A case report of synchronous bilateral multifocal nodular oncocytic hyperplasia in parotid gland.

INTRODUCTION AND IMPORTANCE: Multifocal nodular oncocytic hyperplasia (MNOH), alternatively known as Benign Nodular Oncocytosis, was first identified by Schwartz and Feldman in Cancer in 1969. It manifests as numerous nodular growths of oncocytic cells scattered within the salivary gland tissue; Bilateral and multifocal lesions in the parotid gland are rare occurrences. Among these, bilateral multifocal oncocytic lesions are even less common. CASE PRESENTATION: We report a case of 59-year-old woman with no prior medical or surgical history who presented to our ENT department due to a gradual, painless enlargement of both parotid glands that had been ongoing for four months. She underwent bilateral parotidectomy. Histologic exam confirmed the diagnosis of bilateral multifocal nodular oncocytic hyperplasia with a histological variant of clear cells. The postoperative course was unremarkable. CLINICAL DISCUSSION: Diagnosis presents challenges due to the rarity of this condition. Precise diagnosis relies on imaging techniques such CT scans and MRI features. There is no consensus on the therapeutic management. CONCLUSIONS: Our case report adds to the scarce literature concerning this condition, emphasizing the importance of careful clinical evaluation, precise diagnosis, and proper management.

Malignant degeneration of thyroglossal duct cysts: Clinical aspects, imaging findings and management: Case series.

INTRODUCTION AND IMPORTANCE: Thyroglossal duct cysts (TDCs) are congenital anomalies that can rarely undergo malignant transformation, with approximately 1 % of operated TDCs demonstrating malignant degeneration. Therapeutic management and follow-up methods are still controversial subjects. CASE SERIES PRESENTATION: We report 3 cases of a papillary carcinoma of thyroid occurring in a thyroglossal duct cyst. The diagnosis was suspected preoperatively in 2 patients, hence the indication of frozen section examination. All patients underwent Sistrunk procedure associated with total thyroidectomy and central neck dissection. Concomitant papillary thyroid carcinoma was found in 2 patients. A complementary treatment by radioactive iodine 131 with frenetic hormone therapy was undertaken in all the cases. The follow-up showed no recurrence. CLINICAL DISCUSSION: The clinical presentation of thyroglossal duct cyst carcinoma is often nonspecific, posing challenges in early diagnosis. The chosen treatment strategy, involving the Sistrunk procedure, total thyroidectomy, and central neck dissection, along with adjuvant therapy using radioactive iodine 131 and frenetic hormone therapy, was effective in preventing recurrence. CONCLUSION: The management of degenerated TDC is based on a multidisciplinary approach. Papillary carcinomas of TDC generally have a good prognosis.

A rare case of submandibular mucocele extending into the oral cavity: A case report.

INTRODUCTION AND IMPORTANCE: Salivary mucoceles, originating from major and minor salivary glands, rarely affect the submandibular gland, accounting for just 0.6 % of its tumors and cysts. With only 18 case reports in the literature to date, their occurrence in this location is infrequent. CASE PRESENTATION: The patient is a 9-year-old male with no relevant medical history who developed progressive submandibular swelling extending into the oral cavity. CT scan confirmed a submandibular gland mucocele. Surgical treatment involved excision of the mucocele along with the submandibular and sublingual glands. The postoperative course was unremarkable. CLINICAL DISCUSSION: Diagnosis presents challenges due to potential similarities with congenital and acquired lesions. Precise diagnosis relies on imaging techniques such as ultrasound, CT scans, and MRI. Distinguishing between submandibular mucoceles and plunging ranulas remains intricate based solely on imaging findings. CONCLUSIONS: This case report contributes to the limited literature available on this condition, highlighting the necessity for vigilant clinical assessment, accurate diagnosis, and appropriate management within the pediatric population.

Acute presentation of giant parathyroid adenoma extending to the mediastinum: A case report.

INTRODUCTION AND IMPORTANCE: Primary hyperparathyroidism is the most common cause of hypercalcemia in outpatients. Giant parathyroid adenomas are rare and can present diagnostic and therapeutic challenges. The clinical presentation is often insidious, and acute presentation is uncommon. CASE PRESENTATION: Herein we report a case of primary hyperthyroidism secondary to giant parathyroid adenoma in a 54-year-old woman presenting with acute and severe hypercalcemia. Preoperative laboratory exams indicated elevated values of parathormone and serum calcium. CT scan and parathyroid scintigraphy showed a giant right inferior parathyroid adenoma measuring 6 cm in its largest diameter extending to the mediastinum. Despite its size and extension, the gland was successfully managed through a transcervical parathyroidectomy. The patient is actually asymptomatic and normocalcemic after a follow up of 3 years. CLINICAL DISCUSSION: Giant parathyroid adenomas can cause severe hypercalcemia. Imaging studies are crucial for preoperative localization. A classic transcervical approach can be used to remove giant adenomas, even when they extend into the anterior mediastinum. Despite their size, giant parathyroid adenomas have a good prognosis if they are removed surgically. CONCLUSIONS: Hypercalcemia associated with a giant, functional parathyroid adenoma can be life-threatening. It is management is urgent. It is both medical and surgitforward, and various morphologiccal including correction of hypercalcemia and parathyroidectomy.

Fungal necrotizing external otitis: diagnosis, management and outcomes of 15 cases.

Fungal necrotizing external otitis (NEO) is a rare disease. It is an aggressive and potentially fatal infection. The most commonly reported pathogen is Candida. We aim through this study to share our experience in the management of fungal necrotizing external otitis and discuss its diagnosis tools, anti-fungal treatment choice, and outcomes. We included fifteen patients with diagnosis criteria of fungal NEO; clinical features of NEO with positive culture swabs and/or positive serologic test to a fungal pathogen. The mean age was of 70 years with a prevalence of males. The main symptoms were otalgia (n=15) and otorrhea (n=7). Facial palsy was observed in four cases. Fungal pathogens were Candida(n=10) and Aspergillus (n=5). Complications were observed in eight cases: extension to the temporo-mandibular (n=4), abscess in the retropharyngeal space (n=2), abscess in the parapharyngeal space (n=1) and thrombophlebitis of the internal jugular vein (n=1). Six patients were treated with fluconazole, eight with voriconazole, and one patient with itraconazole. After a mean duration of 52 days of antifungal therapy, fourteen patients have been cured with normalization of the ear symptoms, biological, and imaging features. One patient died of septic shock. No recurrence of the disease was observed after a follow-up of 12 months in all cases.

Dysphagia revealing diffuse idiopathic skeletal hyperostosis: report of two cases and literature review.

Diffuse Idiopathic Skeletal Hyperostosis (DISH) also known as Forestier's disease, is a musculoskeletal disorder characterized by the calcification of ligaments essentially the vertebral longitudinal anterior ligament. Men are generally affected. It is often asymptomatic. The most common extra-spinal clinical manifestation of this disease presents as dysphagia followed by respiratory disturbances such as dyspnea and sleep apnea. In this paper we discuss two cases where the patients have experienced progressive dysphagia. Radiological findings were compatible with DISH. The management was based on diet modification and anti-inflammatory medication.

A huge retropharyngeal lipoma: a rare cause of dysphagia: a case report and literature review.

Dysphagia is commonly seen after a cerebral vascular accident. It is rarely caused by lipomas of the retropharyngeal region which are rare benign mesenchymal neoplasms. We report a case of a 53-year-old man who presented with a history of ptyalism and dysphagia occurring after a brain stroke. Flexible nasal endoscopy revealed a pooling of saliva in both pyriform sinuses. Cervical and neurological examinations were unremarkable. Computed tomography (CT) scan suggested the diagnosis of retropharyngeal lipoma. The mass was resected by trans-cervical approach. The histological examination confirmed the diagnosis of a retropharyngeal lipoma. The postoperative course was unremarkable. Although lipomas in the retropharyngeal space are rare, clinicians should evoke this diagnosis when treating a patient presenting with dysphagia, even if there is a medical history of cerebral vascular accident.

Primary papillary carcinoma of the thyroglossal duct in a 14-year-old female: case report and review of the literature.

Thyroglossal duct carcinoma is a rare pathologic entity. The surgeon's main concern is whether to perform thyroidectomy or not. In this paper, we report another case of thyroglossal papillary duct carcinoma in a 14-old girl suspected preoperatively and confirmed postoperatively on the histological analysis of resected specimen by a Sistrunk procedure. Therapeutic strategy was completed by a total thyroidectomy with radioactive iodine therapy and suppressive levothyroxine therapy. In the absence of clear guidelines, the management of thyroglossal duct carcinoma is depending on the clinical situation and the experience of the team of surgeons.

A rare location of thyroglossal duct cyst in a newborn.

Thyroglossal duct cyst of the tongue is a rare entity. Occurrence in the anterior part of the tongue is exceptional. We report in this paper a rare case of thyroglossal cyst of the anterior part of the tongue, discovered in a five-days-old newborn at delivery. Images have shown a cystic mass with homogenous liquid content. A transoral complete resection of the lesion was performed, with no postoperative complication. The histological analysis confirm the diagnosis of lingual thyroglossal duct cyst. There were no recurrence with a follow-up of eight months.