Skip to content Skip to navigation

Synchronous bilateral tonsillar squamous cell carcinoma related to human papillomavirus: Two case reports and a brief review of the literature

April 30, 2016  |  Allison Rasband-Lindquist, MD; Yelizaveta Shnayder, MD; Maura O'Neil, MD


Human papillomavirus (HPV) was recently identified as a risk factor for oropharyngeal squamous cell carcinoma (SCC) independent of tobacco and alcohol use. The prognosis of patients with HPV-related oropharyngeal carcinomas is better than that for patients with non-HPV-related cancers. Researchers and clinicians can test for HPV infection in cancer by (1) testing directly for HPV DNA and (2) testing for overexpression of the downstream p16 protein; there is currently no consensus regarding which is the better test. The chances of developing a reliable oropharyngeal HPV screening test for high-risk populations are promising. Such a test would allow for secondary prevention by identifying individuals with precursor or early-stage cancerous lesions that are more amenable to treatment. HPV testing has particular significance in SCC of an unknown primary site in head and neck cancer. Successful HPV testing of nodal metastasis can localize cancer specifically to the oropharynx. The optimal evaluation for SCC of an unknown primary in the head and neck has yet to be determined. Some studies have shown that the tonsillar fossa is the most probable primary site, followed closely by the base of the tongue. Biopsies often miss tonsillar carcinoma in the deep crypts of the lymph tissue, as well as in those rare cases in which the primary tumor is located contralateral to the metastatic lymph node. Recently, there has been an increase in the number of reports of diagnosed synchronous bilateral HPV-related tonsillar carcinomas. This increase has profound implications for the surgical approach of SCC of an unknown primary site in the head and neck and in tonsillar carcinoma, and it supports the need for bilateral tonsillectomy. We present 2 cases of incidentally discovered synchronous bilateral tonsillar carcinoma, and we review the literature.

Intramuscular hemangiomas of the head and neck: Three case reports

April 30, 2016  |  Omer Aydin, MD; Gurkan Keskin, MD; Mete Iseri, MD; Arif Ulubil, MD; Fatma Demir Kuru, MD; Abdulkadir Oran, MD; Serhan Derin, MD


Hemangiomas are tumors of vascular origin that frequently occur on the skin and mucosal surfaces in the pediatric age group. Hemangiomas located in skeletal muscles are called intramuscular hemangiomas. Intramuscular hemangiomas mostly occur in the extremities and the trunk. In this article, 3 cases of surgically treated intramuscular hemangiomas that could not be diagnosed by routine preoperative investigations are presented in light of recent literature.

Ear and temporal bone meningioma

April 30, 2016  |  Lester D. Thompson, MD

Because of anatomic restrictions, most tumors are smaller than 1.5 cm, removed in multiple, gritty tissue fragments.

A large vestibular schwannoma after recent negative MRI: A case report

April 30, 2016  |  Thomas J. Muelleman, MD; James Lin, MD


Vestibular schwannomas are, on average, slowly growing tumors that may remain quiescent for some time before manifesting themselves symptomatically or being found incidentally on imaging. We describe a case of a vestibular schwannoma that grew rapidly and to a large size in a patient who had undergone negative imaging 5 years earlier for unrelated issues. This case highlights the importance of repeat imaging in patients with symptoms concerning for vestibular schwannoma who might have previously undergone negative scans.

Metastatic pilomatrix carcinoma: Not so rare after all? A case report and review of the literature

March 16, 2016  |  Daniel M. Walker, MBBS; Samuel Dowthwaite, MBBS, FRACS; Drew Cronin, MBBS; Tristan Molden-Hauer, MBBS; Brent McMonagle, MBBS, FRACS


Pilomatrixoma is a slowly growing benign tumor of the dermal hair cells. Metastatic disease is exceptionally rare. Pilomatrixoma can occur at any age, but most patients are older than 40 years at presentation. Approximately 60% of these lesions occur in the head and neck region. Their size is usually about 4 cm at the time of presentation. Surgical excision with adequate margins is still the preferred treatment. We report a case of an aggressive malignant metastatic pilomatrixoma in a 43-year-old woman who underwent multiple extensive local resections. However, she died within 4 months of presentation.

Papillary carcinoma in thyroglossal duct cyst: Two case reports and review of the literature

March 16, 2016  |  Neil S. Patel, MD; Kianoush Sheykholeslami, MD, PhD


The thyroglossal duct cyst is one of the more common congenital anterior neck masses. In rare cases, carcinoma has been detected within one of these cysts on histopathologic analysis of resected tissue. Since the incidence of thyroglossal duct cyst carcinoma is low, the appropriate management of the thyroid gland proper is not algorithmic. We present 2 cases of papillary thyroid carcinoma that were discovered in a thyroglossal duct cyst, and we describe the diagnostic and therapeutic measures taken in each case. Particular attention is paid to two points: (1) fine-needle aspiration biopsy may not be sufficient to rule out carcinoma and (2) removal of the thyroid gland may be advisable in selected situations.

Endolymphatic sac tumor in association with von Hippel-Lindau syndrome

March 16, 2016  |  Kevin Shaigany, BS; Alejandro Vazquez, MD; Kelvin M. Kwong, MD; James K. Liu, MD; Robert W. Jyung, MD

Patients with ELST present most commonly with sensorineural hearing loss, tinnitus, and vertigo, in a pattern reminiscent of Ménière disease.

Bilateral intubation granulomas

March 16, 2016  |  Wen-Sen Lai, MD; Yuan-Yung Lin, MD; Yueng-Hsiang Chu, MD, PhD; Jih-Chin Lee, MD

Granulomas typically appear as pale, pedunculated masses, usually found on the posterior one-third of the vocal folds overlying the vocal process of the arytenoid cartilage.


March 16, 2016  |  Lester D. Thompson, MD

Surgical treatment is the mainstay of therapy for rhinosporidiosis, but there is a 10% recurrence rate.

Ectopic thyroid tissue simulating metastasis

March 16, 2016  |  Juan S. Gomez, MD; Enrique Palacios, MD, FACR; Jeremy Nguyen, MD; Harold R. Neitzschman, MD, FACR