Congenital crico-thyroid dysplasia: a comprehensive description.

INTRODUCTION: We describe a first case of human congenital crico-thyroid dysplasia associated to a right sided aortic arch and an aberrant subclavian artery. CASE PRESENTATION: Our patient presented with a two-weeks history of acute dyspnea, and reported hoarseness since his childhood. An urgent tracheotomy was performed, followed by direct laryngoscopy. Endoscopic examination showed a deviation of the dorsoventral axis of the larynx, with an obstructive submucosal swelling the area of the right false cord and aryepiglottic fold. Computed tomography conducted the following day confirmed the crico-thyroid dysplasia, an infected laryngocele, and the presence of a right sided aortic arch and an aberrant subclavian artery. CONCLUSION: The embryological basis of these anomalies is attributed to congenital defects of the development of the fourth and sixth pharyngeal arches. To our knowledge, the congenital crico-thyroid dysplasia has not been previously reported in human. This case underscores the importance of recognizing anatomical variations in laryngeal cartilages, understanding their embryological origins, and potential associated malformations.

[Association of thyrolipoma and thyrolipomatosis: A case report]. / Association thyrolipome et thyrolipomatose : à propos d'un cas.

We report a rare case of thyrolipoma-thyrolipomatosis' association. A 48-year-old patient, with a past history of high blood pressure and chronic renal failure secondary to AA amyloidosis, presented with a midline neck swelling increasing in size since one year. Ultrasound showed a multinodular goiter, the worst nodule was left-lobar and categorized as EU-TIRADS 4. Grossly, cut section of the thyroïd specimen showed a yellow-tan left-lobar nodule measuring 2.5cm, the surrounding tissue had a diffuse yellow-brown appearance with scattered whitish areas. Histopathologic examination revealed that the nodule corresponded to a follicular adenoma.Thyroid fat infiltration was noticed both within the nodule and in the neighboring parenchyma. Thus, the diagnosis of an association thyrolipoma-thyrolipomatosis was rendered. The association of thyrolipoma-thyrolipomatosis is a very rare occurrence of unclear pathogenesis. To the best of our knowledge, this report describes the second case in the literature. The diagnosis is retained on the basis of certain histological features, revealing mature adipose tissue within thyroid gland as a combined nodular and diffuse pattern.

Therapeutic Management of Primary Atrophic Rhinitis (Ozene): About 4 Cases.

Objective: To study the clinical characteristics and therapeutic means of primary atrophic rhinitis. Method: We present 4 cases of atrophic rhinitis caused by Klebsiella ozaenae observed in our hospital over a period of 5 years. Results: All patients presented the clinical triad: mucosal atrophy, presence of crusts, and cacosmia. Treatment was medical in 3 patients and surgical in 1 patient. We used rifampicin and sulfamethoxazole as antibiotics as well as trimethoprim for a period of 4 months. The surgical treatment consisted of recalibration of the nasal cavities by placing 2 silicone sticks in the subperiosteum. The evolution was marked by obstruction and cacosmia in 3 out of 4 patients. Conclusion: The treatment of primary atrophic rhinitis poses a problem for the clinician in terms of means and therapeutic effectiveness given that it is a chronic pathology requiring regular monitoring.

Glottal Features in Vocal Assessment Following Thyroidectomy.

OBJECTIVES: Vocal dysfunction is a frequent complication following thyroidectomy that can be associated with a negative impact on patients' quality of life. Although the effect of thyroidectomy on acoustic features has been widely studied, the examination of glottal flow characteristics to assess vocal outcomes following thyroid gland surgery has not been included in empirical research, to date. The goal of our study was to evaluate early and short-term vocal outcomes following thyroidectomy based on the analysis of glottal acoustic features during speech production. STUDY DESIGN: Prospective analytical study. MATERIALS AND METHODS: We evaluated vocal outcomes in patients who underwent thyroidectomy between September 2021 and March 2022. We extracted glottal flow features from their vocal recordings preceding surgery and postoperatively at Day1 and Month1 postoperatively. The extraction of glottal features was performed using a signal processing-based approach. We extracted the following features: Open quotients (OQ1 and OQ2), Quasi-open quotient (QoQ), Closing quotient (ClQ), Amplitude quotient (AQ), Normalized Amplitude quotient (NAQ) and Speed quotients (SQ1 and SQ2). We included 39 patients. OQ2 and QoQ decreased significantly at Day1 and Month1. OQ1 and NAQ decreased significantly at Month1. ClQ remained stable at both postoperative assessments. AQ decrease was not significant at both dates. SQ1 increased at Day1 and Month1 but the change was not significant. SQ2 decreased significantly at both Day1 and Month1. OQ, QoQ, AQ, NAQ, and SQ2 did not recover at Month1. We noted that the decrease of SQ1 and SQ2 correlated significantly with the increase of the Voice Handicap Index-10 (VHI-10) at Month1. CONCLUSION: The analysis of glottal acoustic features can be a reliable modality to detect vocal changes following thyroidectomy. Thyroidectomy was associated with a vocal dysfunction that was manifested by the decrease of open, amplitude, and speed quotients. Glottal features can present a potential tool to objectively assess the effect of thyroidectomy on vocal folds movements.

Primary Ewing Sarcoma in the Sphenoidal Sinus: A Case Report.

Ewing's sarcoma (EWS) is a rare malignant bone tumor that primarily affects children and young adults. While it typically affects long bones, it can occur in the head and neck region, including the paranasal sinuses in rare cases. We present a challenging case of a 45-year-old female diagnosed with an EWS of the sphenoidal and the right nasal fossa. A subtotal removal of the mass was performed on the patient followed by combined adjuvant radiotherapy and chemotherapy. Due to its rarity, the diagnosis and management of EWS in the paranasal sinuses are challenging.

Parathyroid Carcinomas: A Series of 6 Cases and Literature Review.

Parathyroid carcinoma (PC) is a rare endocrine malignancy. We report 6 cases of PCs operated on in our department, during a period of 12 years (2010-2021). All of our patients presented severe hyperparathyroidism, high calcium levels, and very elevated parathormone (PTH) rates. Five were between the fifth and sixth decades of life and 1 patient was 37 years old. The parathyroid gland was only palpable in 1 case. All of our patients underwent cervical ultrasound and 5 of them underwent 99m Tc-MIBI scintigraphy. One of the patients presented bilateral parathyroid masses. All our patients were treated surgically: a parathyroidectomy was performed in all cases. In 1 patient, parathyroidectomy was performed in conjunction with a homolateral loboisthmectomy, as the diagnosis of PC was suspected preoperatively due to pulmonary metastases. The final anatomopathological study revealed PC in all cases. Follow-up was uneventful in 5 cases and 1 patient was lost to follow-up. Clinicians should suspect PC in patients with severe hypercalcemia, extremely elevated PTH levels, large parathyroid lesions, and distant metastases. Complete surgical resection, extended to the homolateral thyroid lobe, remains the recommended treatment.

External auditory canal metastasis revealing bronchogenic carcinoma: A case report and literature review.

This report presents a rare case of bronchogenic adenocarcinoma with initial metastasis in the external auditory canal. The patient, a 64-year-old man with a history of bladder urothelial carcinoma, initially presented with a persistent right otitis externa. Otoscopic examination revealed a mass obstructing the right external auditory canal. The temporal bone computed tomography scan revealed a mass that completely obstructed the right external auditory canal and extended into the middle ear. A biopsy showed a poorly differentiated adenocarcinoma of bronchogenic origin, confirmed by positive immunohistochemical staining for cytokeratin 7 and Thyroid transcription factor-1. Further imaging revealed a large tumor mass in the lung involving the mediastinum and parenchyma, along with carcinomatous lymphangitis and cerebral metastasis. Histopathological examination of the primary lung tumor confirmed a poorly differentiated adenocarcinoma with similar features to the metastasis in the external auditory canal. The tumor was staged as T4N2M1c, and the patient underwent local external-beam radiation therapy with chemotherapy.

Pregnancy-Related Recurrent Benign Goiter With Intratracheal Extension.

This report describes the unique case of a 37-year-old pregnant patient with a history of total thyroidectomy who presented worsening dyspnea due to a recurrent benign goiter. The goiter grew through the tracheal wall and narrowed the tracheal lumen. After unsuccessful treatment with bronchodilators and corticosteroids, the patient underwent an emergency tracheostomy and cesarean section. Cervicothoracic computed tomography revealed a 4 cm mass in the left lobe of the thyroid gland with endotracheal extension in the subglottic region. Exploratory cervicectomy revealed a macroscopically resected mass that resembles the structure of the thyroid, adherent to the esophagus, anterior to the cricoid cartilage, and the trachea. Intratracheal thyroid tissue was not excised due to the increased risk of bleeding, and endoscopically guided biopsies were performed. Histopathological examination confirmed the benign nature of the thyroid tissue. A follow-up computed tomography scan after 2 months showed spontaneous regression of the intratracheal mass, and the tracheostomy tube was successfully removed without complications.

Lymphoepithelial carcinoma of the parotid gland.

Primary lymphoepithelial carcinoma of the salivary glands is an exceptional oncological condition that predominantly emerges within the parotid gland. A significant prevalence of lymphoepithelial carcinoma has been reported in the Inuit population, along with an associated positive serology for Epstein-Barr virus in these endemic regions. In this paper, we present a case of primary lymphoepithelial carcinoma of the parotid gland in a 68-year-old female patient with a history of diabetes and hypertension residing in a non-endemic area. Histology plays a critical role in the definitive diagnosis, and confirming the primary origin of lymphoepithelial carcinoma after ruling out metastasis from undifferentiated nasopharyngeal carcinoma. The mainstay of treatment is a combination of surgical resection and adjuvant radiotherapy. Inoperable forms are typically managed with chemoradiotherapy.

An intramuscular hemangioma of the semispinalis muscle: A case report.

Intramuscular hemangiomas are uncommon benign endotheliomas that typically occur in the trunk and limbs. Head and neck involvement is relatively infrequent, with the masseter muscle being the most commonly affected site. We present a rare case of intramuscular hemangiomas arising from the semispinalis muscle. A 31-year-old male presented with a painless swelling in the left upper neck region, gradually increasing in size over the past year. Imaging studies revealed a well-defined mass originating from the semispinalis muscle. Surgical excision was performed successfully, and histological examination confirmed the diagnosis of a mixed intramuscular hemangioma. The patient remained recurrence-free during the 2-year follow-up period. Intramuscular hemangiomas in the posterior neck muscles are rare, with only a few reported cases. Wide surgical resection with control of feeding vessels is the optimal treatment, and follow-up is recommended to monitor for local recurrence. This case report highlights the clinical presentation, diagnostic challenges, and successful surgical management of intramuscular hemangiomas in a unique location, emphasizing the importance of accurate diagnosis and appropriate treatment of this rare tumor.

Predictive factors for hypothyroidy after hemithyroidectomy.

Background: Hemithyroidectomy is one of the most common procedures performed. It is used to treat patients with benign unilateral nodules. Hemithyroidectomy results in fewer risks of hypothyroidism and the need for thyroid hormone replacement therapy. The present study was designed to identify potential clinicopathologic risk factors associated with the onset of biochemical hypothyroidism. Methods: We conducted a retrospective review of all patients who underwent hemithyroidectomy between 2004 and 2019. Hypothyroidism was defined as a serum thyrotropin level greater than 5 mIU/L. The patients were analyzed for age, sex, preoperative and postoperative thyroid stimulating hormone (TSH), state, side, and volume of the remaining lobe, and histologic diagnosis. Results: Hypothyroidism was diagnosed in 30.8% of 214 patients. This complication appeared in the first year in 83.3% of the cases. A preoperative TSH level greater than 1.32 mIU/l, a remaining volume of the lobe less than 3 ml, and the presence of thyroiditis were associated with a significant increase in the risk of developing hypothyroidism (p<0.01). There were no significant differences in age, sex, state, and side of the remaining lobe. The mean thyroxine dose was 57 ± 26 micrograms. Conclusions: The risk of hypothyroidism after hemithyroidectomy should be assessed prior to surgery. Close monitoring is recommended in patients at high risk of developing this complication. However, all patients who undergo hemithyroidectomy should be monitored at least for the first year.