Vagal Paraganglioma Presenting as a Neck Mass Associated with Cough on Palpation.

A 70-year-old female presented with a neck mass and sporadic dry cough, often leading to fits of coughing severe enough to cause vomiting. The patient reported that touching the mass triggered the cough. On examination, a 2.5 cm right-sided level two neck mass deep to the sternocleidomastoid was present. Palpation of the mass immediately triggered coughing. Cross-sectional imaging proposed vagal paraganglioma as the chief differential, which was confirmed following surgical excision. The patient reported complete resolution of her severe dry cough after surgery. Vagal paragangliomas are rare neuroendocrine tumors arising from the neural crest-derived paraganglionic tissue surrounding the vagus nerve, typically presenting as a neck mass associated with hoarseness or pulsatile tinnitus. To the best of our knowledge this is a unique description in the English literature. This case is presented to aid physicians should they encounter a neck mass associated with cough. Vagal paraganglioma, although rare, should be part of the differential in such a presentation.

A rare case of pediatric Nontraumatic Myositis Ossificans in the posterior triangle.

BACKGROUND: Myositis Ossificans Cicumscripta is a rare condition characterized by aberrant bone formation in paramuscular soft tissue of the extremities usually associated with trauma or a genetic mutation. Very few cases involve the head or neck and it is rarely found in the pediatric population. OBJECTIVES: We present a case of a 5-month old with a rapidly growing posterior neck mass suspicious for neoplasia, which was treated with surgical resection and found to be a non-traumatic, non-genetic form of Myositis Ossificans. The workup, treatment, and findings of the patient are outlined and a review of the literature on this disease is discussed. CONCLUSION: Myositis Ossificans is characterized by aberrant bone formation typically occurring after trauma but may be secondary to an underlying genetic abnormality. The case presented in the absence of trauma or an underlying genetic abnormality and is therefore an exceedingly rare instance of the sporadic form that presented spontaneously in the head and neck of a pediatric patient.

Extracranial Intraluminal Extension of Atypical Meningioma within the Internal Jugular Vein.

Meningiomas represent the most common benign intracranial neoplasms, and may spread by direct extension into nearby venous sinuses, but gross spread to the extracranial venous system is uncommon. We report the case of a patient with extracranial intraluminal spread of meningioma within the internal jugular vein to level III of the neck. Review of the preoperative assessment and management is also presented.

Carcinosarcoma de novo of the parotid gland: case report.

BACKGROUND: Salivary gland carcinosarcoma is a rare and aggressive malignant mixed tumor in which carcinomatous and sarcomatous elements coexist and metastasize together. The tumor may occur in the background of a preexisting pleomorphic adenoma or may arise de novo. We report a case of a woman presenting with a carcinosarcoma de novo of the parotid gland. METHODS AND RESULTS: Our patient underwent surgical resection and adjuvant radiotherapy and demonstrates no evidence of recurrence at 14 months posttreatment. CONCLUSIONS: Review of the literature supports combined modality, surgery with postoperative radiation, as the standard of care for this malignancy, although the long-term prognosis for these patients is unclear.