Hemangioma of base of tongue.

Although vascular malformations of the tongue comprise a significant portion of head and neck angiodysplastic lesions, hemangioma of base of tongue is rare. We report a case of hemangioma of base of tongue extending to the supraglottis, which necessitated an extended supraglottic laryngectomy. Patient had an uneventful recovery and at three year, follow-up has a normal speech and no difficulty in swallowing or aspiration. More importantly, there was no recurrence of hemangioma or bleeding. Although hemangiomas may be treated by various conservative methods, occasionally patient may require surgical excision as in the present case due to the repeated bleeding episode and difficult access. A high index of suspicion and radiological investigations should be performed if the clinical presentation is atypical for malignancy, as in our case.

CT staging of pancreatic and periampullary carcinoma.

Sixteen cases of carcinoma head pancreas and seven cases of periampullary carcinoma are staged together on CT scan because of their morphological similarity and similar parameters. Following parameters are considered for CT staging: tumour mass, involvement of splanchnic vessels, locoregional lymph nodes and presence or absence of hepatic metastases. Findings were confirmed on surgical exploration. A contrast enhanced CT scan was 58.3 percent sensitive and 100 percent specific for the involvement of lymph nodes and 100 percent sensitive and 93.4 percent specific for hepatic metastases. The cases diagnosed as non-resectable on CT staging were found inoperable on exploration. Authors believe that for all practical purposes, pancreatic and periampullary malignancies can be grouped together and a contrast enhanced CT scan can provide reliable information for the staging of the tumor.

Retropharyngeal lipoma.

Lipomata in retropharyngeal region are extremely rare. Accurate preoperative diagnosis is very important to assess invasion of muscles and to prevent local recurrence. A case of retropharyngeal lipoma is being discussed along with review of its clinical, radiological and surgical aspects. The role of CT scan in its definitive diagnosis is also discussed.