Histological surprise of parotid tuberculosis: about two cases.

Parotid tuberculosis remains a very rare localization in the Department of Otolaryngology and Cervico-Facial Surgery (ENT) sphere. It is presented in the form of a deceptive clinical picture causing confusion with other pathologies of the parotid gland, including tumor pathology. In addition, its lack of knowledge by practitioners increases the risk of missing the diagnosis. Often, the diagnosis is a histological surprise on a piece of excision after an exploratory parotidectomy. However, its treatment is primarily medical if the positive diagnosis is well established. We report medical observation of two new cases aged 44 and 45 respectively, who consult our center for parotid swelling. Radiological examinations were in favor of intraparotid cystic lesions. Both patients benefited from an excision whose histopathological study was in favor of primary parotid tuberculosis. The subsequent evolution was favorable under antituberculous treatment.

[Lipoma of the deep lobe of the parotid gland]. / Lipome du lobe profond de la glande parotide.

Lipomas of the parotid gland are benign tumors developing from the fatty tissue in the gland. They are rare, accounting for 0.6-4.4% of all benign tumors. Those located in the deep lobe of the gland are uncommon. Clinically, they are very difficult to diagnose. CT scan and especially MRI can support the diagnosis. Surgery is the treatment of choice but its modalities remain controversial. We report the case of a 52-year old female patient, with no particular past medical history, presenting with asymptomatic left preauricular mass evolving over 1 year and gradually increasing in volume. Clinical examination showed painless elastic swelling, measuring 2 × 1.5 × 1 cm, extending from the ear lobule to the left mandibular angle. Stensen duct wasn't obstructed and saliva was clear. The patient showed no facial paralysis. CT scan showed perfectly delimited unilobular hypodense homogeneous mass in the deep lobe of the parotid gland. No suspected cervical lymphadenopathy was detected. MRI confirmed the presence of homogeneous, lipomatous intraparotid tissue process. After superficial parotidectomy and translocation of the branches of the facial nerve, a yellowish mass appeared under the buccal and mandibular branches of the facial nerve. The patient underwent complete resection up to the left parapharyngeal space. The postoperative course was uneventful. Anatomo-pathological examination confirmed the diagnosis of lipoma of the deep lobe of the parotid gland.

Contralateral facial nerve palsy following mandibular second molar removal: is there co-relation or just coincidence?

Peripheral facial nerve palsy (FNP) is the most common cranial nerves neuropathy. It is very rare during dental treatment. Classically, it begins immediately after the injection of local anaesthetic into the region of inferior dental foramen and it's homolateral to the injection. Recovery takes a few hours, normally as long the anaesthetic lasts. The authors present a 44-year-old patient who presented a contralateral delayed-onset facial paralysis arising from dental procedure and discuss the plausible pathogenesis mechanism of happen and a possible relationship between dental procedure and contralateral FNP.

Castle man disease: a case report and review of the literature.

The Castleman disease (CD) is a rare disease of unknown etiology, characterized histologically by angiofollicular lymphoid hyperplasia. It comes in two forms, unicentric and multicentric. We report a case of Castleman disease in a 58 year old man, who had consulted for chronic cervical lymphadenopathy. This case was a multicenteric and rapidly fatal despite aggressive treatment with corticosteroids, and chemotherapy.