H.O. El Malki

La tuberculose de la thyroïde. Diagnostic et traitement

Thyroid tuberculosis is rare. We present the case of a 25 year-old woman with tuberculosis of the thyroid. Although seldom observed, tuberculosis should be considered in the differential diagnosis of nodular lesions of the thyroid. Diagnosis is made by histological examination and demonstration of the tubercle bacilli from biopsy or aspiration specimen. The efficacy of fine-needle aspiration cytology in diagnosis of tuberculosis of the thyroid is proved. Administration of antituberculous drugs is considered as the treatment of choice. Abscess drainage is sufficient. In rare cases surgery is necessary. The prognosis is good.

Kyste hydatique récidivant de la thyroïde : à propos d’un cas

Nous rapportons une observation concernant un jeune patient âge de 21 ans opere en 1987 pour kyste hydatique du segment VIII du foie. Six ans plus tard, le patient a presente un nodule froid du lobe gauche de la thyroide, en per operatoire une ponction du nodule avec etude cytologique a confirmer la nature hydatique du kyste, le patient a eu une resection du dome saillant. En 1996 le patient a eu une recidive cervicale, et lors d’une tentative de perikystectomie survient une plaie de l’artere sous Claviere, dont l’hemostase a necessite une desarticulation sternoclaviculaire. Le kyste hydatique de la thyroide est rare, cependant il faut l’evoquer devant les tumeurs cervicales anterieures en pays d’endemie. Le traitement consiste alors a faire soit une kystectomie, une isthmolobectomie ou une thyroidectomie sub-totale, la resection du dome saillant sera reservee a la recidive.

Parathyroid incidentaloma. Literature review about three case reports.

BACKGROUND Parathyroid incidentaloma is not a well-known entity. The aim of this study was to show its incidence and to discuss its management. METHODS This was a prospective study analyzing cases of enlarged parathyroid glands discovered during thyroid surgery. The records of patients with parathyroid incidentaloma were reviewed. We also reviewed all cases of primary hyperparathyroidism (HPTPs) operated during the same period for comparison. RESULTS Three cases of enlarged parathyroid were found. No clinical or biochemical features led us to suspect hyperparathyroidism before surgery, but a macroscopically enlarged parathyroid gland was discovered during the dissection and was removed in all three patients. CONCLUSIONS Enlarged parathyroid glands discovered at the time of surgery may represent an early pathological stage responsible for overt primary hyperparathyroidism. In absence of major risk for recurrent nerve palsy, we recommend removal of any enlarged parathyroid discovered during neck surgery in order to avoid the risks of future surgical procedures, preserving in the same time at least one normal parathyroid gland.