Tumor

Fetal rhabdomyoma of the tongue in a newborn

July 20, 2015     Nicole L. Aaronson, MD; Julia C.D. Toman, MD; Michael Z. Lerner, MD; Eric D. Baum, MD
article

Most extra-cardiac rhabdomyomas in the oral cavity arise in the floor of mouth,

Radiographic findings of a well-differentiated sinonasal neuroendocrine neoplasm: Case report and review of the literature

July 20, 2015     Cui Ping Mao, PhD; Ming Zhang, MD; Chen Niu, PhD; Min Li, MD; Yuan Wang, MD
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Abstract

Typical carcinoid is a rare tumor among other neuroendocrine neoplasms that occur in the nasal cavity. Only a few cases of typical carcinoids in the nasal cavity have been reported. We report a case of typical carcinoid of the nasal cavity in a 61-year-old man who had a history of persistent nasal obstruction and epistaxis for approximately 17 years. Computed tomography revealed a huge, lobulated mass in the nasal cavity with extension into the posterior sphenoid sinus. Extensive bone destruction could be seen in the neighboring sphenoid sinus. MR imaging suggested that the tumor was close to the dura. The final histologic evaluation of the excised biopsy specimen yielded a diagnosis of a well-differentiated neuroendocrine neoplasm (typical carcinoid). In this article, the relevant reports in the literature are reviewed, and the role of radiographic findings on tumor diagnosis and on the establishment of a surgery plan is emphasized.

Duplication of the right internal jugular vein: A case report

June 4, 2015     Srinivasalu Bathala, FRCS(ORL-HNS); Zvoru G. Makura, FRCS(ORL-HNS)
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Abstract

We present a case of duplication of the right internal jugular vein (IJV) in a patient who underwent neck dissection as part of the management of carcinoma of the larynx. The patient was a 63-year-old man who presented to the otolaryngology department with a 7-month history of hoarseness and a 3-week history of noisy breathing. Flexible endoscopy detected a transglottic tumor that had extended beyond the vocal folds. The patient underwent a total laryngectomy and bilateral selective neck dissection at levels II-VI. Intraoperatively, the right IJV was noted to be duplicated. The duplicate segment was approximately 10 cm in length, and it rejoined the normal vein before the normal vein joined the subclavian vein.

Maxillary myxoma: A case report and review

June 4, 2015     Matthew P. Connor, MD, Capt.; Michael Neilson, DMD, Maj.; Cecelia E. Schmalbach, MD
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Abstract

An odontogenic myxoma is a rare, benign tumor that is found almost exclusively in the facial bones, usually the mandible. The diagnosis poses a challenge because its features overlap with those of other benign and malignant neoplasms. We present an unusual case of odontogenic myxoma that involved the maxilla, and we review the clinical, radiographic, and histologic characteristics of this case. Even though it is benign, odontogenic myxoma can be locally invasive and cause significant morbidity. Complete surgical excision is the treatment of choice, but it can be challenging because of the tumor's indistinct margins.

Internal auditory canal osteoma: Case report and review of the literature

June 4, 2015     Sharon Ovnat Tamir, MD; Francoise Cyna-Gorse, MD; Olivier Sterkers, MD
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Abstract

We report a case of internal auditory canal osteoma and discuss this entity's etiology, natural history, and treatment options. The internal auditory canal osteoma is a rare entity with only a few reports published in the medical literature. Its diagnosis is based on two complementary imaging modalities: thin-slice computed tomography and magnetic resonance imaging. No consensus exists regarding the treatment of this entity, and treatment should be tailored to each patient depending on that patient's initial complaints, as well as his or her medical findings.

Perineural spread of cutaneous squamous cell carcinoma along the great auricular nerve

April 27, 2015     Daniel Thomas Ginat, MD, MS; Diana Bolotin, MD, PhD; Alexander J. Langerman, MD
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Although perineural tumor spread in the head and neck most commonly involves the cranial nerves, particularly the trigeminal and facial nerves, the spinal nerve branches can also be affected.

Massive myiasis in an advanced metastatic neck tumor

April 27, 2015     Tomasz Rowicki, MD, PhD; Mirosława Pietniczka-Załęska, MD, PhD
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Abstract

Only a small number of cases of myiasis have been previously reported in patients with a head and neck malignancy; most of these occurred in patients with primary or metastatic skin cancer. We report a case of massive Lucilia sericata myiasis in the neck of a 57-year-old man with primary squamous cell carcinoma of the larynx and hypopharynx that metastasized to the neck lymph nodes. The neck disease manifested as necrosis and skin involvement. Clinical examination revealed an extensive wound within the neck tumor at levels II and V on the right that was heavily infested with maggot larvae. Removal of larvae clusters was performed, and the isolated larvae were subsequently identified as L sericata. To the best of our knowledge, this is the first report of an infestation of L sericata myiasis in a metastasis to the neck lymph nodes.

A case of solitary fibrous tumor arising from the palatine tonsil

March 2, 2015     Takeharu Kanazawa, MD, PhD; Kozue Kodama, MD; Mitsuhiro Nokubi, MD, PhD; Kazuo Gotsu, MD; Akihiro Shinnabe, MD; Masayo Hasegawa, MD; Gen Kusaka, MD, PhD; Yukiko Iino, MD, PhD
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Abstract

Solitary fibrous tumor (SFT) is a distinctive, relatively uncommon soft-tissue neoplasm that usually arises from the pleura. It occurs at various sites; head and neck lesions are very rare. While most of these tumors have a benign course, a small number have malignant potential. We describe a rare case of SFT arising from the left palatine tonsil in a 66-year-old Japanese woman. The mass was completely resected. Immunohistochemical studies were strongly positive for CD34 and bcl-2, mildly positive for phosphorylated protein kinase B and phosphorylated extracellular signal-regulated kinase 1/2, and negative for platelet-derived growth factor receptor alpha and p53. These findings suggested that this tumor was benign. The patient showed no evidence of recurrence during 2 years of follow-up. We believe that the candidate prognostic marker should be checked to distinguish malignant from benign SFTs.

Glottic myxoma presenting as chronic dysphonia: A case report and review of the literature

January 19, 2015     Christopher G. Tang, MD; Daniel L. Monin, MD; Balaram Puligandla, MD; Raul M. Cruz, MD
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Abstract

Myxomas of the vocal fold are rare benign tumors often presenting with chronic dysphonia and less frequently with airway obstruction. The current consensus is that all laryngeal myxomas should be totally excised with clear margins to prevent recurrences. The recommendation for complete excision, however, has to be balanced with consideration of preserving vocal fold phonatory and sphincteric function. We report a case of vocal fold myxoma recurring twice after subtotal excision via two surgical approaches. This case illustrates a benign lesion with potential for recurrence and the need for a balanced treatment approach.

A case of myoepithelioma mimicking a parotid cyst

January 19, 2015     Haldun Onuralp Kamburoglu, MD, FEBOPRAS; Aycan U. Kayikcioglu, MD; Cigdem Himmetoglu, MD
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Abstract

Myoepithelioma is an uncommon tumor of the myoepithelial cells that is considered to represent a distinct category of tumor by the World Health Organization. It accounts for less than 1% of all tumors that develop in the salivary glands. We describe the case of a 35-year-old woman who presented to us with a painless swelling on the right side of her face. She was diagnosed with a parotid gland cyst by ultrasonography and computed tomography. Following excision of the mass, however, the pathology report identified the tumor as a solid myoepithelioma. To the best of our knowledge, this is the first reported case of a myoepithelioma that exhibited cystic features on radiologic examination even though it had a solid architecture. We also discuss the preoperative diagnostic aspects of the myoepitheliomas.

Laryngeal inflammatory myofibroblastic tumor

December 19, 2014     Fábio M. Girardi, MD, MSc; Ciro W. Fontana, MD; Ricardo G. Kroef, MD; Marinez B. Barra, MD; Felipe O. Detanico, MD; Nilton T. Herter, MD
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Inflammatory myofibroblastic tumor seldom involves the larynx, as only about 50 to 60 cases have been described in the literature. Even though these tumors are often not aggressive, they have the potential for invasion and local recurrence. We describe the case of a 27-year-old man who was admitted to an emergency department with signs of upper airway obstruction secondary to an obstructive mass. Histology identified the mass as an inflammatory myofibroblastic tumor of the subglottis. The patient underwent an emergency tracheotomy followed by a partial laryngectomy. During 14 months of follow-up, he remained free of active disease.

Giant-cell tumor of the tendon sheath in the external auditory canal

October 17, 2014     Margherita Trani, MD; Massimo Zanni, MD; Paolo Gambelli, MD
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Abstract

Giant-cell tumor of the tendon sheath (GCTTS) and pigmented villonodular synovitis belong to the same type of benign proliferative lesions originating in the synovia that usually affect the joints, bursae, and tendon sheaths. They frequently involve the hands, knees, ankles, and feet. We report a case of GCTTS in the external auditory canal in a 53-year-old woman who presented with hearing loss, fullness, and a sessile lesion protruding from the anterior wall of her external ear canal. The 1.5-cm diameter mass was spherical, well encapsulated, firm, and covered with normal skin. The lesion was completely excised, and the patient's symptoms resolved. No recurrence was detected at 2 years of follow-up.

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