A Rare Case of Parotid Nodular Fasciitis in a Six-Month-Old Female.

Nodular fasciitis (NF) is a rare benign self-limiting lesion that is often mistaken for malignancy due to its progressive nature. Reported cases of nodular fasciitis in the parotid gland are uncommon, and its incidence is variable among different age groups. Histopathological and immunohistochemical studies are helpful in distinguishing these kinds of lesions. We report a case of a six-month-old baby with a two-month history of progressive rapid-growing mass in the left parotid region. Clinical examination showed some mild facial nerve weakness with no other significant findings locally or systemically. Fine-needle aspiration (FNA) was inconclusive, and surgical excision was the choice of treatment. On histological examination, the mass was confirmed to be nodular fasciitis, and on follow-up, the patient had no signs of recurrence. Nodular fasciitis can appear in young infants and, if confirmed histopathologically and immunohistochemically, should be treated conservatively.

Secondary Acquired Cholesteatoma in Langerhans Cell Histiocytosis Patient.

Langerhans cell histiocytosis (LCH) is a multi-faceted disease defined by the accumulation of dendritic cells in various organs with characteristics similar to the epidermal Langerhans cells and can affect any organ of the body. It is most commonly seen in young adults and children. Cholesteatoma is a congenital or acquired condition and is categorized into primary and secondary cholesteatomas. Only a few reported cases of primary or secondary cholesteatoma have been reported among patients treated for temporal bone LCH. We report a case of secondary acquired cholesteatoma in a six-year-old girl after five years of her LCH treatment. The patient initially presented with ear discharge and aural polyp which did not improve with medical management. A computed tomography scan of the mastoid showed a left middle ear cavity and temporal bone lesion with bony erosions and total obliteration of the left external auditory canal. The patient underwent multiple biopsies, and a histopathological evaluation confirmed the diagnosis of cholesteatoma. The diagnosis of LCH can be difficult due to variable clinical manifestations. Involvement of the ear as resemblance to other diseases such as mastoiditis and chronic otitis media are quite common. Computed tomography scan and biopsy are reliable tools for diagnosis. Cholesteatoma following LCH remains a rare entity, hence, critical examination at follow-up visits is needed. Surgery remains the treatment of choice for cholesteatoma patients.

Frequency of Preoperative Localization Techniques of Parathyroid Adenoma at King Abdulaziz University Hospital, Saudi Arabia.

Background Accurate preoperative radiological localization of parathyroid pathologies paves the way to enable less invasive surgical procedures. Results on the accuracy of the different diagnostic measures are conflicting. Also, little is known about the most common location of parathyroid lesions. This paper aims to determine the most common location of parathyroid adenoma and evaluate the diagnostic performance of radiological modalities such as ultrasonography, sestamibi scintigraphy/single-photon emission computerized tomography (SPECT), magnetic resonance imaging (MRI), and computed tomography (CT) scan for the preoperative localization of parathyroid pathologies. Methods This is a retrospective study. Data were collected from patients who underwent total or partial parathyroidectomy at King Abdulaziz University Hospital between January 2000 and March 2020. The parathyroid adenoma site was detected preoperatively by a radiological method and confirmed postoperatively by the histopathology report. The performance of each preoperative localizing radiological method was evaluated based on the accuracy in localizing parathyroid pathology. Results A total of 73 patients were included in the analysis, with females being the most common gender in the study at 64%. Only complete data files were included and incomplete data files were excluded. The most frequent mode of detecting parathyroid adenoma was a sestamibi/SPECT scan (62.5%) followed by a CT scan (50%), ultrasound (34.6%), and MRI (25%). The most common location of a parathyroid adenoma was the left side. Conclusion Sestamibi/SPECT is a frequent radiological method for detecting the parathyroid lesion site as compared with CT, MRI, and ultrasonography.