Exophthalmos revealing an olfactory esthesioneuroblastoma: A case report.

INTRODUCTION AND IMPORTANCE: Olfactory neuroblastoma or esthesioneuroblastoma is a rare malignant tumour, that develops in the olfactory neuroepithelium and is one of the rarest tumours of the nasal cavity. Ocular manifestations are uncommon. The diagnosis is based on histology: biopsy, immunohistochemistry and ultrastructural findings. CASE PRESENTATION: We report a case of olfactory neuroblastoma of the olfactory placode in a 36-year-old woman with orbital involvement. Computed tomography and magnetic resonance imaging of the skull, showed a suspicious lesion with significant orbital and cranial extension. After anatomopathological study of the biopsy, a protocol palliative radiotherapy was established. CLINICAL DISCUSSION: We discuss the clinical, radiological, anatomopathological and therapeutic aspects of this condition, emphasising the importance of evoking this diagnosis in the presence of unilateral tumour-like exophthalmos associated with suggestive rhinological signs. CONCLUSION: Ophthalmological involvement usually occurs at an advanced stage of esthesioneuroblastoma. This case highlights the fatal course of olfactory neuroblastoma. As it can present with the comlex symptoms related to ocular and nasal sites. Early diagnosis is the key to better therapeutic choices according to its level of extension, purposing at the best possible prognosis for the patient.

Congenital Facial Infiltrating Lipomatosis: A Rare Cause of Facial Asymmetry in Infants.

Congenital facial infiltrating lipomatosis (CFIL) is a rare condition that typically affects the trunk and limbs, but can also occur in the face. Managing CFIL is a significant challenge due to its diffuse involvement in important facial structures. This case report aims to describe a rare form of lipomatosis and discuss the clinical and therapeutic aspects of this entity. The patient was a 5-year-old girl who was admitted to our department due to a right paralateronasal swelling that had been present for 5 months. During the physical examination, a swelling of the right nasolabial was observed. A computed tomography scan of the facial bone revealed an extra bony soft tissue mass near the vestibule of the right nostril in contact with the frontal process of the maxillary bone and the anterior wall of the right maxillary sinus. The patient underwent excision under general anesthesia. The histological report indicated congenital focal lipomatosis. There was no recurrence of swelling a year after initial surgery. Facial infiltrating lipomatosis is a rare congenital disorder in which mature lipocytes invade adjacent tissue. Due to its diffuse infiltration and involvement of important facial structures, complete surgical excision is often impossible. Specific management of this condition requires insight into its pathogenesis as surgical removal of the mass is usually unsuccessful.

Clinical manifestations, diagnosis, and management of first branchial cleft fistula: Case series and review of the literature.

INTRODUCTION AND IMPORTANCE: The first branchial cleft (FBC) is an extremely rare occurrence, manifesting as cysts, sinuses or fistula. Among all branchial anomalies, FBC represents 8-10 % of branchial clefts. It accounts for about 17 % of all cervical masses in childhood. FBC can be caused by inadequate removal or closure of the ectoderm. The location of the fistula can be adequately determined by magnetic resonance imaging (MRI). CASE SERIES PRESENTATION: We report three cases from the first branchial cleft fistula (FBCF) in our ENT Department with a good response to surgical treatment. Patients had an average of 24 months of follow-up. The aim of our study is to study the clinical manifestations, the diagnosis and the surgical management of the FBCF. DISCUSSION: An in-depth knowledge of the embryology of the neck and face will ensure early diagnosis and complete surgical resection of FBCFs, which will minimize the risk of severe complications including facial paralysis. CONCLUSION: FBC is rare and may present as a cyst or fistula. It is managed by surgical excision, leaving the tract cyst of the fistula intact with preservation of the facial nerve.

Neonatal Suppurative Parotitis: Case Report and Review of Literature.

Neonatal suppurative parotitis is a rare condition that is diagnosed primarily through clinical evaluation. The prognosis is generally good. In this report, we present the case of a 21-day-old female infant who was treated in our ENT department for neonatal suppurative parotitis. The patient presented with a feverish, hard, red, and tender swelling of the parotid loge which displaced the right earlobe outward. In addition, purulent exudate was observed from Stensen's duct. A computed tomography scan of the cervical and cerebral regions revealed a swollen right parotid gland with heterogeneous density and enhancement, but no detectable collection. The patient received intravenous antibiotics for 48 hours, resulting in a favorable outcome without the need for surgical treatment. The aim of this study is to emphasize the diagnostic and therapeutic aspects of this clinical condition. Suppurative parotitis should be suspected by the clinician in newborns who present with an inflammatory preauricular swelling, with or without contributing factors. The outcome is generally favorable, and complications are rare with timely and appropriate medical treatment.

Huge second branchial cleft cyst: A case report.

INTRODUCTION AND IMPORTANCE: Second branchial cysts are benign dysembryological cystic tumors that develop in the antero-lateral part of the neck. They represent 2 % of laterocervical tumors of the neck and are usually diagnosed before adulthood. The cysts can increase in size and cause multiple complications. Ultrasound and MRI (Magnetic Resonance Imaging) confirm their cystic nature. Treatment consists of surgical excision. CASE PRESENTATION: We report the case of a 31-year-old woman who presented with a left laterocervical swelling measuring 8 cm, which had been present for 18 months without any other associated symptoms. An exploratory cervicotomy was performed, and the histological diagnosis was a second branchial cleft cyst without signs of malignancy. CLINICAL DISCUSSION: The definitive diagnosis of a second branchial cleft cyst is confirmed by anatomopathological examination. Therapeutic management is always surgical and should be performed as early as possible to limit the risk of complications. CONCLUSION: Second branchial cleft cysts are relatively uncommon malformations. Diagnosis is suspected based on physical examination, guided by imaging data, and confirmed by anatomopathological examination. Treatment is surgical, with complete removal of the cyst being necessary to prevent recurrence.

Esthesioneuroblastoma presenting as syndrome of inappropriate antidiuretic hormone secretion.

Hyponatremia is the most common fluid electrolyte disorder in hospitalized patients. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) is the main cause of normovolemic hyponatremia, it can be caused by diverse etiologies: malignant tumors are the most feared cause that clinician persists in finding. Exceptionally, SIADH can complicate Esthesioneuroblastoma (ENB) or olfactory neuroblastoma, a rare tumor of the nasal sinus cavities. We report the case of a 26-year-old female patient admitted for recurrent headaches and vomiting, with a profound normovolemic hyponatremia at the initial assessment. Biological explorations have concluded in a SIADH. Imaging showed a mass of the left nasal cavity with extensions to the ipsilateral paranasal sinuses. The biopsy of the lesion, under endoscopic control, was inconclusive. The anatomopathological study, after surgical removal, concluded in ENB. The postoperative evolution was marked by the normalization of the natremia.

Parapharyngeal metastasis from papillary thyroid microcarcinoma.

Carcinoma of the thyroid gland is one of the most commonly encountered endocrine malignancies. Papillary carcinoma is the most common histological type and its pattern of metastasis are usually lymphatic. Lymphatic metastasis to parapharyngeal space is rare and have been reported, so we report the case of a 50-year-old male patient who had an occult papillary carcinoma of the thyroid presented as right lateral node of the neck and a nodal involvement of the right parapharyngeal space.

Acute idiopathic velopharyngeal insufficiency.

Idiopathic velopharyngeal insufficiency is a rare clinical entity. Typical clinical features are rhinolalia and nasopharyngeal regurgitation. It is usually observed in children. We report a case of a 28-year-old female with this rare disorder. The symptoms were rhinolalia and regurgitation of liquids into the nose. The magnetic resonance imaging of the brain and upper cervical region was normal. The infectious serologies were negative.