BackgroundThis study was conducted to determine the efficacy of surgery in the treatment of complex aspergilloma comparatively with simple aspergilloma.MethodsFrom January 2006 to December 2014, 115 cases of pulmonary aspergilloma were admitted in our department. One operation on one side was counted as one case and the patients were divided into two groups. In group A: 61 cases of complex aspergilloma. In group B: 50 patients underwent 54 cases of lung resection for simple aspergilloma. People who underwent arteriography and embolization were excluded. Surgical treatment was indicated when 1) recurrent aspergilloma-related hemoptysis, 2) definite simple or complex aspergilloma and 3) a simultaneous bilateral aspergilloma.ResultsPeople with complex aspergilloma were big smokers with lower BMI, and had reduced lung function parameters. The main symptoms were repeated hemoptysis, chronic cough, abundant purulent expectoration and respiratory infections. Lobectomy was the most performed indication. In group B, number of wedge resections was larger than group A with statistical significant difference (p = 0.001). In the post-operative course morbidity was higher in group A (16 %) vs (9 %) in group B with statistical difference (p = 0.026). The median follow-up was 30 months (range 19–52 months).The median duration of chest tube drainage was 4 days. The duration of chest tube drainage was longer in the group A (4.7 ± 1.4 versus 2.9 ± 1.3; p = 0.005). The prolonged postoperative air leakage occurred more frequently in group A (14.75 %; versus 1.8 % p = 0.015). In group A, 3 cases and 2 in group B underwent a secondary operation for post operative hemothorax. Bronchopleural fistula occurred exclusively in group A (n = 4).ConclusionsThe surgical resection should be used in a multidisciplinary approach. Preoperative Interventional therapies could optimize the conditions for the operation. Total surgical resection must be the treatment of choice of localized causative lesions.

Riedel's thyroiditis is a very rare inflammatory condition. It affects not only the thyroid gland but also the adjacent vital structures. It may also be associated with different forms of systemic fibrotic disorders. The exact etiology is unknown, but currently, the most favorable opinion is that it is a localized form of the systemic fibrotic process. We report the case of a 38-year-old woman, presented with a 10-month history of progressive hypothyroidism, dysphonia, and dysphagia. A Doppler ultrasound study revealed massive thyroid enlargement with multiple Eu TIRADS 3 and 4 nodules. Fine needle aspiration was noncontributive on two occasions. A hard subtotal thyroidectomy was performed. Pathological study confirmed Riedel's thyroiditis with the presence of IgG4 antibodies in immunohistochemistry. The patient was successfully treated with levothyroxine replacement and corticosteroid therapy with rapid resolution of obstructive symptoms. The case descriptions highlight the diagnostic challenge of this disease, describe the response to surgical management and corticosteroid therapy, and give a short review of the subject.

Echinococcosis is an endemic zoonotic infection. The liver and the lung are the most affected organs, but muscle hydatidosis is very rare. We reported a case of a 39-yearold man, admitted for a cystic lesion of the right infraspinatus muscle, with radiological presumption of a hydatid cyst or a cystic tumor on computed tomography. Surgical excision of the cyst was performed. Preoperatively a diagnosis of an hydatid cyst was obvious. The pathologist confirmed the diagnosis.

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Anaplastic thyroid cancers are the final dedifferentiation form of follicular thyroid tumors. They are one of the most serious cancers with a survival average of 6 months after diagnosis. Many studies suggest that anaplastic thyroid cancers are a form of a pre-existing differentiated thyroid carcinoma, but only a few cases have been reported in the literature. We report the case of a 64-year-old patient, with a 30-year history of a thyroid nodule. He presented a latero cervical swelling with compression signs, evolving for 2 months in a context of general state alteration. The tomodensitometry objectified a malignant process of the right thyroid compartment with repression of the upper airways. This process is associated with a large necrotic right jugulocarotid adenopathy, multiple lymph nodes, and secondary pulmonary parenchymal lesions (balloon release). The patient underwent a total thyroidectomy with lymph node dissection. The anatomopathological study revealed an anaplastic carcinoma of the thyroid developed on a papillary thyroid carcinoma (PTC). Thus supporting anaplastic transformation of PTC. Subsequently, the patient received radiochemotherapy but died from the disease 3 months after diagnosis. The case reports highlight that although rare, the transformation of a differentiated thyroid carinoma into anaplastic carcinoma can occur on the initial lesion or on metastases. This transformation radically changes the patients prognosis. Early management and rigorous long-term follow-up are therefore necessary.