RESUMEN
Hearing loss can result from a wide range of pathologies affecting patients of all ages. It may be due to abnormalities of the outer, middle or inner ear. In this article, we present a case of a 50 years old female patient presenting to the ENT and Head & Neck surgery department of 20 August hospital, complaining of bilateral hearing loss, in whom clinical examination found right attical retraction pocket with scales and left normal tympanic membrane. Complementary investigations revealed the association of two distinct conditions, rarely described in literature: otosclerosis, and chronic otitis media with cholesteatoma in right ear and left otosclerosis. The challenge in this case was to determine the therapeutic strategy: start with left otosclerosis? the right cholesteatoma? simultaneously treat otosclerosis and cholesteatoma right?
RESUMEN
INTRODUCTION: Chondrosarcomas of the head and neck are extremely rare, accounting for approximatively 0.1% of all head and neck malignant tumors. Mesenchymal chondrosarcomas are particularly aggressive, with a high propensity for recurrence. CASE REPORT: We report the case of a 25 years old man with no prior medical history, who presented to our facility with an aggressive tumor of the left maxilla. Upon radiologic and histopathological examinations, the tumor was revealed to be a mesenchymal chondrosarcoma. The patient was treated using surgical excision of the tumor, neoadjuvant chemotherapy and adjuvant radiotherapy. CONCLUSION: Due to the high risk of recurrence and the possibility of metastasis occurring long after the initial diagnosis, it is important that patients with mesenchymal chondrosarcomas receive close and regular follow-ups after treatment.
RESUMEN
INTRODUCTION: Juvenile ossifying fibroma (OF) is a benign fibro-osseous tumor, affecting the bones of the face. It's locally very aggressive, with a strong tendency to recur. We report a case of a juvenile psammomatoid ossifying fibroma (JPOF) complicated with exophthalmos undergoing an entirely endoscopic resection. CLINICAL PRESENTATION: A 14-years-old, young woman presented with a 7 months history of headache and right chronic tearing complicated with exophthalmos. Nasal endoscopy revealed a polylobed mass filling the right nasal cavity, the ophthalmic examination showed an isolated exophthalmos. CT scan revealed a well-limited benign mass covered by a thick shell of bone, pushing out the orbital lamina papyracea responsible for a grade 1 exophthalmos. On the facial MRI, we excluded intracranial or intraorbital involvement. A biopsy of the mass describes a psammomatoid juvenile ossifying fibroma. The patient underwent endoscopic transnasal approach with image-guided neuro-navigation system. CLINICAL DISCUSSION: JPOF is an aggressive variant of ossifying fibroma occurring predominantly in children with a predilection for the paranasal sinuses. CT scan images show a characteristic well-limited benign expansile mass covered by a thick shell of bone, but sometimes it's mistaken for a mucocele. MRI helps with excluding intracranial or intraorbital involvement. Endonasal endoscopic approaches have been increasingly used and it tends to become the new standard of care. CONCLUSION: Treatment consists of complete surgical removal; incomplete resection is associated with a high local recurrence rate. Clinician should keep in mind the need for clinical and radiological follow-up for many years.
RESUMEN
INTRODUCTION: Lemierre's syndrome is a rare and potentially fatal entity characterized by the spread of an oropharyngeal infection, with secondary suppurative thrombophlebitis of the internal jugular vein and septic emboli. PRESENTATION OF CASE: We discuss the case of a 52-year-old male who developed Lemierre's syndrome following peritonsillar abscess. He presented with submandibular and submental swelling extending into the neck. His management included; incision and drainage of the abscesses; and prolonged anticoagulant therapy. CONCLUSION: The incidence of Lemierre's disease appears to be increasing, perhaps due to ignorance of the disease by many clinicians, and diagnosis is often delayed with potentially fatal consequences.
RESUMEN
INTRODUCTION: Rhabdomyosarcoma (RMS) is a malignant mesenchymal neoplasm uncommon in adults. PRESENTATION OF CASE: We report the case of an alveolar rhabdomyosarcoma in a rare location and in an adult. It concerns a 46-year-old woman with a mandibular location invading the parotid gland. The Immunohistochemical analysis revealed intense positivity for myogenin and desmin, favoring the diagnosis of alveolar rhabdomyosarcoma. The patient had a right hemi-mandibulectomy with parotidectomy and received chemotherapy with radiotherapy. The evolution was good up to 2 years postoperatively then the patient relapsed with a recurrence of tumour rapidly progressing and metastases in the cervical spine. DISCUSSION: RMS is an aggressive but rare disease that is one of the most common malignant head and neck tumors in children. The predilection sites of adult rhabdomyosarcoma are the extremities. Current treatment includes a combination of ablative surgery, chemotherapy, and radiation therapy. CONCLUSION: The prognosis of head and neck rhabdomyosarcomas in adults remains very poor given the often initially advanced stage of the disease and the high metastatic potential.