Migratory Fish Bone in the Hyoglossus: Catch Me if You Can.

Foreign body ingestion is one of the most frequently encountered cases in otorhinolaryngology and most of the cases can be managed non-operatively. If left untreated, migration of foreign bodies can occur and presents a significant challenge in patient management. We hereby describe the case of an elderly gentleman who had a preceding history of fish bone ingestion and complained of dysphagia for two days. Clinical examination revealed swelling of the right vallecula with minimal pus discharge. Computed tomography (CT) of the neck confirmed the diagnosis of a migratory foreign body in the neck. He underwent open neck exploration and foreign body removal under intraoperative fluoroscopy guidance. A high index of suspicion of a migratory foreign body is warranted in cases of persistent, unresolved symptoms with the failure of endoscopic evaluation to detect the foreign body. Migratory foreign body of the neck may cause life-threatening complications and requires early surgical intervention.

Axillary Metastasis as the Initial Presentation of Recurrent Nasopharyngeal Carcinoma.

The recurrence of nasopharyngeal carcinoma (NPC) is either at the local primary site or at regional or distant metastases. However, an axillary metastasis is a rare entity in NPC. We highlighted a case of recurrent NPC that presented with axillary swelling as the main initial complaint. Clinical examinations showed enlarged left axillary lymph nodes and left cervical lymph nodes. Histopathological examination of the axillary lymph node biopsy confirmed the recurrence of NPC. The patient underwent palliative chemotherapy in view of the advanced stage of recurrent disease. A thorough clinical history and examination during surveillance are crucial for early diagnosis and better survival outcomes.

Pleomorphic Adenoma in a Posterior Cervical Soft Tissue Mass: A Diagnostic Conundrum.

Diagnosing a soft tissue tumor in the head and neck region can be challenging due to its complex anatomy and diverse histological spectrum. This case report highlights the case of a woman who presented with a painless neck lump in the posterior triangle of the neck. Various pathological and imaging studies were suggestive of pleomorphic adenoma, which arises from the left prevertebral space. The patient underwent complete surgical excision via the transcervical approach. Pleomorphic adenoma in the posterior triangle of the neck is extremely rare and causes a diagnostic dilemma in managing soft tissue tumors of the neck.