RESUMO
Epidermoid cysts (ECs) are benign lesions that can be encountered throughout the body, but with a low incidence in the head and neck (1.6 to 7%). In oral cavity, the most common affected site is floor of the mouth, but tonsillar location remains extremely rare (less than 0.01%). Here we present an epidermoid cyst of the right palatine tonsil which was incidentally detected in a patient who consulted for a chronic headache.
Assuntos
Cisto Epidérmico/diagnóstico , Cefaleia/etiologia , Tonsila Palatina/patologia , Adulto , Doença Crônica , Feminino , HumanosRESUMO
Parathyroid carcinoma is a very rare malignant tumor of the parathyroid gland. Clinically, this cancer is characterized by the presence of severe primary hyperparathyroidism. Diagnosis is based on histological examination but is not always easy. Surgery is the treatment of choice. We report the case of a 59-year old woman with a personal history of arterial hypertension and of recurrent renal lithiasis, presenting with diffuse bone pain associated with asthenia. Neck examination showed hard basi-cervical swelling with nonpalpable lower edge. Laboratory tests showed hypercalcaemia 4.1 mmol/l, hyperparathyroidism with very high parathyroid hormone (PTH) value (1088 pg/ml or 13 times normal). Technetium-99m-sestamibi scintigraphy showed fixed MIBI abnormality in the projection of the left inferior parathyroid. The patient underwent left inferior parathyroidectomy, with ipsilateral mediastinal-recurrent nerve dissection. The postoperative course was marked by normalization of plasma calcium and THP. Anatomopathological examination showed parathyroid carcinoma. The diagnosis of parathyroid carcinoma is generally based on the combination of biological, radiological and histological signs. The severity of this pathology is due to severe hypercalcaemia and to the risk of recurrence and distant metastases, justifying prolonged monitoring.