Le chondrosarcome naso-sinusien: à propos de deux cas et revue de la literature

Le chondrosarcome est une tumeur maligne très destructrice d’origine cartilagineuse, osseuse et  mesnchymateuse. La localisation au niveau de la tête et cou est rare et le siège naso sinusien est encore plus rare. Nous rapportons deux observations de chondrosarcome du sinus maxillaire droit et sphéno ethmoïdale. Le but de notre travail est de montrer à travers ces deux cas cliniques, l’intérêt de la tomodensitométrie et de la résonance magnétique dans la présemption diagnostique en corrélation avec la clinique et l’endoscopie,de discuter le choix de la voix et la technique d’abord chirurgical et la surveillance post opératoire. A travers ces deux observations nous soulignerons les difficultés que pose cette tumeur à l’anatomopathologiste pour différencier entre chondrome et chondrosarcome.Key words: Chondrosarcome naso-sinusien, tumeur maligne, sinus maxillair

La tuberculose extra-ganglionnaire primitive de la sphère ORL: à propos de 15 cas

Les localisations ORL extra ganglionnaires de la tuberculose sont rares. La symptomatologie clinique ainsi que les examens paracliniques sont souvent  trompeurs,posant ainsi le problème de diagnostic différentiel avec la pathologie tumorale. Nous rapportons 15 cas de localisations extra ganglionnaires de  tuberculose, colligés au service ORL et CCF de l’Hopital Militaire Avicenne de Marrakech colligés entre 2009 et 2013. L'âge moyen de nos patients est de 33 ans. L'étude topographique a montré 6 cas au niveau du cavum, un cas de miliaire  tuberculeuse pharyngée, 4 cas laryngés; 2 localisations auriculaires ; 1 parotidienne et 1 localisation sous maxillaire. Le diagnostic était anatomopathologiquedans tous les cas. Tous nos patients ont reçu un  traitement antituberculeux avec une bonne évolution.Mots-clés : Tuberculose, amygdale, rhinopharynx,  larynx, glandes salivaires,Oreille moyenne

About a rare tumor of the upper lip: the mucoepidermoid carcinoma

Mucoepidermoid carcinoma represents about 5% of all salivary gland tumors, in which, about one-third occurs in the minor salivary gland. Mucoepidermoid carcinoma is the third most frequently encountered minor salivary gland tumor, preceded only by a mixed tumor and adenoid cystic carcinoma. The affected minor salivary glands are most frequently located in the palate, followed by the lower lip. Tumors of the minor salivary glands occur predominantly in women in the fourth to fifth decades of life. The tumors are characterized by endophytic growth and often present a slowly progressive course, which delays the diagnosis. We report a 42-year-old woman, who consulted for a painless mass with a diameter of 3x2, 5 cm on the internal aspect of the upper lip. The mass had appeared 3 years earlier. The lesion was lobulated, of elastic consistency, and covered by a normal mucosa. Its growth had been slowly progressive. There were no palpable locoregional lymph nodes. As the swelling was progressively increasing in size, surgical excision of the swelling was planned. The mass was removed under general anesthesia and sent to the Pathology Department for histopathological examination. Low-grade mucoepidermoid carcinoma was diagnosed. Although malignant minor salivary gland tumors are rare in the lip, they must be kept in mind in the differential diagnosis. As the prognosis of low-grade mucoepidermoid carcinoma is excellent after wide local resection, although rare, the possibility of mucoepidermoid carcinoma should be always be considered while dealing with any lip mass.Pan African Medical Journal 2015; 2

Ameloblastic carcinoma of the mandible: A case report and review of the literature

Aim: The purpose of this paper was to report an additional case of ameloblastic carcinoma of the left hemi-mandible and to review and analyze clinical, radiological and histopathologic features, treatment modalities and prognosis. Presentation of case: A 70 year old malepatient presented to Maxillofacial Department for a painful swelling of the left cheek. An ameloblastic carcinoma of the left hemi-mandible was diagnosed. He underwent radical surgical intervention comprising hemimandibulectomy, supraomohyoid neck dissection, and fibula free-flap reconstruction. Postoperative radiotherapy was employed. Discussion: Ameloblastic carcinoma of the mandible is a rare aggressive tumor with a poor prognosis. It can be seen in different ages. The most common symptom is a rapidly progressing painful swelling. It is defined as a malignant epithelial odontogenic tumor that retains the features of ameloblastic differentiation with cytologic features of malignancy. Non therapeutic consensus is established. However, wide surgical excision with radiotherapy is the most common treatment. Conclusion: Diagnosis of ameloblastic carcinoma at early stage and close periodic screening for metastasis are necessary to improve patient prognosis