Keratocystoma of the parotid gland.

An 18-year-old man had a painless, elastic, firm mass in his left parotid area that gradually increased in size over a period of 6 months. At the time of examination, the parotid mass was poorly mobile and 46 mm in size. Although fine needle aspiration cytology revealed no malignant findings, we suspected a malignancy because the movement of his left mouth angle was slightly impaired; facial nerve paralysis as a result of tumor invasion was suspected. A superficial parotidectomy was performed. The tumor had a strong adhesion to the subcutaneous tissue and facial nerve. Histologically, multiple, randomly distributed cystic structures containing keratinized lamellae were present. The cystic spaces were lined with stratified squamous epithelium lacking a granular layer, and no skin appendage was observed. We diagnosed this case as a keratocystoma. Keratocystoma of the parotid gland is a rare benign tumor with only 6 cases reported worldwide. This case is the first to describe facial nerve palsy in association with a keratocystoma.

Persistent petrosquamosal sinus: underlying cause of otitic hydrocephalus with lateral sinus thrombosis.

Lateral sinus thrombosis (LST) occurs when a middle ear infection disseminates directly via bone erosion or disseminates indirectly through the venous networks. The petrosquamosal sinus (PSS) is the residual accessory dural sinus connecting intracranial to extracranial drainage. This report describes a case of a patient with persistent PSS running through the mastoid in context of otitic hydrocephalus with LST. To identify PSS, enhanced CT and reconstructed image from CT venography were more useful than MRI. The possibility of persistent PSS running through the mastoid should be considered if LST without marked inflammation and bone erosion is noted.

Nasopharyngeal tuberculosis.

Today, the opportunity to see tuberculosis is decreasing. Nasopharyngeal tuberculosis is a rare entity, even in endemic tuberculosis areas. A case of nasopharyngeal tuberculosis is described. A 28-year-old woman presented with a sore throat. Irregular mucosal thickening was seen in the nasopharynx. Staining for acid-fast bacilli was positive (Gaffky 1), and the PCR test was positive for Mycobacterium tuberculosis from pharyngeal mucus. Computed tomography showed mucosal thickening in the pharynx and old pulmonary tuberculosis in the right upper lobe. Multiple anti-tuberculosis drug therapy was performed for 6 months. A few days after the initiation of therapy, the pharyngeal pain subsided. The irregular mucosal thickening was quite thin after 1 month of multidrug therapy and was no longer observed after 2 months. A case of nasopharyngeal tuberculosis is reported. A good result was obtained with multiple anti-tuberculous drug therapy for 6 months. Nasopharyngeal tuberculosis should be considered in the differential diagnosis of a white nasopharyngeal coating, especially in a patient with a history of pulmonary tuberculosis.

Multiple primary pleomorphic adenomas in a single parotid gland: report of a new case.

The development of multiple primary pleomorphic adenomas in a single parotid gland is extremely rare in previously untreated patients, as only nine cases have been previously reported. In this article, we report the tenth such case, which occurred in an 87-year-old Japanese women. We also report the results of our 7-plus-year review of the types of parotid tumors seen at our institution. We identified 98 tumors in 89 patients; pleomorphic adenomas were the most common tumors, accounting for 45.9% of the total.