Intrathyroid thyroglossal duct cyst: A case report.

INTRODUCTION: Thyroglossal duct cysts (TDCs) can be detected in several different locations, although in the literature, intrathyroidal presentations are rare. CASE PRESENTATION: Our patient was a 56-year-old woman who was diagnosed with hypothyroidism and presented with a right-lateral neck mass that was clinically indistinguishable from a thyroid nodule. Cytology revealed normal-looking squamous cells on fine-needle aspiration. Right hemithyroidectomy was performed, and histopathological examination revealed a cyst lined by squamous epithelium that was consistent with a thyroglossal duct cyst (TDC). DISCUSSION: Our recommendation is to diagnose intrathyroid thyroglossal duct cyst (ITTDC) in front of anterior basicervical masses, particularly when the patient has hypothyroidism. Fine needle aspiration cytology can be used to detect benign squamous cells and may rule out malignancy. CONCLUSION: Although relatively rare, an intrathyroid thyroglossal duct cyst (ITTDC) is a benign lesion whose diagnosis must be correctly established for appropriate therapeutic management.

Rhino-orbital cerebral mucormycosis in a child with type 1 diabetes: A case report.

Rhino-orbital cerebral mucormycosis is a rare but potentially severe fungal infection in children with high rate of morbidity and mortality. In pediatric patients, uncontrolled diabetes mellitus is considered to be a predisposing factor only in 15% of cases. To prevent and reduce mortality rate of this severe disease, early diagnosis based on clinical findings and biopsy is highly recommended. Herein, we report a case of rhino-orbital cerebral mucormycosis in a 12-year-old girl with type 1 diabetes to demonstrate that a multimodal management approach, involving early surgery which consists in frequent endoscopic sinus debridement and appropriate antifungal therapy, is essential to effectively reduce the spread of infection and achieve effective outcome.

[Performance of the magnetic resonance imaging in parotid gland tumor histopathology]. / Performance de l´imagerie par résonance magnétique dans l´approche histopathologique des tumeurs parotidiennes.

INTRODUCTION: salivary gland tumors mainly occur in the parotid gland. These tumors are rare but are characterized by histological heterogeneity, thus posing diagnostic challenges. Magnetic resonance imaging (MRI) is currently the most reliable imaging test for the evaluation of these tumors. The purpose of this study was to highlight the diagnostic value of MRI and its role in parotid gland tumor histopathology. METHODS: we conducted a retrospective descriptive and analytical study of 50 patients with parotid gland tumor, operated and treated in the ear, nose and throat (ENT) Department and in the Department of cervicofacial surgery at the Tahar Sfar University Hospital of Mahdia between 2001 and 2019. All patients underwent preoperative MRI of the parotid gland. RESULTS: out of 50 patients included in the study, 36 (72%) had benign tumor and 14 (28%) malignant tumor. The sensitivity of MRI for the diagnosis of malignant tumor was 92.8% with a specificity of 97.2%, a negative predictive value of 93% and a positive predictive value of 97%. With respect to benign tumor characterization, MRI suggested the diagnosis of Warthin tumor in all cases (13 cases) and of pleomorphic adenoma in 22 out of 23 cases. There were two diagnostic errors: MRI suggested the diagnosis of pleomorphic adenoma instead of adenoid cystic carcinoma in one case and of malignant tumor instead of pleomorphic adenoma due to diffusion restriction. CONCLUSION: MRI is highly efficient in the assessment of parotid tumor histology and, especially, after the advent of new functional sequences. However, only histological examination allows to confirm with certainty the diagnosis.

Necrotising otitis externa: A single centre experience.

INTRODUCTION: Necrotising otitis externa (NOE) is a rare infection of the ear canal with frequent bone erosion. This study's objective is to describe the different features of NOE as well as its management in an ear-nose-throat department. We also tried to identify the particularities of the fungal infection. PATIENTS AND METHODS: It is an observational cohort that included all the patients hospitalised for the management of NOE. The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019. RESULTS: A total of 40 patients were included. The mean age was 65 ± 12.9 years and the sex ratio was 0.9. Ninety percent of the patients included were diabetics. The most common signs found were oedema of the external canal (97.5%) and auricular discharge (92.5%). The main pathogen isolated was Pseudomonas aeruginosa (61.7%). Fungi were isolated in 9 cases (26.47%). Computed tomography was performed for 32 patients (80%). Bone erosion was seen in 26 cases (81.3%). The main complications were cerebral venous thrombosis, retropharyngeal abscess and cerebral empyema. Thirty one patients received only antibiotics, 2 received only antifungal treatment, and 7 received both antibiotics and antifungal treatment. All patients had a favorable outcome. Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections. No other differences were noted. CONCLUSION: Our management protocol seems to be efficient since all patients had initial favorable outcome. A higher median erythrocyte sedimentation rate was associated with fungal infections.

Predictive epidemiological and clinical factors of nasopharyngeal carcinoma diagnosis: Adult versus pediatric population.

OBJECTIVE: The objective of this study is to compare the clinical presentation and the cancer staging of nasopharyngeal carcinoma (NPC) between pediatric and adult populations to highlight the main characteristics of this disease within the two subgroups. MATERIEL AND METHODS: It is a retrospective study including all patients with a primary diagnosis of NPC over a period of 19 years. The pediatric group included patients aged less then 16 years old. RESULTS: A total of 80 patients were included. The pediatric population represented 22.5% of the cases. No difference in gender distribution was found (p˃.05). The most common presenting symptom was neck mass in children (77.8% vs. 48.4%, p = .02), and nasal obstruction in adult patients (64.5% vs. 16.7%, p < .01). The median time between the presenting symptom's onset and the diagnosis was 5 months. The diagnosis of NPC was delayed in pediatric patients compared to adults (<0.05). We noted a predominance of patients with stages III and IV (32.5% and 40%, respectively) with no difference between the two subgroups (p˃.05). CONCLUSION: Our study showed some differences in NPC clinical features between pediatric patients and adults. Neck mass was the most common symptom in children. The initial presentation is sometimes misleading. NPC was mainly diagnosed in advanced locoregional stages in both pediatric and adult patients. Efforts toward early diagnosis are of great importance.