Null-Cell Ectopic Pituitary Adenoma of the Nasal Cavity.

An ectopic pituitary adenoma (EPA) is an uncommon type of pituitary adenoma, accounting for only 2% of all pituitary adenomas. EPAs are benign tumors that can occur anywhere along the migratory embryonic path of the pituitary gland and have no relationship to intrasellar elements. They are usually hormonally active and have a minor female predominance. The clinical features of EPAs are highly dependent on its hormonal activity, anatomical location, and its local mass effect. Appropriate radiological imaging is essential for the evaluation of EPAs. Imaging investigations show a normal pituitary gland and sellar turcica, provide details on the size of the tumor, its margins, and extent, and help with surgical planning. The criteria for diagnosing an ectopic pituitary adenoma depend on detailed histopathological examination. EPA management should be individualized. We present a case of a 71-year-old male who presented with a 9-month history of left nasal obstruction, purulent nasal discharge, and intermittent anterior epistaxis. The patient was being managed by his general practitioner for chronic rhinosinusitis but failure of his symptoms to resolve prompted a visit to the otorhinolaryngologist. The patient was diagnosed with a null-cell ectopic pituitary adenoma through histological analysis of a biopsy specimen that showed adenohypophyseal cells without cell-type-specific differentiation. The patient subsequently underwent an endoscopic endonasal excision and had an uneventful hospital stay.

Pediatric-Onset Relapsing Polychondritis With Otolaryngeal Manifestations.

Relapsing polychondritis (RP) is a rare autoimmune disease that can present with various clinical manifestations. Among the affected sites, the ear, nose, and throat cartilages are frequently involved, often leading to subtle and episodic symptoms that can be challenging to diagnose. A high index of suspicion is necessary for the early identification of these subtle signs, which can aid in early diagnosis and prompt management. In this report, we present a rare case of pediatric-onset relapsing polychondritis that was initially misdiagnosed as laryngotracheobronchitis.

Apixaban-Induced Pseudo-Ludwig's Angina.

Ludwig's angina describes fulminant cellulitis involving the oro- and hypopharynx, which typically stems from bacterial pathogens, whereas "pseudo-Ludwig's angina" is ascribed to sublingual swelling due to noninfectious causes. There is a paucity of case reports implicating warfarin as the culprit for sublingual hematoma mimicking Ludwig's angina; however, we describe a novel case of apixaban-induced pseudo-Ludwig's angina, which was successfully managed with urgent surgical intervention and supportive care with antibiotic and glucocorticoid therapy.

ALK-Positive Anaplastic Large Cell Lymphoma: A Diagnostic Dilemma for the Otolaryngologist in a Resource Poor Setting.

Anaplastic large cell lymphoma is a rare subtype of non-Hodgkin's lymphoma. The morphological diversity with which its anaplastic cells confer make the diagnosis of this hematological entity extremely challenging to the pathologist in a resource poor setting. We present a case of a 35-year-old male with a nasopharyngeal mass and cervical lymphadenopathy and the adversities faced by out otolaryngology department with obtaining the diagnosis of ALK-positive anaplastic large cell lymphoma.

Doxycycline Sclerotherapy of a Cervical Cystic Hygroma: A Caribbean Institution Experience.

Cervical cystic lymphangiomas are rare benign tumors that pose a formidable challenge to surgeons confronted with managing this uncommon entity. Due to the intimacy with which these cystic lesions blend with critical cervical structures, a considerable number of patients who undergo surgical management are often plagued with recurrence and morbidity. As a result, doxycycline sclerotherapy has become an attractive, safe, and effective alternative as a primary treatment modality in a select group of pediatric patients. This case report presents an 18-month-old patient with a large cervical cystic hygroma that was effectively treated with exclusive doxycycline sclerotherapy.

Odontogenic Cutaneous Fistula: A Cause of Persistent Cervical Discharge.

Odontogenic cutaneous fistulas often lead to intense levels of patient discomfort and suffering. Due to its rarity and the absence of dental symptoms, a considerable number of patients are usually misdiagnosed which results in inappropriate management. This case report presents a 16-year-old patient with a 2-year history of a nonhealing, persistently discharging lesion in the left submandibular region of the neck. The patient underwent exploration of the left submandibular region, and a fistulous tract directed superomedially to the ipsilateral lower molar teeth was excised. A subsequent panoramic orthopantomogram performed one week postoperatively demonstrated radiolucency is the distal root of tooth 37. A final diagnosis of odontogenic cutaneous fistula was made, and the patient was referred to the Maxillofacial Department for treatment of the offending tooth.