Mass

Unusual presentation of a midline neck mass

January 19, 2015     Yann-Fuu Kou, MD; Gopi Shah, MD, MPH; Ronald Mitchell, MD; Larry L. Myers, MD
article

Venous malformations are usually visible at birth, although deeper lesions may have normal overlying skin or a bluish discoloration. They grow proportionately with the child and can expand in adulthood.

IgG4-related disease of the thyroid: A consideration in the differential diagnosis of an expanding thyroid mass

January 19, 2015     Irina Chaikhoutdinov, MD; Eelam Adil, MD, MBA; Michael D.F. Goldenberg, BA, MA; Henry Crist, MD
article

Riedel thyroiditis is a rare inflammatory process associated with IgG4; it involves the thyroid and surrounding cervical tissue, and it is associated with various forms of systemic fibrosis.

Acute exacerbation of Hashimoto thyroiditis mimicking anaplastic carcinoma of the thyroid: A complicated case

December 19, 2014     Hiroaki Kanaya, MD; Wataru Konno, MD; Satoru Fukami, MD; Hideki Hirabayashi, MD; Shin-ichi Haruna, MD
article

The fibrous variant of Hashimoto thyroiditis is uncommon, accounting for approximately 10% of all cases of Hashimoto thyroiditis. We report a case of this variant that behaved like a malignant neoplasm. The patient was a 69-year-old man who presented with a right-sided anterior neck mass that had been rapidly growing for 2 weeks. Fine-needle aspiration cytology revealed clusters of large multinucleated cells suggestive of an anaplastic carcinoma. A week after presentation, we ruled out that possibility when the mass had shrunk slightly. Instead, we diagnosed the patient with an acute exacerbation of Hashimoto thyroiditis on the basis of laboratory findings. We performed a right thyroid lobectomy, including removal of the isthmus, to clarify the pathology and alleviate pressure symptoms. The final diagnosis was the fibrous variant of Hashimoto thyroiditis, with no evidence of malignant changes. Physicians should keep in mind that on rare occasions, Hashimoto thyroiditis mimics a malignant neoplasm.

Submental nodular fasciitis: Report of an unusual case

October 17, 2014     Jiun Fong Thong, MRCS(Eng); Tiong Yong Tan, FRCR(UK); Shi Wang, FRCPA(UK); Paul Mok, FRCS(Glasg); David Loke, FRCS(Edin)
article

Abstract

A 30-year-old woman presented for evaluation of a hard, enlarging, submental mass that was fixed to the underlying mandible. Fine-needle aspiration cytology initially led to a diagnosis of pleomorphic adenoma, which was unusual given the superficial location of the lesion on computed tomography. The lesion was a well-defined rim-enhancing mass, and it had displaced adjacent structures medially. Intraoperatively, the mass was found to abut against and erode the mandibular cortex. A diagnosis of nodular fasciitis was established by histologic analysis. Such a location for this tumor is unusual. The prognosis for patients with this benign condition is excellent following complete surgical excision. We discuss the clinical presentation and the cytologic, histologic, and radiologic features of this uncommon entity.

Osteoma of the middle ear

October 17, 2014     Tsung-Shun Chang, MD; Wen-Sen Lai, MD; Chao-Yin Kuo, MD; Chih-Hung Wang, MD, PhD
article

Management of middle ear osteoma can be complicated when the round window is obliterated. Therefore, the patient should be informed about what to expect prior to surgery.

Salivary gland choristoma of the middle ear

October 17, 2014     Paolo Fois, MD; Anna Lisa Giannuzzi, MD; Carlo Terenzio Paties, MD; Maurizio Falcioni, MD
article

Abstract

Choristoma of the middle ear is a rare condition characterized by the presence of normal salivary gland tissue in the middle ear space. Salivary gland choristomas are benign lesions that are frequently associated with ossicular chain and facial nerve anomalies. Total surgical excision is indicated when there is no risk of damaging the facial nerve. We describe a new case of salivary gland choristoma of the middle ear, and we discuss the etiology, histologic features, and management of such lesions. Our patient was a 22-year-old woman in whom we surgically removed a whitish retrotympanic mass. Intraoperatively, we also detected an ossicular chain malformation. Histologic examination of the choristoma revealed the presence of salivary gland tissue. Furthermore, the lesion contained an extensive and previously undescribed component: a well-defined pseudostratified respiratory-type epithelium, similar to that of a normal eustachian tube. Ten months after removal of the choristoma, we surgically repaired the ossicular chain anomalies. No recurrence was noted on follow-up.

Arytenoid cartilage chondroma

August 27, 2014     Joel E. Portnoy, MD; Johnathan B. Sataloff; Mary J. Hawkshaw, BSN, RN, CORLN; Robert T. Sataloff, MD, DMA, FACS
article

Strobovideolaryngoscopy revealed a mass along the medial aspect of the left arytenoid cartilage.

Two cases of pyogenic granuloma in pregnancy

August 27, 2014     Alex Fernandez, MS; Jason Hamilton, MD, FACS; Raphael Nach, MD
article

Management and treatment of rhinologic issues in pregnant patients can be complex because of the limited availability of safety data.

Neopharyngeal diverticulum

August 27, 2014     Rebecca J. Howell, MD; Gregory N. Postma, MD
article

Endoscopic examination showed no distal stricture or cricopharyngeus muscle.

Large osteoma of the maxillary sinus accompanied by an unerupted tooth

July 13, 2014     Jae-Hoon Lee, MD
article

CT of the maxillofacial region is required for patients with an osteoma to rule out Gardner syndrome, which should be considered when a patient has more than one osteoma.

Endoscopic view of osteogenesis imperfecta of the maxilla

June 8, 2014     Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
article

Osseous lesions in the maxilla can represent ossifying fibroma, fibrous dysplasia, amelogenesis imperfecta, or osteogenesis imperfecta.

Madelung disease: Multiple symmetric lipomatosis

March 18, 2014     Enrique Palacios, MD, FACR; Harold R. Neitzschman, MD, FACR; Jeremy Nguyen, MD
article

Patients with multiple symmetric lipomatosis commonly also suffer from various neuropathies, especially paresthesias and autonomic neuropathy.

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