In accordance with ACCME regulations, the American College of Surgeons must ensure that anyone who is in a position to control the content of the education activity has disclosed to us all relevant financial relationships with any commercial interest (see below for definitions) as it pertains to the content of the presentation. Should it be determined that a conflict of interest exists as a result of a financial relationship you may have, you will be contacted and methods to resolve the conflict will be discussed with you. In addition, all affirmative disclosures must be revealed by a slide at the beginning of the presentation. Failure or refusal to disclose or the inability to resolve the identified conflict will result in the withdrawal of the invitation to participate.

The American College of Surgeons

Cystic echinococcosis (CE) is a zoonotic parasitic disease caused by the larval stages of the cestode Echinococcus granulosus. Worldwide, pulmonary hydatid cyst is a significant problem medically, socially, and economically. Surgery is the definitive therapy of pulmonary hydatidosis. Benzimidazoles may be considered in patients with a surgical contraindication. This review will focus on pathogenesis, lifecycle, clinical features, and management of pulmonary hydatid disease.

Cystic pulmonary hydatidosis.

The receptor for advanced glycation end products (RAGE) is a non-specific multi-ligand pattern recognition receptor capable of binding to a range of structurally diverse ligands, expressed on a variety of cell types, and performing different functions. The ligand-RAGE axis can trigger a range of signaling events that are associated with diabetes and its complications, neurological disorders, cancer, inflammation and other diseases. Since RAGE is involved in the pathophysiological processes of many diseases, targeting RAGE may be an effective strategy to block RAGE signaling.

/pdf/pathophysiology-of-rage-in-inflammatory-diseases-2tmrjqpy.pdf

Pathophysiology of RAGE in inflammatory diseases

The mediastinum is an anatomically defined space in which organs and major blood vessels reside with surrounding soft tissue elements. The thymus is an important organ in the mediastinum, and many of the masses encountered in the mediastinum are related to this organ. Most neoplasms diagnosed in the mediastinum are epithelial tumours (thymomas and thymic carcinomas), lymphomas or germ cell tumours. In contrast, soft tissue tumours of the mediastinum are rare. In 1963, Pachter and Lattes systematically reviewed soft tissue pathology of the mediastinum, covering the hitherto described [2, 226, 227] In this review, based on the 2013 WHO classification of soft tissue tumours and the 2015 WHO classification of tumours of the lung, pleura, thymus and heart, we provide an updated overview of mesenchymal tumours that may be encountered in the mediastinum.

/pdf/mesenchymal-tumours-of-the-mediastinum-part-i-32ws6p3qy5.pdf

Mesenchymal tumours of the mediastinum--part I.

Background Foreign body (FB) aspiration requires a high index of suspicion for diagnosis and prompt management to avoid morbidity and mortality This retrospective study was conducted to review pediatric foreign body aspiration at the Ear, Nose and Throat (ENT) Unit of the Tamale Teaching Hospital (TTH) Materials and Methods The theater records of children managed for foreign body aspiration from January 2010 to December 2016 at the ENT Unit of TTH were retrieved and data summarized with respect to age, gender, indications for bronchoscopy, nature of foreign body, location of foreign body, and outcome of the bronchoscopy procedure Results A total of 33 children were managed within the five-year study period and comprised 16 (485%) males and 17 (515%) females The commonly aspirated FBs were groundnuts (13, 394%) and metallic objects (7, 211%) The peak incidence occurred in children aged ≤ 3 years The foreign bodies (FBs) were commonly localized to the right (242%) and left (242%) main bronchi, respectively One patient had emergency tracheostomy for failed bronchoscopy Conclusion Groundnuts were the most commonly aspirated foreign body with most of the FBs localized in the bronchi

/pdf/foreign-body-aspiration-in-northern-ghana-a-review-of-4ykm6uunj4.pdf

Foreign Body Aspiration in Northern Ghana: A Review of Pediatric Patients

OBJECTIVES Hydatid disease is a zoonosis resulting from the growth in man of the larval form of Echinococcus granulosus. Involvement of the bones is rare and localisation to the ribs is exceptional. The aim of our study is to present the pathophysiological and diagnostic characteristics of hydatid disease of the ribs and to define the radiological features. PATIENTS AND METHODS We undertook a retrospective study, over a period of 10 years, of 12 cases of hydatid rib disease. We have analysed the demographic, clinical and biological parameters and we examined the radiological details as well as the effect of surgery on the progress of the disease. RESULTS The mean age of the patients was 33.5±10 years. There was no sexual predominance. The clinical picture was characterised by chest pain in ten cases and by swelling in five. General health was satisfactory in all patients. The chest X-rays showed a shadow of water density with lytic rib lesions. Thoracic CT scans showed the relationships with the neighbouring structures, particularly the spinal column. In three cases T1- and T2-weighted MRI scans showed the extent of intraspinal extension and in two cases excluded medullary involvement. Hydatid serology was positive in five cases. All our patients were operated on, with rib resection and vertebral curettage in three cases, and resection of the transverse process in two. Histological examination of the surgical specimens confirmed the diagnosis. Eight patients were treated with albendazole. All patients were reviewed for a mean of 3 years and the progress was favourable. CONCLUSION Hydatid disease of the ribs is a very rare disorder and the diagnosis is difficult. It is sometimes an unexpected surgical finding but careful examination of the chest X-ray, supplemented by a CT scan, thanks to the liquid density of the lesions, is a great help in diagnosis. However, in the light of the results of our series, the radiological picture may be atypical and the interpretaion difficult.

Hydatid disease of the ribs

Leiomyoma of the mediastinum is rare. We report a case of a 57-year-old woman with a cervical mass diving to the intrathoracic. Chest radiography and computed tomography revealed a mass in the right superior mediastinum. The tumor was enucleated by cervicotomy. Histologically, the tumor was diagnosed as leiomyoma.

/pdf/primary-mediastinal-leiomyoma-a-case-report-4xr0fnpruz.pdf

Primary mediastinal leiomyoma: a case report

Well-differentiated fetal adenocarcinoma (WDFA) is a very uncommon malignant tumor originating in the lung. This report describes the case of a 38-year-old woman with a WDFA treated by surgery. The malignancy is low grade and associated with a good prognosis, and so it is important for clinicians to be aware of and to identify this rare variant of adenocarcinoma.

Well-differentiated fetal adenocarcinoma: A very uncommon malignant lung tumor

Les sarcomes tenosynoviaux ou synovialosarcomes sont des tumeurs malignes des tissus mous, l'atteinte primitive de la paroi thoracique est rare. Nous rapportons l'observation d'un patient suivi pour des douleurs thoraciques avec a l'examen une masse parietale, le bilan radiologique a montre un developpement egalement endothoracique de la tumeur. L'analyse anatomopathologique de la biopsie de la masse a conclu a un synovialosarcome, le patient a eu une resection de la tumeur associe a une radio chimiotherapie, le suivi a ete marque par la recidive au bout d'un an. A travers cette observation, nous insistons sur la rarete de la localisation, les caracteres histologiques, les differentes approches therapeutiques et le pronostic de ces tumeurs qui reste pejoratif.

/pdf/une-tumeur-rare-de-la-paroi-thoracique-le-synovialosarcome-iea1ybempb.pdf

Une tumeur rare de la paroi thoracique: le synovialosarcome

Resume Introduction Le but de ce travail est d’evaluer les resultats du traitement chirurgical des kystes hydatiques abdominaux rompus dans le thorax. Patients et methodes Nous rapportons une etude retrospective monocentrique de 160 cas de kystes hydatiques abdominaux rompus dans le thorax colliges entre 1997 et 2008. Le diagnostic etait base sur les antecedents de kyste hydatique abdominal opere, sur les signes cliniques dont la biliptysie (40 % des cas) et la vomique hydatique etaient les maitre-symptomes, ainsi que sur le bilan radiologique (radiographie thoracique ; echographie abdominale et TDM thoraco-abdominale). Ces cas se repartissaient en 158 kystes hydatiques de localisation hepatique, un kyste splenique et un kyste renal. Tous les patients ont ete operes par thoracotomie premiere. Resultats Le taux de mortalite etait de 7,5 %. Les complications postoperatoires (16 %) ont ete surtout d’ordre pleuropulmonaire. Conclusion La thoracotomie offre un abord simultane et adequat pour acceder aux lesions thoraciques, diaphragmatiques, hepatiques et spleniques avec une mortalite et une morbidite acceptables.

La place de la thoracotomie dans le traitement des kystes hydatiques abdominaux rompus dans le thorax

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