Deep-seated intermuscular lipoma of posterior neck muscles: a case report and review of literature.

Lipomas are the most common soft tissue tumours, accounting for nearly 50% of all soft tissue neoplasms. Among the types of lipomas, intermuscular lipomas are rare. We report the case of a 46-year-old man with a deep-seated lipoma located between the trapezius and splenius capitis muscles in the posterior neck triangle. A successful surgical excision was performed. This case highlights challenges in diagnosis, surgical management, and the importance of complete excision in minimizing the risk of recurrence. This type of lipoma remains relatively understudied; therefore, further studies are needed to increase awareness of its incidence, clinical presentation, diagnostic evaluation, and optimal management.

Spontaneous hemorrhagic thyroid nodule: a case report and review of the literature.

Spontaneous hemorrhage within thyroid nodules is infrequent and challenging to manage. Patients with this condition typically manifest acute neck pain, swelling, and discomfort. This report details a rare case of a 49-year-old male patient who was not known to have any history of thyroid disease. He presented with a distinctive clinical scenario of a spontaneous hemorrhagic thyroid nodule that was managed surgically and had a satisfying outcome. In addition, we have conducted a review of the literature regarding the clinical presentation, diagnosis, and outcomes of published cases in correlation with our discussed case.

Nasal lobular capillary hemangioma: Report of a case managed by endoscopic excision and pre-operative angio-embolization.

INTRODUCTION: Lobular capillary hemangiomas are fast-growing benign vascular lesions with distinctive histopathological characteristics. The head and neck region is a common location for lobular capillary hemangiomas. However, the presence of such lesions in the nasal cavity is rare. Although several contributing factors have been identified in literature, the exact pathophysiology is not yet well understood. Predisposing factors include nasal trauma, pregnancy, and the use of contraceptive pills. Thus, the disease is more prevalent in females, with variable peak incidence in pediatric patients. Unilateral nasal obstruction and recurrent epistaxis are the most common symptoms of nasal lobular capillary hemangiomas. Radiological evaluation using contrast-enhanced computed tomography and magnetic resonance imaging is often required for large lesions. CASE PRESENTATION: We present a 30-year old female who presented to ENT clinics with two month complaint of left-sided nasal obstruction and epistaxis with left facial pain and headache. She had no predisposing risk factors. Imaging with CT and MRI revealed a large hypervascular mass in left nasal cavity. Surgical excision preceded by pre-operative embolization was done. DISCUSSION: Endoscopic endonasal excision is the standard of treatment. While some authors believe that pre-operative embolization is not required, others advocate its use. Based on literature, recurrence rate is variable. CONCLUSION: We believe that use of pre-operative embolization for large nasal lobular capillary hemangioma would have an impact on perioperative morbidity.

Intramuscular Hemangioma of the Sternocleidomastoid: A Rare Tumor in an Unusual Location.

Intramuscular hemangiomas (IMH) are benign vascular tumors of the skeletal muscles. These tumors are uncommon in the head and neck region and usually affect the trunk and extremities. IMH of the masseter and trapezius muscles have been reported in the head and neck region. However, the sternocleidomastoid is extremely rare. In the current case report, we described a 25-year-old man with a rare case of intramuscular hemangioma involving the sternocleidomastoid muscle and reviewed the relevant literature. Contrast-enhanced computed tomography was initially obtained and showed a slightly hyperdense soft tissue mass. Head and neck magnetic resonance imaging (MRI) demonstrate a well-delineated hyperintense lesion on the T2 sequence suggestive of a soft tissue hemangioma. Subsequently, angioembolization using onyx was performed, followed by surgical excision of the mass under general anesthesia. Histopathological examination of the mass showed vascular proliferation within the skeletal muscles, and fatty tissue with an abundance of capillaries, which are consistent with capillary type intramuscular hemangioma. The patient was followed up in the clinic until the wound healed. Three months after surgery, no recurrence was observed. Preoperative angioembolization contributed to the success of IMH surgery by reducing morbidity, facilitating complete excision, and decreasing the risk of recurrence.

Castleman disease: Report of a case and review of literature on role of preoperative embolization.

INTRODUCTION: Castleman disease, which was first described by Dr. Castleman in 1954, is relatively rare and represents a spectrum of heterogeneous lymphoproliferative disorders with characteristic histological features on biopsy. It is classified based on body location and histology with variable clinical presentations. Its treatment depends on the subtype, and preoperative embolization for Castleman disease has rarely been discussed in the literature. PRESENTATION OF CASE: A 22-year old man presented to the ENT clinic with a four-week history of a mass on the left side of the neck, which was associated initially with headache, fever, and fatigue for 2 days. Contrast tomography and magnetic resonance imaging revealed a hypervascular mass located at levels two and three of the left side of the neck with feeding vessels from the external carotid artery. Preoperative embolization was planned; however, the neurointerventionist considered it a lymph node that did not need embolization. Surgical excision was performed with relatively increased operative time and bleeding. A biopsy confirmed a hyaline-vascular type Castleman disease. DISCUSSION: We reviewed the evidence-based management of CD. We reviewed the available literature on the role of preoperative embolization in management. CONCLUSION: Based on published articles and the hypervascular nature of the disease, we believe that preoperative embolization helps decrease morbidity.

A giant tonsillolith.

Tonsillar stones are the products of calcified accumulates of cellular debris and microorganisms, in the crypts of palatine tonsils. Tonsillar stones are common findings and the known cause of bad breath (halitosis). Development of large tonsillar stones, however, is rare with only a few cases reported in the literature. We present the case of a 45-year-old man with a history of recurrent sore throat and tonsillitis for a long period, and snoring with other unremarkable ears, nose and throat findings. A large-sized tonsillar stone detected in the left tonsil measured 3.1 × 2.3 cm. The patient underwent elective stone removal and tonsillectomy.

Knowledge and information sources on standard precautions and infection control of health sciences students at King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia, Riyadh.

BACKGROUND: Only one study has been conducted in Saudi Arabia to assess medical students' knowledge of standard precautions (SPs) and infection control (IC). In this study, we examined knowledge of SPs and IC among clinical students attending the King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. METHODS: In this cross-sectional study, we targeted clinical students from the following five colleges: Medicine (fifth and sixth years); Dentistry (second semester of the third, fourth, fifth, and sixth years); Applied Medical Sciences (third and fourth years); Nursing (third and fourth years); and Pharmacy (third, fourth, and fifth years). The data collection instrument was an adopted 41-item questionnaire that measured knowledge of SPs and IC in five domains. A score of ≥24 (60%) indicated sufficient knowledge. RESULTS: The participants comprised 129 students (67 men). The proportions of participants from each college were: Medicine, 58.1% (n=75); Dentistry, 14% (n=18); Applied Medical Sciences, 13.2% (n=17); Nursing, 10.9% (n=14); and Pharmacy, 3.9% (n=5). Most students (73.6%) demonstrated sufficient knowledge (men, 67.2% and women, 80.6%). The highest scores were obtained for the domains "general concept of SPs", "hand hygiene", and "personal protective equipment", whereas the lowest scores were obtained for "disposal of and injuries from sharp objects" and "health-care providers' care". The main information source was formal curricular teaching. CONCLUSIONS: In Saudi Arabia, students' knowledge of SPs and IC is satisfactory, with no significant differences between the sexes or between colleges. Thus, formal curricular teaching is an effective way to increase students' knowledge of SPs and IC.