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.

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.

Unusual cervicofacial localization of two subcutaneous tuberculous cold abscesses in an immunocompetent subject.

INTRODUCTION: Subcutaneous tuberculous cold abscesses represent a rare form of extra-pulmonary tuberculosis and their cervicofacial localization is exceptional. The management of this unusual form and location is medico-surgical and must be adapted to avoid progression to complications. CASE REPORT: We report the case of a double cervicofacial localization of subcutaneous tuberculous cold abscesses in an immunocompetent patient followed for pulmonary tuberculosis who benefited from a surgical drainage of the two abscesses with anti-tuberculosis treatment with good clinical evolution. DISCUSSION: The diagnosis of subcutaneous tuberculous cold abscesses is based on a combination of anamnestic, clinical and paraclinical findings. Cold abscesses are most commonly described in patients with disseminated tuberculosis or during human immunodeficiency virus infection, but they may also occur in immunocompetent subjects. Monofocal localization is the most common and the association of several localizations is unusual. The treatment is medical-surgical, combining surgical drainage with anti-tuberculosis treatment. CONCLUSION: Subcutaneous tuberculous cold abscesses should be considered in the presence of any stubborn collection occurring in a context of tuberculosis infection. Early diagnosis is the best guarantee of a cure without complications.

Seborrheic keratosis of the cheek simulating squamous cell carcinoma.

INTRODUCTION: Seborrheic keratoses are benign tumours that occur electively on the head, neck and trunk. It can be confused on its clinical appearance with other skin tumours and it is the histological examination that establishes the diagnosis. We report a case of seborrheic keratosis simulating squamous cell carcinoma. OBSERVATION: A 62-year-old woman consulted for a budding right jugal lesion that had been evolving for 6 months. Clinical examination found a right jugal budding lesion with crusts on its surface, pedunculated, surrounded by a hyperpigmented halo at its base, firm to palpation, painless and non bleeding on contact. An initial biopsy of the lesion for histological examination confirmed the diagnosis, followed by complete surgical excision. DISCUSSION: Seborrheic keratoses are benign tumours that occur mainly in subjects over 50 years of age. They occur electively on the trunk, head and neck. Its clinical aspect is generally typical but sometimes misleading, as found in our case; only histology allows to make the diagnosis of certainty.

Congenital bilateral zygomatico-maxillo-mandibular fusion associated with gumfusion: Case report.

INTRODUCTION: Maxillomandibular sygnathia is a rare and severe craniofacial deformity defined by gingival mucosal fusion (synechia) or bony fusion (synostosis). CASE REPORT: We will present a case of complete closure of the mouth since birth from eastern Morocco treated in our department of maxillofacial surgery at the University Hospital of Casablanca. The patient was referred after two months by the pediatrician of the provincial hospital and following the placement of a nasogastric tube. On admission, she presented with facial dysmorphosis, signs of malnutrition with closure of the mouth and fusion of both gums with pro-alveoli and retromandibulia. CT scan with 3D reconstruction confirmed maxillomandibular synostosis. 5 days later, she underwent a fixed mucosal incision with osteotomy at the maxillomandibular joints with early and prolonged active physical therapy. The evolution was marked by the recurrence of mouth closure, the little girl was operated a second time and then she died by a mucous plug at the level of her tracheostomy cannula during resuscitation. DISCUSSION: Maxillomandibular sygnathia is a very rare pathology whose origin remains unknown. Very few cases published in the literature. CONCLUSION: The therapeutic difficulties encountered outside the ideal age of the operation and the management of recurrences were also linked to socio-economic factors making it difficult to ensure adequate postoperative follow-up.

Neglected ballistic trauma of the face in a young subject: A case report.

Injuries by ballistic projectiles concern nowadays more and more frequently civilian populations. If the vital prognosis is rarely put at risk, the functional after-effects are frequent and important. The management of these injuries follows specific rules that must be known because they are sometimes different from the usual traumatology. However, it is important for any surgeon to understand the basic principles of ballistic injury. Indeed, the knowledge of the trajectory of the bullet and its final location allows to consider the potential injuries and to evaluate the management of the patient. CT is the examination of choice for penetrating foreign bodies, allowing for viewing of the entry site, bullet trajectory, possible scattered fragments, and, most importantly, a possible skull base breach, as well as providing useful information for planning the surgical procedure and, generally, for prognosis. The primary surgery must ensure an early and rigorous trimming associated with antibiotic therapy because the quality of the initial trimming significantly influences the final result, so this approach to the removal of the foreign body depends on its size, its anatomical location, the structures involved and the preference of the surgeon.

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.