

INTRODUCTION: The pulmonary epithelioid hemangioendothelioma is a rare vascular intermediate malignancy tumour. CASE PRESENTATION: A 45-year-old man, he shows an isolated chronic cough with a preserved general state of health. The thoracoabdominal Computed tomography showed three well limited opacities of the right lung, among them one shows some calcifications; which we entirely resected by enucleation after a pneumotomy. The histologic examination with immunomarking led to an epithelioid hemangioendothelioma. CONCLUSIONS: The pulmonary epithelioid hemangioendothelioma is a tumour of unpredictable prognosis, bad when linked to the plurifocal and symptomatic forms.

Primary mediastinal leiomyoma: a case report.

Leiomyoma of the mediastinum is rare. We report a case of a 57-year-old woman with a cervical mass diving to the intrathoracic. Chest radiography and computed tomography revealed a mass in the right superior mediastinum. The tumor was enucleated by cervicotomy. Histologically, the tumor was diagnosed as leiomyoma.

Endobronchial lipoma a rare cause of pleural empyema: a case report.

Benign neoplasm of the endobronchial tree is quite rare, while endobronchial lipoma is extremely rare. The irreversible pulmonary damage is due to progressive bronchial obstruction; even so, pleural empyema is exceptionally encountered in a case of endobronchial lipoma. We report a case of a 47-year-old man who had left lung pneumonia with hemoptysis. The chest computed tomography showed cystic bronchiectasis with pleural effusion, Flexible bronchoscopy revealed a round tumor on the left main bronchus.

[Surgical treatment of pulmonary aspergilloma. 278 cases]. / Chirurgie des aspergillomes pulmonaires. Série de 278 cas.

STUDY OBJECTIVES: The purpose of this study was to report the results of surgical treatment of pulmonary aspergilloma in 278 consecutive patients in a hospital using surgical treatment systematically when possible to avoid potentially fatal bleeding. METHODS: Diagnosis required morphological assessment as well as testing of sputum and blood samples. Preoperative studies also included pulmonary function tests for all patients. Surgical intervention was systematic, for treatment or diagnostic purposes. The incision of choice was a standard posterolateral thoracotomy via the 5th intercostal space. Mycological examination of the parenchymatous cavity confirmed the diagnosis. Immediate postoperative surveillance depended on clinical, radiologic, and laboratory findings as well as pleural drainage. Postoperative clinical and radiographic follow-up took place during the first month, the third month and then every 6 months. RESULTS: Between 1982 and 2004, our thoracic surgery department saw 320 cases of pulmonary aspergilloma. In all, 278 patients (161 men and 117 women) underwent pulmonary resection. The mean age was 32 years (range: 16-70 years). The principal underlying disease was tuberculosis (73%), and the most common symptom hemoptysis (83%). Treatment was exclusively surgical in all patients, and there were 279 resections because one patient had staged bilateral segmentectomy. Resections included 130 lobectomies, 51 segmentectomies, 45 pneumonectomies, 33 lobectomies with segmentectomy, 17 bilobectomies and 3 thoracoplasties. There were 16 postoperative deaths (5.7%), 14 of them in patients who had undergone pneumonectomy. Postoperative complications included empyema (12.5%), incomplete reexpansion (9.3%), postoperative bleeding (5%), respiratory infections (4.6%), respiratory failure (4%), bronchial fistula (2.5%) and wound infections (2%). 12 patients had further surgery: 3 for hemothorax, 2 for empyema and 4 for secondary thoracoplasty. The postoperative course was uneventful for 54.1% of cases. CONCLUSION: Surgery for pulmonary aspergilloma is difficult and dangerous. It nonetheless remains the treatment of choice of this opportunistic pulmonary mycosis, despite the high risk of postoperative morbidity and mortality.