[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.

[Epithelial-myoepithelial carcinoma of the nasal cavity]. / Carcinome épithélial-myoépithélial de la cavité nasale.

OBJECTIVES: Epithelial-myoepithelial carcinoma is a rare tumor of the salivary glands with an incidence of less than 1%. Most cases arise in the parotid gland. Extraoral location is exceptional. The purpose of this study was to describe a case with nasal location, which is exceptionally reported in the literature. MATERIALS AND METHODS: We report a case of epithelial-myoepithelial carcinoma arising in the nasal cavity of a 54-year-old woman. RESULTS: The woman presented with right recurrent epistaxis and on nasal endoscopic examination was found to have a polypoid tumor in the right nasal cavity. The CT-scan demonstrated a soft tissue mass without extension to the rhinopharynx or bony destruction. Histopathologic examination revealed the tumor to consist of a mixture of a solid, tubular, and trabecular structures with a double-layered arrangement of inner eosinophilic cells and outer clear cells. Dual differentiation toward myoepithelial and epithelial cells was confirmed immunohistochemically. CONCLUSION: The occurrence of epithelial-myoepithelial carcinoma in the nasal cavity is possible. In published cases, no recurrence or metastasis has been reported in this location.

[Thyroid surgery (356 cases): risks and complications]. / Chirurgie thyroïdienne (356 cas): risques et complications.

The purpose of this study was to evaluate the risks and complication rate of thyroid surgery. The authors present a retrospective study of 356 patients surgically treated for thyroid nodules, between 1987 and 1998, at the military hospital of Tunis. The patients were categorised into 3 groups: group I: 238 solitary thyroid nodules (66.8%); group II: 92 multinodular goitres (25.8%) included 12 retrosternal goitres (3.37%) and group III: 26 cases of Basedow's disease (7.4%). Patients benefitted from unilateral surgery in 72% of cases and from bilateral surgery (total or subtotal thyroidectomy) in the remaining 28% of cases. Malignancy was found in 34 cases (9.5%). The complications observed were haemorrhage (0.56% of cases), unilateral post operative recurrent laryngeal palsy (1.12% of cases), and permanent hypoparathyroidism in 0.81% of cases. Experienced surgeons and the use of a meticulous surgical technique can reduce the incidence of post operative complications in thyroid surgery.