Concurrent impalement of two orbits in a child: A case report.

INTRODUCTION: Orbital impalement is a serious and potentially life-threatening trauma if the brain or vessels at the base of the skull are affected. The authors report the results and aftermath of the management of a case of post-traumatic retention of an intra-orbital metallic foreign body. CASE PRESENTATION: A 5-year-old boy was struck by a motorcycle while crossing a road. His head struck the handlebars of the motorcycle with a left facial-orbital impact point. The examination revealed a foreign body penetrating the orbit at the level of the left upper eyelid with limitation of adduction. The radiological assessment confirmed the intra-orbital presence of the foreign body with probable fracture of the inner wall of the eyeball. Surgical exploration through the palpebral wound revealed an intact eyeball and an incarceration of the medial rectus muscle by a fracture of the internal wall. After delicate and meticulous removal of the foreign body, hemostasis was ensured and the wound was sutured. The evolution was satisfactory, without sequelae or visual prejudice. DISCUSSION: Imaging, i.e. a CT scan and a standard X-ray, is necessary to evaluate the lesions before adapting a therapeutic attitude. The choice of the approach for extraction must meet two cardinal concerns: extraction of the foreign body and minimal dissection or manipulation of the noble structures of the eye and its adnexa. CONCLUSION: Intra-orbital foreign bodies are rare but potentially serious. The type of the foreign substance, its intra-orbital extension and related lesions, as well as the extraction process, all influence the prognosis.

Facial cutaneous horn in three different conditions: A highlight of a malignancy risk.

INTRODUCTION: Cutaneous horns are nodules composed of compact keratin that project above the surface of the skin. The purpose of this work is to show the danger that can constitute the cutaneous horns. PRESENTATION OF CASES: In this paper, the authors report series of three cases of facial cutaneous horns, which were respectively diagnosed as trichilemmal horn in a 79-years old patient, a cutaneous horn underlying epidermoid carcinoma in a 59-years old patient, and a basal cell carcinoma in an 80-years old patient. All patients were treated by surgical excision. DISCUSSION: Cutaneous horns are generally asymptomatic and generate above all cosmetic disorders placing the patient in great social discomfort, thus prompting him to seek medical advice. CONCLUSION: They emphasize the need for careful management of these lesions because of the high incidence of malignant histology.

Parotid lymphoepithelial cysts revealing HIV infection in a 12-year-old girl: A case report.

INTRODUCTION: and importance: benign lymphoepithelial cysts are benign lesions consisting of one or more cysts of the salivary glands or neck regions that occur in 3-6% of patients with positive HIV serology. The objective of this work is to discuss the link between HIV and benign lymphoepithelial cysts. CASE PRESENTATION: The authors report a case of benign lymphoepithelial parotid cysts in a 12-year-old girl who underwent a partial parotidectomy. HIV serology was performed in the patient and all her family and was positive only in the girl. CLINICAL DISCUSSION: Benign lymphoepithelial lesions of the parotid gland represent the main parotid pathology associated with HIV infection. They may be the first clinical manifestation of the virus. Diagnosis is often difficult, in most cases after surgical excision and histopathological evaluation of the mass. Treatment options include observation, highly active antiretroviral therapy (HAART), aspiration, sclerotherapy, and surgery. CONCLUSION: Because of the close relationship between parotid lymphoepithelial cysts and HIV infection, it is important to perform HIV serology in any patient with these types of cysts.

Orbital varix: A rare case of unilateral exophthalmos, case report.

The etiologies of unilateral exophthalmos are multiple, rarely represented by an intra- or extra-conical vascular mass. Orbito-palpebral varixes are rare (2% of orbital masses) and represent a main cause of unilateral intermittent exophthalmos, often of an inflammatory nature. We report a Case of right orbito-palpebral varix in a 65-year-old adult, with no particular history, evolving for 2 years. The ophthalmological examination showed a right palpebral mass, extended to the right external canthus, with palpebral collateral circulation, moderate right ptosis with exophthalmos, non-axial, non-pulsatile, without thrill, painless, without complication, without visual deficit. A vascular mass was suspected and MRI revealed a right orbito-palpebral varix with temporal extension, confirmed by ANGIO-MRI. The latter also allowed to search for a cerebral venous malformation, an encephalocele or a bone defect, associated and also to eliminate differential diagnoses (tumor, arteriovenous fistula …). Color Doppler ultrasound in the proclive position confirmed the diagnosis of orbital varices. A preventive low-dose anticoagulant treatment was started to avoid thrombosis, with therapeutic abstention in the absence of complications. A rigorous monthly follow-up in consultation is ensured. Orbito-palpebral varices are characterized by an extensive posterior intra-orbital character, often during their evolution and imposes a strict surveillance. In Case of complication (thrombosis, hemorrhage, pain, compressive signs of the optic nerve), surgical removal or sclerosis of the varix can be envisaged with disappointing results (recurrence, hemorrhage).

Cutaneous adenoid cystic carcinoma of lower eyelid: Case report of a rare malignant entity.

INTRODUCTION: cutaneous adenoid cystic carcinoma is a rare epithelial tumor with slow development, it is most often described in the scalp; palpebral involvement is very rare. And is accompanied by local aggressiveness and frequent recurrence. The aim of this work is to discuss the management and the interest of a close surveillance of adenoid cystic carcinoma. CASE PRESENTATION: The authors report a case of palpebral cystic adenoid carcinoma in a 65-year-old patient who underwent surgical excision followed by reconstruction of the loss of substance. DISCUSSION: Cutaneous cystic adenoid carcinoma of the eyelids remains a very rare entity that must be evoked in front of a nodular cutaneous palpebral tumor that progresses slowly. An early diagnosis and a complete excision guarantee a better prognosis. CONCLUSION: Adenoid cystic carcinoma, because of its local aggressiveness and its capacity to recur despite satisfactory surgical removal, requires long-term surveillance. Its surgery may be responsible for functional and aesthetic sequelae.

Synovial sarcoma of the maxillary sinus and chest wall: An exceptional association of two synchronous rare locations, Case report.

INTRODUCTION: Synovial sarcoma is a malignant tumour of mesenchymal origin with an aggressive character and a rare cervicofacial location. Its management is multidisciplinary in order to improve prognosis and survival. CASE REPORT: We report the case of two rare and synchronous localizations of monophasic synovial sarcoma of the maxilla and chest wall in a 58-year-old woman, whose management was based on exclusive chemotherapy. DISCUSSION: The cervicofacial location of synovial sarcoma represents 3% of all locations in the body. Its clinical and radiological manifestations are aspecific. Its diagnosis is based on a combination of histological and genetic arguments. Its therapeutic management depends on the tumour stage and prognostic factors. CONCLUSION: Early diagnosis of cervicofacial synovial sarcoma allows to avoid a mutilating procedure for the patient and to improve the long-term prognosis by a good control of the tumour.

Restorative management of human bite injuries to the face: Case series.

Facial skin wounds are common problems seen and treated by emergency centers around the world. Among all wounds, cat and dog bites are frequently seen. Human bite injuries are both deceptive and difficult in their presentation and management. The injuries have a disfiguration effect with possible psychological impact on the patient. The aim of this paper is to compare experience with human bites of the face in our surgical unit, with other similar trials in term of reasons for the circumstances of injuries, age, and sex of the patients, site of injury, pan-time between consultation and treatment, incidence of infection and surgical management. Data in terms of age, gender distribution, circumstances of injury, location of injuries, evolution of surgical management and complications were recorded. We report here a series of 10 cases of human bite wounds to the face, admitted to our department, and treated with different reconstruction procedures.

The solitary plasmacytoma of mandible: A case report.

BACKGROUND: the solitary plasmacytomas entities characterized by the neoplastic proliferation of a single clone of plasma cells, typically producing a monoclonal immunoglobulin. It represents less than 5% of plasma cell dyscrasias. The most common sites of solitary plasmacytomas are long bones. The jaws location remains extremely rare, only 4.4% of solitary plasmacytomas of bone occur in the mandible, the diagnosis is based on the biopsy evidence of plasma cell proliferation and absence of evidence of involvement of other bones. CASE PRESENTATION: The authors report the case of a healthy 49-year-old man with no general history, presented with a painless slow-growing lesion of the left jaw that had persisted and increased in size for one month. Clinical examination revealed a large lesion 4 × 4 cm with irregular borders of the retro-molar area on the left jaw, infiltrated into underlying tissue, with sensory disturbances and facial asymmetry. CONCLUSION: Treatment methods of plasmacytomas of the jaw include local surgery (curettage of the lesion), local irradiation, systemic chemotherapy, or a combining therapy. Early diagnosis and treatment are crucial for better resolution of the disease.

Well-differentiated liposarcoma of the cheek misdiagnosed for lipoma: A case report.

INTRODUCTION: Liposarcoma is the most common sarcoma entity and accounts for 17% to 30% of soft tissue sarcomas. There are several histological types including well-differentiated liposarcoma. This paper aims to underline the interest of immunohistochemical and cytogenetic studies to diagnose well-differentiated liposarcoma and to show the delicacy of performing a surgical procedure in the cheek area. CASE PRESENTATION: The authors report the case of a 48-year-old female patient who presented with the recurrence of a right jugal mass initially diagnosed as a lipoma on the resection specimen. The patient was reoperated 5 years later and further immunohistochemical and cytogenetic studies confirmed the diagnosis of well-differentiated jugal liposarcoma. DISCUSSION: Sarcomas are rare malignant tumors of mesenchymal origin, arising from connective and supporting tissues. It should be noted that certain MRI features can distinguish liposarcoma from lipoma. Conventional histology and immunohistochemistry are the basic means for the diagnosis and classification of liposarcomas. However, molecular biology can add to the pathologist's analysis and rule out differential diagnoses Liposarcoma of the maxillofacial region has a better prognosis compared to other parts of the human body. CONCLUSION: This paper underlines the interest of complementary immunohistochemical and cytogenetic studies to differentiate well-differentiated liposarcoma from lipoma as well as the potential for local recurrence of liposarcomas.