Strangled by His Nerves-Cervical Plexiform Neurofibroma With Infantile Spinal Neurofibromatosis: Case Report in a 14 Years Old Child.

Background: Neurofibromatoses are a rare group of autosomal dominant tumor suppressor phacomatoses syndromes. Neurofibromatosis type 1 (NF1 or Von Recklinghausen's disease) is the most commonly found type of neurofibromatosis, and constitutes the most commonly found autosomal dominant disease of the nervous system. Case presentation: We report a case of a 14-year-old boy who reported a 3-year-history of a slowly enlarging right lateral cervical mass. He has a medical history of a progressive limping gait disorder with scoliotic attitude. MRI identified a dumb-bell shaped intradural right cervical process through right paravertebral gutter on C2 to C4, a second intradural dorsal mass with the same characteristics through left paravertebral gutter on D4 and D5 and a large tissue-like mass infiltrating the lumbosacral subcutaneous soft tissues. A Surgical excision of the cervical and lumbar masses was performed with a good outcome after surgical excision. Conclusions: This case illustrates the need for a collaboration of both neurological and head and neck surgeons in terms of managing difficulties related to a cervical neurofibroma. Benign plexiform neurofibromas are rapidly growing tumors, particularly in children and adolescents, which makes all the importance of early detection and appropriate treatment. Repeated interventions are usually needed in order to adapt and stabilize the tumors extension.

[The inferior laryngeal nerve: anatomical and surgical considerations about 60 thyroidectomy]. / Le nerf laryngé inférieur: considérations anatomiques et chirurgicales à propos de 60 thyroïdectomies.

Thyroid surgery requires a thorough knowledge of cervical anatomy and anatomical variations, in particular of the lower laryngeal nerve, in order to avoid iatrogenic lesions. The objective of our study was to analyze the relationships of the lower laryngeal nerve, the existence of branches of nerve division and a subjective appreciation of the size of the nerve. This is a prospective study of 1 year including 60 patients who underwent thyroidectomy. Sixty patients underwent surgery on the thyroid gland between February 2014 and January 2015 by the same principal operator (10 men and 50 women). The average age of our patients was 51 years. For men were performed 6 total thyroidectomies, 2 left lobo-isthmectomies and 2 right lobo-isthmectomies. For women were performed 33 total thyroidectomies, 8 left lobo-isthmectomies and 9 right lobo-isthmectomies. On the right, the nerve was superficial relative to the artery in 71.6% of cases; it was divided in 33.3% of cases and was abnormally thin in 16.6% of cases. On the left, the nerve was deep in relation to the artery in 83.3% of cases; it was divided in 15% of cases and was abnormally thin in 11.6% of cases. Knowledge of the anatomical variations of the lower laryngeal nerve is essential in thyroid surgery, the risk is particularly important on the right side given the sometimes very small caliber and the existence of branches of division more frequent than on the left side.

[Extra-nodal NK/T-cell lymphoma, nasal type presenting as orbital cellulitis]. / Un lymphome T/NK extra-ganglionnaire de type nasal se présentant comme une cellulite orbitaire.

Extra-nodal NK/T-cell lymphoma, nasal type, is a rare form of malignant non-Hodgkin's lymphomas. It poses a diagnostic problem due to nonspecific symptoms. We report a case of NK/T-cell lymphoma simulating orbital cellulitis. The study involved a 46-year old female patient followed up for Behçet's disease. The patient was admitted with orbital cellulitis. CT scan of the midface showed pansinusitis with orbital infiltration.The patient had no improvement under antibiotic therapy. Surgical treatment with biopsy was performed. Histological examination showed inflammatory vasculitis and the patient underwent corticosteroid therapy with clinical improvement. The patient had recurrence requiring reoperation with ethmoid biopsies whose histological examination showed NK/T-cell lymphoma, nasal type. Treatment was based on radiochemotherapy and the patient died after two months. NK/T-cell lymphomas are aggressive, they primarily affect the nasal cavities and sinus. They cause angiodestruction and necrosis, resulting in unspecific symptoms. Biopsies are often negative, posing a problem of differential diagnosis. Treatment is based on radiotherapy and chemotherapy. Prognosis is reserved.

[Supracricoid partial laryngectomy (SCPL) with either cricohyoidoepiglottopexy (CHEP): our experience with 16 cases]. / Laryngectomies partielles supra-cricoïdiennes avec reconstruction par CHEP: notre expérience sur 16 cas.

Partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) are mainly used to treat glottic cancers becuse they ensure a satisfactory preservation of physiological functions and satisfactory local carcinologic control. Our study aimed to analyze the functional and carcinologic results of this surgical technique. We conducted a retrospective study of patients undergoing partial laryngectomy with either cricohyoidoepiglottopexy in our Hospital between 2011 and 2014. We analyzed the epidemiological data, the surgical peculiarities, the functional outcomes and the carcinologic control of the disease. A total of 16 patients were included in this study. All our patients had T1 or T2 glottis squamous cell carcinoma. Functional outcomes were generally simple, especially in cases where the preservation of the 2 cricoarytenoid units was possible (75% of cases). However post-operative complications were reported in 31.25%. Carcinologic control was satisfactory, only one patient experienced local recurrence. Partial laryngectomy with either cricohyoidoepiglottopexy (CHEP) is a safe surgery preserving physiological functions and ensuring satisfactory quality of life. It also allows for good carcinologic control (it is subject of course to compliance with surgical indications).

Tuberculosis of the parotid gland: histology surprise.

The Parotid gland is rarely involved in tuberculosis, even in endemic countries. We report a case of a 26 year-old woman with no medical history, who presented with a swelling of the parotid lodge. Pathology performed after surgery found a tuberculous parotitis, and the patient received anti-tuberculous regimen with a satisfactory evolution. We discuss both diagnostic and therapeutic modalities for this infection.

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.