Mass

Angioleiomyoma on the dorsum of the nose excised via an open rhinoplasty approach

December 20, 2013     Philip W. Stather, MBChB; Zuhair O. Kirresh, FRCS; Paul N. Jervis, FRCS
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Abstract

We describe what we believe is the first reported case of an angioleiomyoma on the dorsum of the nose. The patient was a 65-year-old woman who presented with a year-long history of an intermittently recurrent lump on the right side of the dorsum. The lesion was removed via an open rhinoplasty approach. Histologic examination identified it as an angioleiomyoma.

Langerhans cell histiocytosis: Temporal bone invasion in an adult

October 23, 2013     Richard L. Alexander, MD, PhD, MBA; Mary L. Worthen, BS; Changlee S. Pang, MD; John S. May, MD
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Despite the characteristic of extensive destruction of the temporal bone in this disease, the facial nerve is surprisingly resistant to destruction, and facial nerve palsy is rare.

Hemangiopericytoma of the parapharyngeal space

September 18, 2013     Brian A. Fishero, MD; Kelly M. Guido, MD; Howard S. McGuff, DDS; Josefine M. Heim-Hall, MD; Frank R. Miller, MD, FACS
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Abstract

Hemangiopericytomas of the head and neck are rarely found in the parapharyngeal space. We report the case of a 53-year-old woman who presented with a globus sensation in her throat. Imaging detected a left submucosal oropharyngeal mass that extended into the prestyloid parapharyngeal space. The tumor was surgically excised en bloc. Histopathologic examination identified it as a hemangiopericytoma. We discuss the diagnosis and management of this rare entity.

Transnasal esophagoscopy and the diagnosis of a mediastinal foregut duplication cyst

August 21, 2013     Amarbir S. Gill, BS and Jennifer L. Long, MD, PhD
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Foregut duplication cysts are true mucus-filled cysts lined with a thin epithelial layer, arising from either bronchogenic, esophageal, or neuroenteric precursor tissue.

Infected sublingual hematoma: A rare complication of frenulectomy

July 21, 2013     Amal Isaiah, MD, DPhil; Kevin D. Pereira, MD, MS
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Given the spectrum of potential poor outcomes, some consensus has emerged in favor of early surgical management of significant ankyloglossia.

Primary laryngeal actinomycosis in an immunosuppressed woman: A case report

July 21, 2013     Tarik Abed, MBBS; Jay Ahmed, MBBS; Niamh O'Shea, MBBS; Simon Payne, FRCPath; Gavin W. Watters, FRCS
article

Abstract

We report a rare case of primary laryngeal actinomycosis, which occurred in a 35-year-old woman with end-stage renal failure secondary to systemic lupus erythematosus with membranous glomerulonephritis. The patient, who had been on long-term immunosuppression therapy, presented with hoarseness. Flexible laryngoscopy detected the presence of a granular glottic mass at the anterior commissure of the larynx. Histology revealed actinomycotic organisms associated with an abscess. The patient was treated with a prolonged course of oral penicillin V and speech therapy, and her dysphonia resolved almost completely. Although actinomycotic infection of the larynx is rare, it should be considered in the differential diagnosis of hoarseness in an immunocompromised patient.

Pigmented villonodular synovitis of the temporomandibular joint

July 21, 2013     Helen Giannakopoulos, DDS, MD; Joli C. Chou, DMD, MD; Peter D. Quinn, DMD, MD
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Abstract

Pigmented villonodular synovitis (PVNS) is a proliferative disorder that affects synovium-lined joints, bursae, and tendon sheaths. It appears in both diffuse and localized forms, depending on the extent of synovial involvement. PVNS rarely involves the temporomandibular joint (TMJ); when it does, it manifests clinically as a slowly growing and painless preauricular mass that resembles a parotid tumor. TMJ dysfunction, paresthesia, and/or hearing loss can result. We present a case of a large extra-articular PVNS of the TMJ, and we review the literature.

Nasal actinomycosis mimicking a foreign body

July 21, 2013     Dimitrios Batzakakis, MD; Petros D. Karkos, AFRCS, MPhil, PhD; Sotirios Papouliakos, MD; Samuel C. Leong, MRCS, DO-HNS; Ioannis Bardanis, MD
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Abstract

Nasal actinomycosis is a rare disease. We present a case of nasal actinomycosis causing symptoms similar to those of a nasal foreign body. A 34-year-old woman presented with a long history of halitosis and unilateral offensive, purulent rhinorrhea. Rigid nasendoscopy showed a hard, dark gray mass between the middle and inferior turbinates. Computed tomography findings were typical of a nasal foreign body. Endoscopic removal of the mass was performed, and histopathology established a diagnosis of actinomycosis. We suggest that every clinician confronted with unilateral nasal symptoms and/or signs should have this clinical entity in mind, since it has justifiably been characterized as the head and neck “mimic.”

Large osteoma of the external auditory canal

July 21, 2013     Takashi Iizuka, MD; Takuo Haruyama, MD; Keiko Nagaya, MD
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Hypopharyngeal lipoma causing obstructive sleep apnea: Discovery on dental cone-beam CT

March 24, 2013     Ashok Balasundaram, BDS, DDS, MDS, MS, Diplomate ABOMR
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Abstract

Cone-beam computed tomography (CBCT) is primarily used for a variety of dental purposes, but it may also yield nondental findings that can have significant implications for patient health. For example, physicians should be aware that CBCT can identify some of the etiopathogenic causes of obstructive sleep apnea, as occurred in the case described in this report. The patient was a 76-year-old man who presented to a dentist for implant therapy. A CBCT that had been performed in preparation for dental implant placement revealed the presence of a large hypopharyngeal lesion that was obstructing the airway. An otolaryngologist excised the lesion, which on biopsy proved to be a lipoma. Following removal of the lesion, the patient's episodic sleep apnea and snoring resolved. Medical physicians should be aware of maxillofacial CBCT technology and its ability to identify lesions that could cause potential life-threatening situations.

Mucocele: Retention and extravasation types

March 24, 2013     Lester D.R. Thompson, MD
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The extravasation type is the most common mucocele, more common in children and young adults, with a peak in the second decade of life.

External auditory canal exostosis

January 24, 2013     Joseph A. Ursick, MD; Jose N. Fayad, MD
article

Exostoses, composed of immature layers of lamellar bone that cause a progressive stenosis of the external ear canal, are typically bilateral, occur at suture lines, and are associated with repeated exposure to cold water.

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