A Rare Nasopharyngeal Adenoid Cystic Carcinoma: Case Report and Literature Review.

BACKGROUND Adenoid cystic carcinoma (ACC) is a malignant tumor that involves the salivary glands and is rarely seen in the nasopharynx. It is characterized by pain, a high rate of recurrence, and poor survival rate and poor prognosis as it tends to invade the perineurium. Due to the ambiguity of patient presentations, most patients present at a late stage, at which point metastasis has already occurred. CASE REPORT The patient in this case report was an otherwise healthy 56-year-old male smoker who presented to the clinic in March 2022 complaining of nasal obstruction, mouth breathing, recurrent epistaxis, headache, and facial pain. He reported significant weight loss in the past 6 months. The nasal scope showed nasopharyngeal fullness and biopsy-confirmed ACC exhibiting tubular, solid, and focal cribriform growth patterns. Further work-up showed an advanced form of nasopharyngeal ACC with intracranial extension and lung metastasis. The patient received concurrent radiotherapy and chemotherapy. After 6 months, the patient reported an improvement in the pain, and repeated images showed regression of the tumor size. CONCLUSIONS ACC is a malignant disease that is rarely seen in the nasopharynx. Currently, the most commonly agreed upon management for resectable ACCs in the literature is through surgical resection with adjuvant radiotherapy. However, most of the reported cases received radiation and chemotherapy due to the difficulty and risk of radical surgical excision of nasopharyngeal malignant tumors. Patients should be followed up to rule out any local recurrence or distant metastasis.

Satisfactory outcomes of post-operative subtalar extra-articular arthroereisis in juvenile flexible flat foot.

OBJECTIVES: To analyze the surgical outcomes of subtalar extra-articular arthroereisis and the patient/parent satisfaction regarding the foot's shape, foot pain, ability to walk, ability to jump, and shoe wear. METHODS: Our retrospective cross-sectional study was carried out through an online-based questionnaire to assess patient satisfaction postoperatively at 3 hospitals (King Khalid University Hospital, Sultan bin Abdulaziz Humanitarian City, and Dallah Hospital, Riyadh, Saudi Arabia) between the years 2014-2021. RESULTS: A total of 65 patients participated in our study. Approximately 86.1% of them had the operation bilaterally. The most important aspects where patients noticed the most improvement were the foot's shape (90.8%), pain (81.5%), and ability to walk (76.9%). CONCLUSION: Several studies have been carried out highlighting the surgical technique and complications of the procedure. However, a limited number of studies have been carried out to assess patient satisfaction with the procedure, especially in Saudi Arabia, as the procedure is considered relatively new in the region with insufficient data regarding it. Therefore, this study is considered one of the few articles regarding subtalar extra-articular arthroereisis in the region.