Peripheral Primitive Neuroectodermal Tumor: A Rare Case in Pediatrics.

Primitive neuroectodermal tumors (PNETs) are a type of malignant tumors made up of small neuroectodermal-derived round cells that affect soft tissue and bone, with a wide range of clinical symptoms and histological commonalities depending on the site of the tumor. PNETs account for 4% of all pediatric and adolescent cancers. Here we report a case of a peripheral primitive neuroectodermal tumor in a five-year-old boy. Two days before admission, he complained of multiple attacks of vomiting and one episode of hematemesis, associated with subjective fever, abdominal pain, and distention. He also complained of weight loss and bruises on his face and lower extremities for the last four weeks. Upon physical examination, there was hepatomegaly to the right iliac fossa. Abdominal ultrasound showed that the liver is hugely enlarged with heterogeneous echo texture and smooth borders. A computed tomography scan with contrast showed hepatomegaly to the right iliac fossa region with no focal lesion. Bone marrow aspiration and bone marrow biopsy showed heavy infiltration by monomorphic cells. Moreover, liver biopsy was done for this patient, and it showed metastatic undifferentiated neuroblastoma. Before the liver biopsy results, the patient deteriorated rapidly and dead. Therefore, peripheral primitive neuroectodermal tumors (pPNETs) should be considered in the differential diagnosis of liver masses in young patients to early diagnosis and treatment, and to increase the survival rate.

A Rare Case of Lung Hypoplasia in a 1-Year-Old Girl.

Pulmonary hypoplasia is a rare form of the congenital disorder that leads to lung underdevelopment. It is more common in children and infrequently noticed in adulthood. While congenital lung abnormalities are frequently discovered in the early years of life, these conditions are also often detected incidentally following routine radiographic imaging and investigations. We report the case of a 1-year-old girl who presented to the emergency department with a three-day history of cough, shortness of breath, fever, and respiratory distress. Investigations revealed right lung hypoplasia, left lung hyperinflation, and an invisible pulmonary artery and vein. A diagnosis of right lung hypoplasia as an incidental finding with associated anomalies was made. She was admitted to the pediatric ward and received supportive care and empirical antibiotics. She was then discharged in a good condition with supportive management for follow-up. This case report aims to describe a rare condition occurring in children with various clinical pictures and presentations to aid future early detection to achieve better diagnostic outcomes.

A Rare Case of a Vocal Cord Foreign Body in an Infant: A Case Report.

A foreign body (FB) is an object or item that is foreign to the area in which it is found. FB in the airway, accompanied by the esophagus, is a common overnight emergency in pediatric otolaryngology. Here we report a case of a healthy 11-month-old girl who presented in the emergency room with stridor and a weak cry. The patient was admitted as a case of croup (laryngotracheobronchitis) and treated with multiple antibiotics for more than five days but showed no improvement, then consulted the ear, nose, and throat team (ENT).

Pediatric Prostatic Abscess Caused by Methicillin-Resistant Staphylococcus aureus.

While prostatic abscesses infrequently occur in adults, they are extremely rare in children. We present a rare case of a prostatic abscess in a 13-year-old male patient caused by methicillin-resistant Staphylococcus aureus (MRSA). The patient had no significant past history and presented to our clinic reporting a two-week history of lower abdominal pain, foul-smelling urethral discharge, a burning sensation during urination with pain in the tip of his penis, and itchiness around the anus. On examination, we noted lower abdominal tenderness, and on per rectal examination, we noted tenderness in the anterior wall of the rectum. A culture from the urethral discharge was positive for MRSA. The patient was diagnosed with a prostatic abscess and was started on antibiotics. We performed ultrasound-guided transrectal drainage, and afterward, the patient's condition improved. He was doing well on the last follow-up. This case reminds physicians to consider prostatic abscesses in patients with lower urinary tract infections that do not respond to antibiotics.

Thyroid neoplasm in Makkah region, Saudi Arabia. A retrospective epidemiological study.

OBJECTIVES: To improve our local data and demographics of thyroid neoplasm in Makkah region, Kingdom of Saudi Arabia and provide some basic statistics for future studies in our local community.  Methods: A record based retrospective epidemiological study was conducted and included 314 thyroid disease patients who were presented to our centers at Makkah region, Kingdom of Saudi Arabia between December 2009 and December 2019. Results: A descriptive statistical analysis was carried out. The average age was 42.77 years, with a female-to-male ratio of 3:1, and most of the patients were Saudi (77%). Fifty-seven percent of cases were benign, while in malignant cases, 33.4% were papillary thyroid carcinoma. The mean follow-up time was 15.44 months, with excellent compliance in 39.4% of the patients.   Conclusion: Thyroid tumors have a leading incidence in head and neck tumors in Makkah, Kingdom of Saudi Arabia, mandating further studies to determine the causes and distribution in other regions of the country.

Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients.

Introduction Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective To evaluate the feasibility and the outcome of simultaneous bilateral Endo-DCR and its impact on the quality of life of the patients. Methods We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients.

Bilateral simultaneous endoscopic dacryocystorhinostomy: outcome and impact on the quality of life of the patients

Introduction: Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective: To evaluate the feasibility and the outcome of simultaneous bilateral Endo- DCR and its impact on the quality of life of the patients. Methods: We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results: Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion: Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients (AU)

Desmoid tumor (fibromatosis) of the head and neck.

Desmoid tumors (fibromatosis) are rare benign tumors, they arise from musculoaponeurotic structures throughout the body. They are locally infiltrative, resulting in a high rate of local recurrence following surgical resection. Due to the rarity of these tumors in the head and neck region, we report a case of a patient with a desmoid tumor in the upper neck that was diagnosed and treated in our institution, to increase the awareness of the Otolaryngology-Head and Neck surgeons, and report available treatment options of this condition.