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Purpose: Systemic Lupus Erythematosus (SLE) in males is rare. Clinical and biological features, as well as, the outcome may differ comparatively to female patients. The purpose of our study is to define these clinical and biological features in Tunisian male patients presenting SLE. Methods: A mono-centric, retrospective and descriptive study of 96 patients followed for SLE out of which 21 are males. A comparative study was then performed between male and female patients groups. Results: Sex-ratio female/male was 3.6/1, the average age at diagnosis of SLE was 37.8±14 years. The most frequently noted clinical manifestations were: skin involvement (81%), renal involvement (71.4%) and joint damage (66.7). We observed a significant difference in clinical features between male and female patients (21 males and 76 females): renal failure (52% vs. 71.4%), serositis (23.8% vs. 2.7%), peripheral neuropathy (19% vs. 4%) and lung interstitial disease (14.3% vs. 1.3%). No significant difference was found in the positivity of serum antibodies between the two groups. Fifteen male patients (71.4%) had a SLEDAI score greater than or equal to 11, referring to high/very high disease activity. Out of the 32 patients who developed infectious complications during the course of the disease, 11 were male (52.4% of males). Concerning the male group, complete remission was observed in 10 patients (47.6%), while 10 others presented persistent sequella. We observed one death in the male group secondary to infective acute respiratory failure. Conclusion: SLE in male patients is rare and associated with poor prognosis. Disparity was observed in clinical and biological features as well as outcome in the different studies. In our study, we concluded that male lupus is more severe.

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The coexistence of a head and neck cancer and a lymph node tuberculosis is rarely described. The problem is essentially diagnostic. We report the case of a patient with cervical lymphadenopathy and non suspect swelliing of nasopharynx. Histopathological study of lymph node reveled an association of a tubercular adenitis and a metastasis of a squamous cell carcinoma.

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RESUMELes carcinomes hybrides sont des tumeurs rares représentant moins de 0,1% des tumeurs des glandes salivaires. Un seul cas de carcinome hybride nasosinusien a été rapporté à ce jour. Nous rapportons le cas d'une patiente âgée de 56 ans présentant une tumeur à double contingent carcinomateux épithélial-myoépithélial et adénoïde kystique développée au niveau de la fosse nasale droite, dont l'exérèse par voie de Caldwell-Luc s'est soldée par une récidive au terme de deux ans d'évolution. Une deuxième chirurgie a été réalisée par voie de Rouge Denker avec une exérèse emportant la récidive localisée mais respectant les structures ostéocartilagineuses des fosses nasales, complétée d'une radiothérapie du lit tumoral et des aires ganglionnaires cervicales. Nous ne disposant pas dʼassez de recul pour parler de lʼévolution. Il s'agit du deuxième cas de tumeur hybride à localisation nasale rapporté à ce jour. Les tumeurs hybrides carcinomateuses à localisation naso-sinusienne sont possibles bien qu'exceptionnelles. Leur prise en charge thérapeutique et leur pronostic sont corolaires du contingent le plus agressif. Mots-clé : Carcinome; hybride; tumeurs fosses nasales. SUMMARYHybrid carcinoma is a rare neoplasm, accounting for less than 0.1% of all registered tumors in salivary glands. Up to now, only one case of hybrid carcinoma of the nasal cavity has been described. In this report, we describe a case of hybrid carcinoma composed of epithelial-myoepithelial carcinoma with an adenoid cystic carcinoma component occurring in the nasal cavity in a 56-year-old woman. Caldwell-Luc means resection was performed and the patient revisited because of the tumor recurrence within two years of evolution. A second surgery was accomplished by means of Red Denker and a adjuvant radiation therapy is envisaged. We have not enough detachment to speak about actual evolution. It is in our knowledge the second case of hybrid tumor of the nasal cavity described in the literature. Hybrid carcinoma of the nasal cavity is possible although rare. Therefore recognition of other component that is more aggressive and has a worse prognosis has therapeutic and prognostic ramifications.

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