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Objective: A retrospective review of 223 patients (242 operations) of pulmonary hydatid cysts. We analyze and evaluate our experience in the surgical management of this Moroccan endemic disease and concluded that parenchyma-saving must be always used., Materials and Methods: In an 8 year period (2002 -2009), 223 patients (242 interventions, 282 pulmonary hydatid cysts) were operated on in our department. There were 166 males and 57 females with a mean age of 45.7 years. The diagnosis was established on the basis of different clinical signs and imaging studies. Surgical approach consisted of a posterolateral thoracotomy in all cases. Different surgical procedures were performed on the pulmonary lesions according to the localization, the size, the complicated or intact cyst and the importance of lung destruction., Results: Parenchyma-saving were done in 217 patients (238 interventions) cases, including cystectomies (189 cysts), pericystectomies (47cysts) with capitonnage of the cavity in 177 cysts. Radical treatment as lobectomies is used in only 6 cases. Postoperative minors complications occurred in 13 cases (5.4%), including 6 prolonged air leak, 4 pneumonias, one wound infection and two transitory residual cavities. There was no postoperative death. All patients were free of recurrence of thoracic hydatid disease in a follow-up ranging from 3 to 90 months (mean: 49 months)., Conclusion: Hydatid cysts of the lung should be treated before complications. Parenchyma saving is the best procedures for this benign disease; the radical resection must be reserved only for pulmonary destruction.

Background: The association of pulmonary and hepatic hydatid cysts is rare. Managing this condition with low mortality and complications is a challenge. The aim of this study is to put forward our experience in managing both sites in single-stage posterolateral thoracotomy. Patients and Methods: A retrospective study of 14 patients who underwent single-stage posterolateral thoracotomy and phrenotomy to treat right lung and liver hydatid cysts between January 2010 and December 2019 were reviewed. Results: Fourteen of 135 patients (10.4%) with double location of hydatid disease were treated in our department for pulmonary hydatid cysts in the same period. There were nine males and five females who were 20 to 72 years old (average age, 42.7 years). Chest computed tomography (CT) and abdominal scan were performed in all cases. The surgical approach was posterolateral thoracotomy and phrenotomy without laparotomy in all cases. Conservation of hepatic and pulmonary parenchymas was possible in 13 patients (92.8%). Average operative time was 122 minutes (range, 95-210 minutes) and the average post-operative hospital stay was 8.7 days. Post-operative complications occurred in two (14.3%) cases, one was atelectasis and the other persistent biliary and air leakage. There was no post-operative mortality. All patients received post-operative medical treatment for three to six months and there was no recurrence after an average follow-up of 26 months. Conclusion: Single-stage thoracotomy is a better option than thoracotomy and laparotomy for the management of double located hydatid cysts. It has a lower complication rate, shorter hospital stay, and rapid resumption of normal activity. [ABSTRACT FROM AUTHOR]

Introduction: Concomitant lung and liver hydatid cyst is a rare condition. Most surgeons agree that both sites should be resected in one-time surgery. Aim: We present a case series of hepatic and pulmonary hydatid cyst treated in one-stage surgery (OSS) compared with patients who underwent two-stage surgery (TSS). Material and methods: This retrospective study included 47 patients separated into two groups (33 TSS and 14 OSS) between 2008 and 2019. Data on clinical symptoms, sites, radiological features, techniques, postoperative complications, mean hospital stay and outcome were analyzed separately for TSS and OSS procedures. Results: A total of 33 patients who underwent TSS (70.2%) were compared to 14 patients operated on by OSS (29.8%). No significant differences were found between groups for age (45.3 vs. 42.7, p = 0.45), sex (male: 57.6% vs. 64.2%) and socio-geographic status (urban: 72.7% vs. 78.6%). But there were more postoperative complications (24.3% vs. 14.3%, p = 0.036) in the TSS group, and operative duration (154 minutes vs. 122 minutes, p = 0.047), postoperative hospital stay (13.8 days vs. 8.7 days, p = 0.022), and interruption of activities and work (56 days vs. 31 days, p = 0.045) were longer in the TSS group. There was no difference in postoperative mortality between the 2 groups. Conclusions: Single-stage surgical management by trans-thoraco-phrenotomy can be recommended to treat dual-seat hepatic and pulmonary hydatid disease with fewer complications and a rapid return to work. This technique is easier and safer for right lung and liver dome hydatid cysts. [ABSTRACT FROM AUTHOR]

We report a very rare case of cT1N0M0 lung adenocarcinoma reveling Lambert-Eaton myasthenic syndrome (LEMS). A 69-year-old nonsmoking woman, with several comorbidities consulted for cough and dyspnea. Chest radiograph and CT scanning detected a left lower lobe mass; Needle biopsy confirmed differentiated adenocarcinoma; 18FDG-PET scan and Brain MRI eliminated metastatic disease dissemination. Our patient underwent a left lower lobectomy with mediastinal lymphadenectomy (pT1N0M0), no adjuvant chemotherapy was administrated. One month later patient present a muscle weakness in both lower limbs and fatigability followed by an inability to walk. The diagnosis of LEMS was made from the distinctive electromyogram (EMG) findings and a treatment with Amifampridine (3, 4-diaminopyridine phosphate [3, 4-DAP]) was prescribed with evident efficacy for symptoms. [ABSTRACT FROM AUTHOR]

Background: Pulmonary sarcomas are uncommon accounting for 0.5 % of all primary lung cancers. Undifferentiated sarcomas account for up to 20 % of soft tissue sarcomas. A lung tumor revealed to be an undifferentiated sarcoma with epithelioid features has never been reported in the literature. Case presentation: A 61-year-old white Moroccan man presented with 2 months' history of hemoptysis and dyspnea. Chest computed tomography showed a cystic mass involving the lower field of his right lung evoking first a hydatid cyst. Abdominal computed tomography revealed bilateral adrenal nodules. Surgical resection of the lung mass was performed. On pathological examination, the tumor was cystic containing necrotic material. A histological diagnosis of undifferentiated sarcoma with epithelioid features was made. A positron emission tomography scan showed involvement of his pleura, left colon, adrenal glands, left thigh muscle, and leptomeninges. Conclusions: Undifferentiated sarcoma with epithelioid features is a rare malignant mesenchymal tumor. Clinical and radiological features are not specific. A differential diagnosis includes sarcomatoid carcinoma, malignant mesothelioma, melanoma, and other epithelioid sarcomas. [ABSTRACT FROM AUTHOR]