Osseous metaplasia in a nasal polyp: report of a rare case and review of the literature.

Metaplasia is the conversion of one adult tissue or cell type into another tissue or cell type. Although osseous metaplasia has been described in many parts of the body, it is rarely encountered in the head and neck region, especially in nasal polyps. This article reports a case of unilateral sinonasal polyp containing areas of osseous metaplasia in a 44-year-old woman presenting with nasal obstruction. Also included are a brief discussion of osseous metaplasia in the head and neck region and a literature review.

Metastatic basal cell carcinoma.

Basal cell carcinoma (BCC) is the most common skin cancer with a high propensity for local recurrence. The incidence of metastases from BCC is rare. We report a 65-year-old man who had BCC of the medial canthus of the left eye. In the 10-year period, he had been operated on approximately 12 times because of local recurrences. Three years after the last operation, he had a suspicious lesion on the operated area and a lumbar pain. Radiologic examination showed multiple metastatic skeletal and liver lesions. He was referred to the oncology department for radiation therapy and chemotherapy.

Epidermal inclusion cyst of external auditory canal.

Epidermal inclusion cyst is a benign cyst filled with keratin fibers, and its wall has nearly the same characteristics as the epidermis. It is commonly seen in the skin and has the tendency to slowly grow toward deeper epidermis parts and to cause cystic expansion. We report a 23-year-old woman who presented with right external otitis lasting for 2 months. The patient's complaints did not respond to treatment even after parenteral antibiotic therapy. Surgical exploration revealed epidermal inclusion cyst of the ear canal. This pathologic entity is discussed in the light of current literature.

Carotid sheath-like foreign body in the neck.

In otolaryngology practice, we see young children who have inserted a foreign body (FB), which is usually found at home, into their ears or nose. Uncommon complications of an ingested FB are penetration and migration into the neck. Interestingly, among such FBs, sharp fish bones are the most commonly observed in Turkey. In our patient, the FB caused deep neck infection because of FB reaction. In our patient, we could not find any clue of a FB during examination. We were able to see the FB by magnetic resonance imaging (MRI). Interestingly, the FB looked like a carotid sheath on the MR image.

Hypoglossal schwannoma presenting only with headache.

Hypoglossal schwannoma is a rarely encountered skull base lesion that has generally both intracranial and extracranial parts. This article reports a case of hypoglossal schwannoma that is purely extracranial and presents itself only with persistent headache. Magnetic resonance imaging delineated a mass at the skull base that consisted of both cystic and solid components, consistent with a nerve sheath tumor. Cervical approach was chosen, and the mass was completely removed. Postoperatively, the patient developed hypoglossal nerve palsy because the hypoglossal nerve was sacrificed. Hypoglossal schwannomas are briefly discussed with a literature review.

Primary tuberculosis involving epiglottis: a rare case report.

The case of a 29-year-old patient with active laryngeal tuberculosis predominantly involving the epiglottis, without pulmonary disease, is presented. The predominant symptoms are dysphagia, odynophagia, and hoarseness. Laryngeal carcinoma, which shares almost the same symptoms and signs, should be ruled out immediately. Laryngeal tuberculosis is discussed with a brief literature review.

Relapsing deep neck infection may indicate a coexisting esophagus cancer.

Neck abscess and deep neck infections are common diseases. Primary head and neck cancers may present initially with neck abscesses or deep neck infections. This presentation leads to delay of the diagnosis of underlying cancer. Head and neck cancers which present with deep neck infection initially have rarely been described. We report a case with relapsing deep neck infection who was diagnosed as proximal esophagus squamous cell carcinoma thereafter.

Huge arteriovenous malformation in masseter muscle.

Arteriovenous malformation is a tumor characterized by direct connection between an artery and vein without capillaries in-between, and it is commonly located intracranially. Intramuscular arteriovenous malformations are rare in the head and neck region. Less than 1% of the vascular tumors are localized in a muscle, 15% of them are in the head and neck muscles. Among the head and neck muscles, masseter muscle is the most common location, with the rate of 4.9%. The condition of a 36-year-old patient who applied to our clinic with the complaints of progressively increasing pain and progressively growing mass in the right cheek that appeared 1.5 years ago was diagnosed as arteriovenous malformation located in the masseter muscle. After preoperative embolization, the mass was successfully treated with total excision. In this case report, diagnostic and therapeutic tools addressing arteriovenous malformation located in the masseter muscle are discussed in the light of current literature.

Tongue reduction in Beckwith-Wiedemann syndrome with CO(2) laser.

Beckwith-Wiedemann syndrome is a congenital syndrome with some anomaly in overgrowth. Most common manifestations are exomphalos, macroglossia, gigantism, and visceromegaly. Overgrowth in tongue's size caused clinical symptoms such as dysphagia, speech disorder, strong in chewing, upper-airway obstruction, and psychological problems with appearance. Cold surgical techniques are commonly used in treating macroglossia. We presented tongue reduction with laser and its early result on a child with Beckwith-Wiedemann syndrome for macroglossia.

Intraglandular toxoplasmic lymphadenitis of the parotid gland.

Most preauricular masses are parotid neoplasms; however, some infectious and inflammatory causes may exhibit similar presentation. Toxoplasmosis is a worldwide parasitary disease. The clinical presentation of toxoplasmosis is mostly asymptomatic and may include subfebrile fever, fatigue, and lymphadenopathy. Only 13 clinical reports of intraglandular toxoplasmic lymphadenitis have been previously reported in the English literature. A careful history and examination with appropriate investigations, including immunoglobulin G avidity assay, will frequently provide the diagnosis of intraparotid toxoplasmosis. Surgery might therefore have been delayed or avoided depending on a satisfactory clinical improvement in consequence of proper medical treatment.

Head and neck hemangiopericytomas: diagnostic contradictions.

PURPOSE: To identify misdiagnostic points of hemangiopericytomas (HPs) of the head and neck. PATIENTS AND METHODS: We reviewed our clinical records from 2000 to 2007 retrospectively and identified 5 patients with HP of the head and neck. The records of each patient with head and neck HP were evaluated for age, sex, location of primary, clinical course, treatment, and tumor embolization (if performed). Pathologic slides of all patients were reviewed to identify histologic features and correlation with the clinical course and outcome for each lesion. RESULTS: Five patients with HP that arose from head and neck sites were identified. Five patients included 3 women and 2 men aged 9 to 52 years, with an average of 33.2 years. Each lesion of the patients derived from different parts of the head and neck. The most common complaints were painless mass (3 of 5) and nasal airway obstruction (3 of 5). Magnetic resonance imaging of the 3 patients reflected hyperintense on T2-weighted imaging and hypointense on T1-weighted imaging with diffuse enhancement after intravenous administration of gadolinium. Angiography was performed to all these 3 patients, and only 1 patient with cranial HP involvement did not show significant vascularity. Two patients had preoperative histopathologic results. All patients were operated on with appropriate approach. Pathologic slides of all patients were investigated and graded according to the tumor diameter, cellularity, mitotic rate, and necrosis. CONCLUSION: Differential diagnosis of clinical features and radiologic and pathologic aspects must be managed more carefully. Diagnostic way of these tumors has different pitfalls for the clinician.

Invasion of the recurrent laryngeal nerve by tracheal tumor: an unusual presentation with coincidental huge multinodular goiter.

Vocal cord paralysis and goiter are 2 common problems encountered in otolaryngology practice. Their coexistence, however, should arouse suspicion of the presence of malignant thyroid disease. Primary tracheal cancer is uncommon, and its incidence is very low compared with laryngeal cancer. Primary tracheal tumors can cause recurrent nerve palsy. We report here a rare case of vocal cord paralysis caused by a clinically occult tracheal squamous cell carcinoma in an 80-year-old patient with coincidental huge multinodular goiter.

Chondrosarcoma of the mandible extending to the infratemporal fossa: report of two cases.

INTRODUCTION: Chondrosarcomas of the mandible affecting the infratemporal fossa are very rare malignant tumors. DISCUSSION: In this article, two cases of chondrosarcoma invading the infratemporal fossa are presented, and clinical, histopathologic features, and therapeutic approaches are discussed, reviewing the literature.

Synovial chondromatosis of the temporomandibular joint with skull base extension.

Synovial chondromatosis is a benign pathologic lesion that is considered to be a metaplastic process. This disease is rarely encountered in the temporomandibular joint (TMJ). In this article, a 72-year-old patient with synovial chondromatosis of the TMJ extending to the infratemporal fossa is presented and the literature is reviewed.