Wound of the Parotid Duct Following a Subcondylar Fracture.

Salivary gland and duct complications following surgical approaches to condylar fractures are well known, particularly in approaches requiring parotid tissue dissection. We report a rare case of a parotid duct wound caused by the fracture itself and due to a lateral displacement of the condylar fragment. Four days after the surgical management of a trifocal mandibular fracture (head fracture on the left side, laterally displaced condylar base and angular fracture on the right side) the patient presented with a fluctuating subcutaneous swelling in the right cheek, evoking a sialocele. The sialography showed a massive leak of iodinated contrast medium just in front of the parotid hilum, joining the subcutaneous undermining made during the approach and confirmed the diagnosis of a parotid duct wound. A pressure dressing was applied to the right mandibular angle for 2 weeks, allowing for complete remission. In conclusion, this unusual clinical case illustrates the fact that the parotid duct may be endangered in the event of condylar base fractures, not only by the surgical approach but also by the fracture itself, especially when there is severe lateral displacement.

[Oesophagus polyps: Giant fibrovascular polyp of the oesophagus disappears!] / Polypes œsophagiens : le polype géant fibrovasculaire de l'œsophage n'existe plus !

The giant fibrovascular polyp of the esophagus is a rare, benign and typical entity described in 1957. This lesion is easily identifiable in its macroscopic and microscopic aspects. However, recent studies question the existence of the giant fibrovascular polyp of the esophagus. The demonstration of an amplification of the MDM2 gene poses the diagnosis of well-differentiated liposarcoma. We describe here a case of an esophagus polyp in a 67-year-old man. The diagnosis of giant fibrovascular polyp of the esophagus was initially retained. Secondly, the immunohistochemical and fluorescence in situ hybridization techniques showed amplification of the MDM2 gene and reclassified the lesion to a well-differentiated liposarcoma. The search for an undifferentiated contingent is essential to not ignore a dedifferentiated liposarcoma, which is a high-grade sarcoma with a poorer prognosis.