Mohamed Smahi

Aspergilloma in combination with adenocarcinoma of the lung.

A 60 year old male with a long standing history of smoking was referred to our department for surgery of aspergilloma in right upper lung lobe diagnosed by computed tomography and confirmed by computed tomography guided needle aspiration biopsy. A lobectomy was performed. Histological study of the surgical specimen revealed a pulmonary adenocarcinoma associated with aspergilloma. By presenting this case we suggest that every case of pulmonary aspergillome should be examined for malignancies, especially in smokers.

Intrathoracic Phrenic Nerve Neurofibroma

The usual location of intrathoracic neurogenic tumors is the posterior mediastinum. Those in a mediastinal anterior or middle location arise from the intrathoracic phrenic nerve, which is extremely rare and causes a problem for etiologic diagnosis. We report what is, to our knowledge, the second case of a mediastinal neurofibroma originating from the phrenic nerve of a 59-year-old woman without von Recklinghausen disease. Diagnosis was suggested by the radiologic features and confirmed by histologic aspects after excision. The prognosis after complete resection is excellent.

Surgical management of hydatid Bilio-bronchial fistula by exclusive thoracotomy

In the industrialized countries, most of Bilio-bronchial fistula are secondary to hepatobiliary trauma, hepatic resection surgery or in the case of congenital malformation of the biliary tract, Bilio-bronchial fistula is recognized as the complication of a number of infectious pathologies such as hydatidosis and hepatic amoebiasis. Among the causes, the Bilio-bronchial fistula of hydatic origin is by far the most frequent especially in the zones of hydatid endemic as Morocco. It is a serious complication of liver hydatid cysts. The surgical management has long been believed to be difficult, and often associated with a very pejorative prognosis due to the simultaneous attack of the thoracic and abdominal stage through the diaphragm. This tripartite involvement reflects the difficulty of choosing the first approach between the thoracic, abdominal or a combination of both approaches. However, progress, especially in the possibility of carrying out adequate preoperative preparation with the increasing introduction of retrograde endoscopic cholangiography with sphincterotomy, has made possible this exclusive thoracotomy surgery with acceptable outcomes.

Pancoast syndrome revealing a hydatid cyst of the lung

Learning point for clinicians Pancoast syndrome is not always synonymous with lung cancer. The search for infectious diseases such as hydatid cyst must be systematic in endemic areas especially for patients with no known risk factors of lung cancer. A 42-year old man, non-smoker, consulted for a 20 years progressive left lower-cervical mass. Physical examination revealed a hard rubbery left lower cervical mass 12 cm in diameter, filling the left supraclavicular fossa with intrathoracic extension. The mass was fixed to both …

About a submucosal tracheal tumor

The authors report the case of 46-year-old man with recurrent hemoptysis. Bronchoscopy revealed a submucosal tumor protruding into the tracheal lumen. Transbronchial biopsy failed to obtain a conclusive diagnosis; only surgery allowed complete resection of the tumor and confirmed the diagnosis of tracheal mucoepidermoid carcinoma. We discuss the unusual submucosal presentation of this tumor, and the contribution of surgery for diagnosis and therapy.