Left parapharyngeal ectopic goitre associated with eutopic thyroid and postoperative Horner's syndrome.

INTRODUCTION: The authors report a case of left parapharyngeal ectopic goitre, in which resection was followed by postoperative Horner's syndrome, and describe the difficult management of this entity. CASE REPORT: A 25-year-old woman presented with upper oesophageal dysphagia and a well-demarcated left parapharyngeal mass displacing the great vessels laterally and posteriorly. The mass was resected via an exploratory neck incision. Histological examination of the operative specimen revealed hyperplastic thyroid parenchyma. The postoperative work-up revealed a eutopic and euthyroid thyroid gland. The postoperative course was marked by Horner's syndrome that persisted at 1-year follow-up. DISCUSSION: Parapharyngeal ectopic thyroid coexisting with a functional thyroid is extremely rare. Parapharyngeal masses are usually derived from the parotid gland and nerves. Surgery of the parapharyngeal space can cause injury to the sympathetic trunk, responsible for Horner's syndrome, as in our patient. CONCLUSION: Ectopic thyroid should be considered as a possible diagnosis of a parapharyngeal mass. Although rare, Horner's syndrome is a dreaded complication of surgery of the parapharyngeal space.

[Malignant parotid tumors: epidemiology in Togo]. / Tumeurs malignes de la parotide: épidémiologie au Togo.

INTRODUCTION: We had for aim to determine the epidemiological profile of malignant parotid tumors in sub-Saharan country: Togo. PATIENTS AND METHODS: We retrospectively studied the files of patients seen and treated for malignant parotid tumors, from January 1989 to December 31, 2008, at the Tokoin teaching hospital. Patients treated for another malignant tumor at the same time were excluded from the study. RESULT AND DISCUSSION: Ninety-six patients were included. Thirty-one tumors (32.29%) were malignant, in 18 male and 13 female patients with a sex ratio of 1.38. The average age was 39years (range 24-70years of age). Two patients could not undergo surgery. Histologically, there were 10 cases of squamous cell carcinoma (32.26%), 6 cases of adenoid cystic carcinoma (19.4%), 6 cases of adenocarcinoma (19.4%), 4 cases of carcinoma in pleomorphic adenoma (12.90%), 3 cases of mucoepidermoid carcinoma (9.7%), 1 case of acinar carcinoma (3.2%), and 1 case of cystadenocarcinoma (3.2%). DISCUSSION: Squamous cell carcinoma was the most frequent histological type observed in Togo, contrary to literature data for which mucoepidermoid carcinoma is the most frequent malignant parotid tumor.

[Mandibular tumours: epidemology, diagnostic and therapeutic aspects concerning 91 cases]. / Tumeurs mandibulaires: aspects epidemiologiques, diagnostiques et therapeutiques a propos de 91 cas.

UNLABELLED: Oro-facial tumours are frequent and raise post-operational functional and aesthetic problems. What might be the situation of the mandibular tumours at CHU Tokoin-Lome (University Hospital Centre of Lome-Tokion). OBJECTIVES: The aim of this study was to determined epidemiological, diagnostic and therapeutic aspects concerning the mandibular tumours. METHOD: This retrospective study concerning 91 colligated files from January 1988 to December 2006 at the Oto-rhino-laryngologic and Cervico-Maxillo-Facial Surgery Service of the University Hospital Centre ( CHU) of Lome-Tokoin. The main inclusion criteria was the anatomopathological examination of the tumour. RESULTS: The mandibular tumours represented 19.95% of the Oto-rhino-laryngological and Cervico-Maxillo-Facial tumours. They were diagnosed with annual average of 5 cases. The most affected age bracket was one going from 10 to 39 years , or the equivalent of 68.13% of the patients. The spreading of these tumours in both sexes was equal. 80.21% of patients were examined after a development period going from 0 to 4 years. The major circumstances of findings were the mandibular tumefaction (98.9%) dental or mandibular pains (48.35%). The favourite seat of these mandibular tumours was the hemi mandible (48.35%). The odontologic tumours were the predominant histological types or the equivalent of 64.84% of the mandibular tumours. The benign forms were the most frequent (72.88%), the ameloblastoma in particular. The treatment was a surgical one. The partial resection of the mandibular bone was the surgical technique that was the most used (67.03%). The short-term development was preferred (69%). The long-term follow-up was difficult. CONCLUSION: The mandibular tumours were relatively frequent and predominated by the ameloblastoma. The findings circumstances were predominated by the mandibular tumefaction. The treatment was the preservative surgery as advocated by the majority of authors.

Tumeurs mandibulaires : aspects epidemiologiques; diagnostiques et therapeutiques a propos de 91 cas

Les tumeurs oro-faciales sont frequentes et posent des problemes fonctionnels et esthetiques post operatoires. Quelle pourrait etre la situation des tumeurs mandibulaires au CHU Tokoin de Lome ? Objectifs : Cette etude s'est fixee pour objectifs; de determiner les aspects epidemiologiques; diagnostiques et therapeutiques des tumeurs de la mandibule au Togo. Methodologie : Il s'est agi d'une etude retrospective sur 91 dossiers colliges de janvier 1988 a decembre 2006 au service d'Oto-rhino-laryngologie et de Chirurgie Cervico-Maxillo- Faciale du Centre Hospitalier Universitaire Tokoin de Lome. Le critere d'inclusion majeur a ete l'examen anatomopathologique de la tumeur. Resultats : Les tumeurs de la mandibule ont represente 19;95des tumeurs oto-rhinolaryngologiques et cervico maxillo faciales. Elles ont ete diagnostiquees avec une moyenne annuelle de 5 cas. La tranche d'age la plus touchee a ete celle de 10 a 39 ans soit 68;13des patients. La repartition de ces tumeurs dans les deux sexes a ete egale. 80;21des patients ont consulte apres une duree d'evolution allant de 0 a 4 ans. Les principales circonstances de decouverte ont ete la tumefaction mandibulaire (98;9) et la douleur dentaire ou mandibulaire (48;35). Le siege de predilection de ces tumeurs mandibulaires a ete l'hemi mandibule (48;35). Les tumeurs odontogenes ont ete les types histologiques predominants soit 64;84des tumeurs de la mandibule. Les formes benignes ont ete les plus frequentes (72;88); en particulier l'ameloblastome. Le traitement a ete chirurgical. La resection partielle de l'os mandibulaire a ete la technique chirurgicale la plus utilisee (67;03). L'evolution a court terme a ete favorable (69) ; le suivi a long terme a ete difficile. Conclusion : Les tumeurs de la mandibule ont ete relativement frequentes et dominees par l'ameloblastome. Les circonstances de decouverte sont dominees par la tumefaction mandibulaire. Le traitement a ete la chirurgie conservatrice comme le preconisent la plupart des auteurs