Multicentric recurrent parotid pleomorphic adenoma in a child.

Mixed tumours of the parotid gland are rare in childhood and recurrence of this tumour is infrequent. Some authors report a higher rate of recurrence with some histological subtypes, like hypocellular variant. Female sex and young age at initial treatment are also risk factor for recurrence. Also the first surgical treatment, tumour enucleation or parotidectomy, has been implicated as a cause for recurrence. We present a case of a multicentric doubly recurrent parotid pleomorphic adenoma, 7 and 14 years after tumour enucleation, in a 9-year-old child. All the nodules resected showed the hypocellular variant of pleomorphic adenoma. We consider the relationships between the choice of treatment, the histologic subtypes of pleomorphic adenomas and multifocal tumours and recurrence. In this case, we believe the recurrence was related to surgical enucleation previously performed and the hypocellular histological subtype. We conclude that tumour enucleation is a risk factor for recurrence and total parotidectomy is the treatment of choice for pleomorphic parotid adenoma also in childhood.

Wegener's granulomatosis: description of a case with oral manifestation.

Wegener's granulomatosis is a multisystemic granulomatous vasculitis that predominantly affects the airways and the kidneys, but may affect any organ. Otorhinolaryngological manifestations may be oral ulcers, gingival swelling or septal perforations that can cause saddle nose deformities, rhinitis, sinusitis and hearing loss. The oral ulcers usually occur when the disease is advanced. Renal involvement is characterized by focal and segmental glomerulosclerosis, and determines the evolution. The diagnosis is made by clinical symptoms and signs, the presence of c-ANCA and a positive biopsy. The anatomic pathology is characterized by vasculitis, granulomatous inflammation with multinuclear giant cells and necrosis. The prognosis has improved as a result of treatment with immunosuppressants associated with corticosteroids. We report a case of a 53-year-old patient with Wegener's granulomatosis with oral manifestation, which began as chronic mastitis.

[Solitary extramedullary plasmocytoma of tubaric tonsil]. / Plasmocitoma solitario extramedular de amígdala tubárica.

Several histopathological modalities of tumours can grow in the rhinopharynx. Solitary extramedullary plasmocytoma (SEP) is a low frequent variety of low-grade lymphoma. The aim of this work is to present a new case of SEP localized in rhinopharynx and to perform a review of diagnostic and therapeutic protocols of these neoplasias. They must be taken into account in the differential diagnosis of nasopharyngeal tumours.

[Chondromyxoid fibroma of the left maxillary and ethmoid sinuses]. / Fibroma condromixoide de seno maxilar y etmoides izquierdos.

Chondromyxoid fibroma is an infrequent bone tumour in the craniofacial bones and exceptional in the paranasal sinuses. This unusual location, its non-specific clinical manifestation and aggressive behaviour with local destruction and a high recurrence rate can complicate precise diagnosis and treatment.