Pleomorphic adenoma of the parotid gland concomitant with tuberculosis infection: A case report and review of the literature.

Tuberculosis of the salivary glands and particularly of the parotid gland is a localization that remains rare even in endemic countries. The association of intra parotid tuberculosis with a benign tumor has been found only in rare cases in literature. A 50-year-old woman with a history of normal pressure hydrocephalus treated surgically, non-smoker, presented with a right parotid swelling progressively increasing in size for 3 years. Clinical examination revealed a 4 cm long, firm, mobile, painless parotid swelling without inflammatory signs and without accessory lymphadenopathy. The oropharyngeal examination was without abnormalities. Ultrasound showed a mass of 31 × 27 mm suggesting a pleomorphic adenoma. MRI confirmed the suspicion of a pleomorphic adenoma of both lobes. The patient underwent a conservative total parotidectomy. The extemporaneous examination was in favor of a pleomorphic adenoma while the final pathology showed the coexistence of active tuberculosis lesions. The patient was put on long-term antituberculosis treatment with good clinical evolution. The clinical presentation of parotid tuberculosis is nonspecific mimicking any other tumor and the diagnosis can only be made by histological examination. Therapeutic management is based on long-term antituberculosis treatment.

Extracranial head and neck neurogenic tumors: report of 47 cases.

UNLABELLED: Extracranial head and neck neurogenic tumors are rare and usually revealed by histological examination. The aim of this study was to review the clinical, radiological and therapeutic particularities of these tumors. METHODS: This retrospective study concerns 47 patients with neurogenic tumors of the head and neck, operated on between 1989 and 2011 (22 years period). All patients had complete physical examination and ultrasonography was performed when a cervical extension was found. CT scan and MRI were performed in 16 cases. Minimum follow up was 4 years. RESULTS:   A sinusonasal tumor was found in 9 cases and a cervical mass was seen in 28 cases. Parapharyngeal extension was observed in two cases. Two patients had tympano-jugular glomic tumors and 8 of them had a cervical soft tissue tumor. Complete surgical resection was performed in 46 patients. Histological examination revealed a benign tumor in 91% of cases (n=43), 24 of them were schwannomas. Malignant tumors were seen in 4 cases: esthesioneuroblastoma (3 cases) and malignant schwannoma (1 case). These patients received post operative radiotherapy. After surgery, two patients had Claude Bernard Horner syndrome and one had a definitive facial nerve palsy. CONCLUSION: Extracranial head and neck neurogenic tumors may have several aspects depending on their localisation and their histological type. Surgery, when performed, should be complete with minimum complications.

[Sinonasal inverted papilloma: 43 cases]. / Le papillome inversé nasosinusien : 43 cas.

PURPOSE: Inverted papilloma (IP) is a common epithelial tumor arising from the nasal vault. The aim of our study was to evaluate the advantages, the results and the limits in the treatment of this tumor. PATIENTS AND METHOD: Retrospective study of 43 patients over the period 1989-2009. RESULTS: The mean age was 53.3 years. We found a maxillary sinus extension in 40 cases and ethmoidal extension in 27 cases. Twenty-nine patients were treated through an endoscopic endonasal approach. A vestibular approach was used in three patients. A paralateral nasal approach was used for 12 cases. We observed a recurrence in 9.3% of the all cases. CONCLUSION: The treatment of IP is surgical. Their high potential of local aggressiveness, fear of recurrence and the possibility of the occurrence of a malignancy require radical treatment.