RESUMO
Hydatidosis is a rare parasitic disease that is endemic in many countries of the Mediterranean basin caused by the larval form of Echinococcus Granulosus. Among unusual localizations, renal involvement is rare, especially extension to the pleural cavity. Herein, we report a rare case of 75-year-old woman with giant renal hydatid cyst complicated by pleural extension. The patient was successfully treated with a median phreno-laparotomy.The renal hydatid cyst was completely emptied with resection of the epiploic hydatid cyst.The diaphragmatic breach was closed after resection of the necrotic margins. With 1 month albendazole therapy.
RESUMO
M1A disease is a recent concept appearing in the 7th TNM classification of lung cancer. M1A encompasses two different entities, malignant pleural or pericardial effusions and separate tumor nodules in the contralateral lung, who constitute very different diseases, with very different management and prognoses. On one hand, patients with pleural dissemination have extremely poor survival, with median and 5-year survivals of 4 months and 3.1%, respectively. Only selected patients whose limited pleural extension has been diagnosed at the time of thoracotomy and completely resected, may experience prolonged survival. On the other hand, recent progress in molecular biology still failed to establish whether a contralateral lesion is a second primary or a metastasis. These contralateral lesions are now gathered as multiple lung cancers in the surgical literature, and misleadingly classified as M1A disease in the TNM classification. Patients with contralateral nodules may experience prolonged survival after the surgical treatment of both localizations. Changing the staging by establishing the diagnosis of metastasis is probably an important issue warranting further biologic research, but according to current results this diagnosis must not in any case preclude surgery.