A Rare Case of Ewing's Sarcoma of Maxilla Managed with a Newly Proposed Multimodality Approach to Achieve Optimal Outcome.

Rare case of Ewing's Sarcoma of maxilla managed with newly proposed multimodalityapproach in which First neo-adjuvant chemotherapy was done to shrink the size oftumor mass and control possible occult distant metastasis and in the second phase surgical management that is followed by adjuvant chemotherapy was done. During Surgical phase, instead of doing a complete surgical resection, we have decided intraoperatively and performed only curettage of the tumor mass left after shrinkage of the tumor mass post chemotherapy phase. This concludes that there is the scope of trying newer ideas for management and, thus, more contemporary approaches for this rare entity. Like in our case, curettage of the tumor rather than radical resection as a part of multimodality approach also gave optimal outcome.

Extrapulmonary tuberculosis and COVID-19 infection coexisting in concurrent necrotising fasciitis with deep space infection of neck: an unusual presentation.

Ludwig's angina is a rapidly spreading, potentially fatal infection of deep fascial spaces of the neck leading to airway oedema and death. This, in recent times when associated with COVID-19 infection, possess treatment challenges making the patient susceptible to opportunistic infections with reduced healing potential. Owing to the multifactorial aetiology in our case and addressing them at the earliest, it is important to achieve favourable outcomes. The space infection that seeded with untreated trivial dental caries progressed to necrotising fasciitis of neck with mycobacterial growth on cartridge-based nucleic acid amplification test for tuberculosis testing. The presence of Mycobacterium organisms should be speculated in patients with pulmonary signs of tuberculosis (TB) because a suppurative TB lymphadenitis of neck could also have the same presentation. The decisive moment in successful outcome was identification of mycobacteria in COVID-19 infected patient, thereby allowing to initiate the antitubercular therapy along with surgical debridement. Thus, medical management of patient with cohabiting infections is difficult task and needs appropriate addressal.

Post-traumatic tuberculosis of Zygoma - An uncommon presentation.

Tubercular osteomyelitis of mid-facial bones is extremely rare because of its immense vascular supply. Due to rare incidence, myriad presentation, and lack of specific symptoms, this condition presents a challenge in diagnosis and calls for acute clinical awareness. This article presents a case report of a 31-year-old martial artist with complaints of trauma to his right malar region since one month and a gradually increasing swelling below his right eye for 3 weeks without any discharge. A diagnosis of primary Tuberculosis of right zygomatic bone was made with the help of multiple diagnostic tools. The patient was treated with four drug anti-tubercular therapy and responded with complete recovery from disease.