RESUMEN
Our patient is a man in his mid-20s with an atypical presentation of a catecholamine-secreting sinonasal paraganglioma. He was referred to our tertiary otolaryngology unit for persistent right infraorbital numbness. A nasoendoscopic examination demonstrated a smooth mass arising from the posterior aspect of the right middle meatus. There was also right infraorbital paraesthesia. Imaging revealed a lesion in the right pterygopalatine fossa. Blood investigations revealed significantly elevated serum normetanephrine levels. The lesion was demonstrated to be octreotide-avid with no other lesions detected. The presumptive diagnosis of a catecholamine-secreting paraganglioma was made, and an endoscopic resection of the tumour was performed. Histopathology of the tumour demonstrated a 'zellballen' growth pattern consistent with a paraganglioma. Catecholamine-secreting sinonasal paragangliomas are exceedingly rare with multifaceted challenges. More studies are required to improve our knowledge of this condition.
Asunto(s)
Catecolaminas , Paraganglioma , Masculino , Humanos , Paraganglioma/diagnóstico por imagen , Paraganglioma/cirugía , Normetanefrina , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To report a case of Aspergillus flavus malignant otitis externa, successfully treated with antifungal agents, surgical debridement, and hyperbaric oxygen treatment. PATIENT: The case was a 77-year-old man with non-insulin dependent diabetes mellitus, who presented with otalgia and purulent otorrhea. Intervention was with surgical debridement, antifungal agents, and hyperbaric oxygen treatment. The main outcome measures were radiological and histological findings. CONCLUSIONS: A. flavus is a rare cause of malignant otitis externa. Aggressive treatment should include surgical debridement, with appropriate antifungal agents and hyperbaric oxygen therapy.
Asunto(s)
Aspergilosis/terapia , Aspergillus flavus , Oxigenoterapia Hiperbárica , Otitis Externa/terapia , Anciano , Antifúngicos/uso terapéutico , Aspergillus flavus/aislamiento & purificación , Humanos , Masculino , Otitis Externa/microbiologíaRESUMEN
OBJECTIVE: To report a case of a giant ecchordosis physaliphora causing local bone remodelling. PATIENTS: A 45 year old man, who presented with sudden sensorineural hearing loss. INTERVENTION: Transpetrosal approach to resect a midline prepontine mass. MAIN OUTCOME MEASURES: Radiological and histological findings. CONCLUSION: The distinction between giant ecchordosis physaliphora and intradural chordoma is questioned and exemplified by our case. It is possible they represent the same entity of disease, which must be distinguished from classical malignant osseous (extradural) chordoma.
