Sternal Metastasis of Lung Cancer: A Case Report and a Review of the Literature.

Primary sternal cancer is exceptionally rare. Secondary sternal cancer typically arises when cancer spreads either through the bloodstream from other sites or directly from neighboring lung or breast cancers. Pain is the primary symptom, but these metastases can lead to skeletal-related events such as pathological fractures, hypercalcemia, and spinal cord or nerve compression, necessitating surgical or radiotherapy interventions. These events contribute to increased morbidity and costs for both patients and the healthcare system. We report the case of a 63-year-old female patient who presented with a sternal mass and whose further investigations revealed metastatic lung cancer in the sternum.

[Synchronous association of two primary lung tumors: a case report]. / Association synchrone de deux tumeurs pulmonaires primitives: à propos d'un cas.

Synchronous multiple primary lung tumors are a relatively rare entity with an increasing incidence in recent years due to the development of thoracic imaging and immunohistochemical techniques. The second lesion is considered in most cases as a secondary location, which partly explains the decrease in the incidence of this entity. We report the observation of a 74-year-old patient with two synchronous primary lung tumors, an adenocarcinoma and an epidermoid carcinoma. Through this clinical observation, we highlight the difficulty of diagnosing synchronous tumors and the major interest of new imaging modalities and immunohistochemical techniques for the optimal management of these tumors.

Papillary Adenocarcinoma: A Rare Subtype of Lung Adenocarcinoma.

Papillary adenocarcinoma (PA) of the lung is a specific form of lung cancer characterized by papillary structures in tumor cells. This type of cancer is relatively rare and has distinct pathological and radiological features that differentiate it from other types of lung adenocarcinomas. Determining the specific subtype of adenocarcinoma is a crucial factor in the choice of chemotherapy treatment. Detecting PA is fundamental, as it has both prognostic and therapeutic implications for patients with lung carcinoma. In this paper, we discuss two cases of young patients diagnosed with PA of the lung. The cases we present are particularly intriguing due to the relatively young age of the patients.

Biliptysis Revealing a Bilio-Bronchial Fistula.

The presence of a bilio-bronchial fistula (BBF) of hydatid origin is considered a serious complication as it can lead to significant injuries at the abdominal, diaphragmatic, and thoracic levels. Here, we report the case of a 70-year-old patient presenting with biliptysis as a symptom and whose thoracic and abdominal CT scan confirmed the presence of a right BBF. The management consisted of an initial endoscopic sphincterotomy, followed by an exclusive left thoracotomy surgery to treat lung, liver, and diaphragmatic injuries. Fortunately, the evolution was favorable with the disappearance of the biliptysis. To diagnose a BBF, it is crucial to conduct a precise assessment, focusing mainly on imaging to accurately locate the injury before any surgical intervention.

Exceptional Manifestation of Multiple Myeloma.

Despite being a rare occurrence, multiple myeloma (MM) has been reported as an alternative cause of pleurisy, with approximately 50 documented cases in the literature so far. In this case report, we present the clinical scenario of a patient who sought medical attention due to symptoms of dyspnea, chest pain, and weight loss. Through a comprehensive diagnostic evaluation, it was determined that the patient's pleural involvement was attributable to MM, a hematological malignancy. This case highlights the importance of considering MM as a potential etiology in patients presenting with pleural manifestations, even in settings where tuberculosis is the prevailing cause.

Exceptional Location of a Papillary Carcinoma of the Thyroid.

Thyroid cancers are a rare condition; of these, differentiated thyroid carcinomas are the most common and have a good prognosis with timely diagnosis and treatment. In the case of a late diagnosis, these carcinomas can breach the thyroid capsule and invade the laryngo-tracheal axis. The surgical treatment of locally invasive papillary thyroid carcinoma is a complete resection with the preservation of laryngeal functions when it is possible. We report the case of an 80-year-old patient who presented with inspiratory dyspnea and hemoptysis showing endotracheal localization of a papillary carcinoma of the thyroid.

Bronchial Fissuring: A Severe Complication of Arterial Aneurysm.

Arterial aneurysms are rare and may occur in the context of Behçet's disease. The natural progression of these aneurysms can lead to an increase in their size and eventual rupture into the bronchi, causing life-threatening hemoptysis. We report a case of a subclavian artery aneurysm in a 30-year-old female patient with Behçet's disease who presented with moderate hemoptysis caused by a fistulized left subclavian artery aneurysm into the left main bronchus. The patient was treated with a bolus of corticosteroids followed by oral therapy, and six boluses of cyclophosphamide were scheduled. Unfortunately, the patient's condition deteriorated, and she died after her second cycle of cyclophosphamide following fulminant hemoptysis. The management of aneurysms in Behçet's disease is not standardized, but embolization appears to be the most promising conservative therapy.

Late distant recurrence of endometrial cancer in the lung after 5 years of radical surgery: a case report.

Most endometrial cancer recurrences are seen within 3 years of radical treatment and are associated with various prognostic factors (tumor size, stage, grading, histotype…). Late relapses are considered rare. In this report, we present a case of a patient who was treated for endometrial adenocarcinoma. She underwent total resection and received four cycles of first-line adjuvant chemoradiation therapy using a combination of platinum salts and taxane. A total of 58 months later, the patient presented with chronic cough, and hemoptysis. A computed tomography scan revealed the presence of lung nodules suggestive of metastases. Biopsies were performed, showed infiltration of the bronchial mucosa by a poorly differentiated carcinoma of an endometrial origin. Our patient received two cycles of palliative chemotherapy but was lost to follow-up and eventually died. Imaging after hemoptysis revealed disease progression. Endometrial carcinoma patients treated with radical surgery (R0) can relapse after years of free disease. Thus, recommended: closer follow-up, clinical examination, symptom-based imaging.

Cystic Adenoid Carcinoma: A Rare Bronchial Tumor.

Although very rare, cystic adenoid carcinoma (CAC) should be considered as a differential diagnosis for any lung tumor arising from the bronchial glands. The diagnosis is typically confirmed through histological examination, and treatment is primarily based on surgical intervention. In this report, we present the case of an 82-year-old male with primary CAC of the lung.

Cough as a Clue: Tracheal Endocarcinoma Unveiled.

Tracheal adenocarcinoma (TAC) is a rare malignancy often characterized by significant delays in diagnosis, often attributed to the non-specific nature of symptoms, leading to subsequent challenges in management. The prognosis remains poor, highlighting the need for early detection and multidisciplinary treatment strategies. Surgical resection is recommended for eligible patients, followed by postsurgical irradiation. However, further research is required to give a better perspective on therapeutic interventions and enhance patient outcomes. This paper reports the case of a 50-year-old male, who presented with dyspnea, hemoptysis, and cough. The computed tomography (CT) revealed an intratracheal tissue mass. The cytological examination and immunocytochemistry confirmed the diagnosis of primary adenocarcinoma in the trachea. The treatment involved silicone tracheobronchial Y-stent followed by adjuvant chemotherapy with carboplatin and paclitaxel, and radiotherapy (60 Gray) with good clinical improvement.

Lung Sarcomatoid Carcinoma: An Intriguing Case Report of a Rare Malignancy.

Sarcomatoid carcinoma (SC) is a rare primary malignant tumor belonging to the group of non-small cell lung cancer (NSCLC). The diagnosis requires proper tumor sampling to exclude sarcoma, which is the main differential diagnosis. However, the prognosis of these tumors is poor, with a median survival rate lower than other NSCLC cases, mainly due to their aggressiveness and resistance to chemotherapy, especially platinum salts. In this report, we discuss a case of a 62-year-old male patient who presented at admission with hemoptysis and dyspnea. The diagnosis process involved thoracic computed tomography (CT) and fiberoptic bronchoscopy, which revealed tissue thickening at the carina and a mass extending from the lower end of the trachea to the carina, which was confirmed by biopsy. Unfortunately, despite receiving neoadjuvant radiotherapy and having endotracheal prosthesis, the patient succumbed to tumor progression. Our case highlights the aggressive nature of this tumor and underscores the importance of early detection.

Allergic Bronchopulmonary Aspergillosis: A Case Report.

Allergic bronchopulmonary aspergillosis (ABPA) is an underdiagnosed lung condition in patients with asthma and cystic fibrosis. Its clinical and diagnostic manifestations result from an allergic response to multiple antigens expressed by Aspergillus fumigatus, which colonize the bronchial mucus. This report presents the case of a 73-year-old female patient referred to our hospital for uncontrolled asthma for 35 years. The diagnosis of ABPA was made on the basis of clinical symptoms, peripheral blood eosinophilia, elevated total serum immunoglobulin E, positive aspergillus serology, and bronchiectasis with mucoid impaction. Systemic corticosteroids and antifungal therapy came up with satisfactory clinical results.

A Young Woman Presenting With a Post-traumatic Tracheal Wound.

Tracheobronchial injury is a rare but potentially fatal occurrence, with most cases resulting from penetrating trauma or blunt and iatrogenic injury during medical procedures such as endotracheal intubation, bronchoscopy, or surgery. Early recognition of clinical symptoms can help stratify patient risk and guide management, though these symptoms are often non-specific. We report the case of a 42-year-old patient who presented with post-traumatic chest pain from a sharp object. Radiographic investigation revealed pneumomediastinum and significant subcutaneous emphysema, while bronchial fibroscopy confirmed a wound on the posterior surface of the trachea. The patient underwent surgery with an uneventful postoperative course. Follow-up radiographic evaluation three weeks later showed healing of the tracheal wound and good clinical improvement.

Anaphylactic Shock After First-Line Treatment With Antituberculosis Drugs in a Patient With Lupus.

Tuberculosis (TB) is still a major public health concern in Morocco. Although first-line antituberculosis drugs (ATD) are generally considered safe and effective, serious adverse events can occur. In this case report, we describe a female with pulmonary TB who experienced anaphylaxis induced by rifampicin (RFP) and pyrazinamide (PZA) during ATD therapy. Anaphylactic reactions to first-line ATD can occur and may lead to treatment discontinuation and challenges in finding effective alternative treatment options. Healthcare professionals should be aware of the potential of anaphylaxis with the use of these drugs, especially in patients with a history of lupus. Further research is needed to better understand the mechanisms underlying anaphylaxis and develop effective preventive and management strategies. A young female patient with a history of lupus and splenectomy presented with respiratory symptoms and deterioration of general condition. She was diagnosed with pulmonary tuberculosis and received first-line ATD, which caused complications including liver dysfunction and anaphylactic shock. Despite these challenges, the anaphylactic shock was successfully managed; she was put on a combination of levofloxacin, kanamycin, and ethambutol (ETB), as well as a desensitization protocol for isoniazid (INH); the patient was cured.

Pleurisy as a Sign of Chronic Lymphocytic Leukemia.

The diagnosis of chronic lymphoid leukemia (CLL) is essentially based on a blood smear and immunophenotyping by flow cytometry of circulating lymphocytes. Unusual locations of the disease can sometimes be observed. Here we report the case of a patient admitted for the management of pleurisy. The pleural effusion was lymphocytic exudate; histological examination of the pleural biopsy along with immunohistochemistry helped yield the diagnosis of secondary localization of CLL. The patient was transferred to the Internal Medicine department where chemotherapy was introduced.

Atypical Bronchial Carcinoid Tumor Revealed by Liver Biopsy.

Bronchial carcinoid tumors develop from the Kulchitsky cells of the bronchial epithelium, which are stem cells with neuroendocrine properties. These tumors are divided into two types: typical forms and atypical forms, the latter being much rarer, more aggressive, and having a much higher probability of recurrence and distant metastasis. We report herein a rare case of an atypical lung carcinoid tumor metastatic to the liver. The patient is a 79-year-old woman who presented with purely digestive symptoms evolving for two years, with loss of appetite and deterioration of her general condition. The radiological assessment showed a pulmonary lesion with secondary hepatic and osseous nodules. A hepatic biopsy was performed and morphological and immunohistochemical results were compatible with an atypical bronchial carcinoid tumor, metastatic to the liver and bone.

A Rare Case of Neuroendocrine Tumor in a Patient With Neurofibromatosis Type 1: Is There Any Association?

Neurofibromatosis type 1 (NF1) is an autosomal dominant condition characterized by café-au-lait spots, cutaneous neurofibromas, axillary and inguinal freckling, and iris Lisch nodules; however, the presentations vary greatly, even within families. NF1 is also a recognized risk factor for the development of malignancy particularly malignant peripheral nerve sheath tumors (MPNST), optic gliomas, other gliomas, and leukemia. Nevertheless, the occurrence of lung cancer in a patient with neurofibromatosis type 1 is a rare phenomenon. Here we present a case of neuroendocrine tumor in a patient with neurofibromatosis type 1, highlighting the association between the two diseases. This case report also aimed to raise awareness of possible malignancies in patients with neurofibromatosis type 1.

Low-grade fibromyxoid sarcoma arising in the mediastinum: Case report and review of the literature.

Low-grade fibromyxoid sarcoma (LGFMS) is a rare tumor characterized by bland histological features and aggressive clinical course, it is a distinctive variant of fibrosarcoma with high metastasizing potential and sometimes a long interval between tumor presentation and metastasis, the most common anatomic locations of occurrence are the lower extremities, thorax, inguinal area, and upper limbs, Here, we present the case of a 29-year-old patient with a deceptively benign-appearing mass arising in the mediastinum that had been discovered on computed tomography, a biopsy under cervicotomy was performed and histopathological examination revealed low-grade fibromyxoid sarcoma. In conclusion, LGFMS can arise in the mediastinum, and physicians should consider this entity as a differential diagnosis in the presence of such mass.

Pleuroparenchymal Fibroelastosis: A Case Report.

Pleuroparenchymal fibroelastosis (PPFE) is a rare, idiopathic interstitial pneumonia. wherein the first symptom might be dyspnea or a dry cough. The condition can also be manifested with chest pain secondary to pneumothorax. While the definitive diagnosis is based on a histological evaluation (which is not often performed), a computed tomography scan shows findings, such as apical fibrosis and pleural thickening of the apical lobes, which help assess the diagnosis. We describe a case of PPFE diagnosed radiologically in a 69-year-old man. This case highlights that PPFE is a pathology that can go unnoticed for a long time, and patients might neglect the revealing symptoms such as coughing.

Large Cell Neuroendocrine Carcinoma of the Lung: A Case Series of 14 Cases.

Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subtype of neuroendocrine tumor, presenting with very aggressive behavior and a poor prognosis. The diagnosis is difficult and requires histological confirmation of the neuroendocrine nature by an immunohistochemical study on a biopsy sample. We retrospectively studied a series of 14 patients from the pneumology department of the Mohammed VI University Hospital of Oujda, Morocco, over a period of five years (from April 2017 to March 2021). The average age was 63.41 years (45-80 years). All our patients were male and smokers. The clinical signs were dominated by deterioration in general condition and dyspnea. Bronchoscopy was performed in 92% of patients, with neoplastic stenosis being the main found aspect, in 35% of cases. The histological diagnosis was obtained by bronchoscopy in 50% of cases. In the remaining cases, it was carried by CT-guided transparietal biopsy in 28% of cases, pleural biopsy in 7% of cases, biopsy of a metastatic site in 7% of cases and finally thoracoscopy with pleural biopsy in the remaining 7% of cases. Therapeutically, no patient received surgical treatment and three patients were put on palliative treatment. The positive diagnosis is often late, which makes the prognosis bad and the therapeutic possibilities limited. Hence the importance of strategies for the prevention of tobacco control and early detection in population at risk.