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Parapharyngeal space neuroglial heterotopia with tumoral differentiation
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Abstracts / International Journal of Pediatric Otorhinolaryngology 74 (2010) 107–110
inflammation, erythema, and external drainage. In this patient population respiratory symptoms are frequently part of the initial presentation, and respiratory failure due to cyst mass effect is often fatal in newborns. The case presented here is unusual in terms of age at presentation (4 days), type of infecting bacteria (GBS), rapid cyst enlargement, and prominent respiratory symptoms (previously unreported in cysts inferior to hyoid bone). Although rare, TGDCs should be included in the differential diagnosis of congenital neck masses or unexplained respiratory compromise in neonates, especially when the presentation includes positional, intermittent, or progressively worsening obstructive respiratory symptoms. As this case illustrates, infection of these cysts is common but does not always manifest with visible neck inflammation and swelling. With rapid diagnosis the potentially fatal complications of TGDCs can be avoided in neonatal patients. doi:10.1016/j.ijporl.2009.11.022
Rapidly progressing palatal pleomorphic adenoma in an adolescent Sami P. Moubayed, Fahad AlSaab, Sam J. Daniel * Department of Otolaryngology, Head and Neck Surgery, Montreal Children’s Hospital, McGill University, Montreal, QC, Canada
Minor salivary gland neoplasms are rare in children. Only 5% of pleomorphic adenomas of the minor salivary glands have been reported in patients under 20 years of age. We report a case of a 13year-old female who presented with a rapidly growing hard palatal mass, confirmed to be a myoepithelial cell-rich pleomorphic adenoma with cytological atypia. Pleomorphic adenomas should be included in the differential diagnosis of rapidly growing palatal masses in children and adolescents. Surgical excision is curative, and long-term follow-up is indicated as recurrence is frequent.
Parapharyngeal space neuroglial heterotopia with tumoral differentiation Joseph Y. Chan a,*, Chris K.C. Lai b, Victor J. Abdullah a, Micheal C.F. Tong c, C.A. vanHasselt c a Department of Ear, Nose and Throat, United Christian Hospital, Hong Kong, China b Department of Anatomical Cellular Pathology, Prince of Wales Hospital, Hong Kong, China c Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, China
Introduction: Neuroglial heterotopia is a rare condition in which mature neuroglial tissue is found in the body other than in the central nervous system. Nasal glioma is neuroglial heterotopia in the nasal cavity. We report an extremely rare case of heterotopic neuroglial tissue in the temporal bone with tumoral transformation. Case report: Our patient was a 1-year-old Chinese girl. She was born with a left facial swelling. CT and MRI revealed a heterogeneous mass with cystic component occupying the parapharyngeal space. The upper airway was significantly compromised by the mass which extended into the middle cranial fossa. A combined approach to its resection was undertaken by ENT and neurosurgeons which was uneventful with all cranial nerves in its vicinity preserved. Intraoperative findings confirmed the absence of direct communication between the mass and the brain. Pathological examination confirmed mature neural tissue with tumoral differentiation. Conclusion: Heterotopic neuroglial tissue is a rare condition in the temporal bone. Ganglioglioma formation within the heterotopic neuroglial tissue is an even rarer condition. Careful preoperative investigations and planning is the key to successful and complete excision of the abnormal tissue whilst preserving normal function. doi:10.1016/j.ijporl.2009.11.025
doi:10.1016/j.ijporl.2009.11.023
Congenital esophageal duplication cyst: A rare cause of infantile stridor and a diagnostic challenge Lemierre’s syndrome after modified radical mastoidectomy: An unusual variant caused by Citrobacter freneli Prakash Adhikari *, Rajendra P. Guragain, Chop Lal Bhusal, Rabindra B. Pradhananga Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Lemierre’s syndrome is characterised by an oropharyngeal infection leading to secondary septic thrombophlebitis of the internal jugular vein. Most of the cases are caused by Fusobacterium necrophorum. Here, we report an unusual variant of Lemierre’s syndrome developed after modified radical mastoidectomy. There was right sigmoid sinus and right internal jugular vein thrombosis along with multiple abscess foci seen in bilateral lung with right pyopneumothorax. The organism isolated from chest foci was Citrobacter freneli. We also briefly review the literature of Lemierre’s syndrome. doi:10.1016/j.ijporl.2009.11.024
V. Kumar a,*, A.P. Singh a, R. Meher a, A. Raj a, S.K. Aggarwal b a Department of Otolaryngology and Head, Neck surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India b Department of Pediatric Surgery, Maulana, Azad Medical College and Lok Nayak Hospital, New Delhi, India
Duplication cyst of the cervical esophagus represents a rare congenital anomaly. The children with esophageal duplication cyst usually present with respiratory distress or as asymptomatic thoracic mass found on incidental chest X-ray. We here present a case of a 3-month-old male infant who presented with noisy breathing and progressive respiratory distress and with no other abnormality. After laryngoscopy, barium esophagography and MRI study, congenital esophageal duplication cyst was diagnosed. Transcervical excision of the cyst was done using a harmonic scalpel. Histopathological examination of the specimen confirmed the diagnosis. The patient remains asymptomatic after one year of follow up.
doi:10.1016/j.ijporl.2009.11.026
Abstracts / International Journal of Pediatric Otorhinolaryngology 74 (2010) 107–110
inflammation, erythema, and external drainage. In this patient population respiratory symptoms are frequently part of the initial presentation, and respiratory failure due to cyst mass effect is often fatal in newborns. The case presented here is unusual in terms of age at presentation (4 days), type of infecting bacteria (GBS), rapid cyst enlargement, and prominent respiratory symptoms (previously unreported in cysts inferior to hyoid bone). Although rare, TGDCs should be included in the differential diagnosis of congenital neck masses or unexplained respiratory compromise in neonates, especially when the presentation includes positional, intermittent, or progressively worsening obstructive respiratory symptoms. As this case illustrates, infection of these cysts is common but does not always manifest with visible neck inflammation and swelling. With rapid diagnosis the potentially fatal complications of TGDCs can be avoided in neonatal patients. doi:10.1016/j.ijporl.2009.11.022
Rapidly progressing palatal pleomorphic adenoma in an adolescent Sami P. Moubayed, Fahad AlSaab, Sam J. Daniel * Department of Otolaryngology, Head and Neck Surgery, Montreal Children’s Hospital, McGill University, Montreal, QC, Canada
Minor salivary gland neoplasms are rare in children. Only 5% of pleomorphic adenomas of the minor salivary glands have been reported in patients under 20 years of age. We report a case of a 13year-old female who presented with a rapidly growing hard palatal mass, confirmed to be a myoepithelial cell-rich pleomorphic adenoma with cytological atypia. Pleomorphic adenomas should be included in the differential diagnosis of rapidly growing palatal masses in children and adolescents. Surgical excision is curative, and long-term follow-up is indicated as recurrence is frequent.
Parapharyngeal space neuroglial heterotopia with tumoral differentiation Joseph Y. Chan a,*, Chris K.C. Lai b, Victor J. Abdullah a, Micheal C.F. Tong c, C.A. vanHasselt c a Department of Ear, Nose and Throat, United Christian Hospital, Hong Kong, China b Department of Anatomical Cellular Pathology, Prince of Wales Hospital, Hong Kong, China c Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Hong Kong, China
Introduction: Neuroglial heterotopia is a rare condition in which mature neuroglial tissue is found in the body other than in the central nervous system. Nasal glioma is neuroglial heterotopia in the nasal cavity. We report an extremely rare case of heterotopic neuroglial tissue in the temporal bone with tumoral transformation. Case report: Our patient was a 1-year-old Chinese girl. She was born with a left facial swelling. CT and MRI revealed a heterogeneous mass with cystic component occupying the parapharyngeal space. The upper airway was significantly compromised by the mass which extended into the middle cranial fossa. A combined approach to its resection was undertaken by ENT and neurosurgeons which was uneventful with all cranial nerves in its vicinity preserved. Intraoperative findings confirmed the absence of direct communication between the mass and the brain. Pathological examination confirmed mature neural tissue with tumoral differentiation. Conclusion: Heterotopic neuroglial tissue is a rare condition in the temporal bone. Ganglioglioma formation within the heterotopic neuroglial tissue is an even rarer condition. Careful preoperative investigations and planning is the key to successful and complete excision of the abnormal tissue whilst preserving normal function. doi:10.1016/j.ijporl.2009.11.025
doi:10.1016/j.ijporl.2009.11.023
Congenital esophageal duplication cyst: A rare cause of infantile stridor and a diagnostic challenge Lemierre’s syndrome after modified radical mastoidectomy: An unusual variant caused by Citrobacter freneli Prakash Adhikari *, Rajendra P. Guragain, Chop Lal Bhusal, Rabindra B. Pradhananga Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Maharajgunj, Kathmandu, Nepal
Lemierre’s syndrome is characterised by an oropharyngeal infection leading to secondary septic thrombophlebitis of the internal jugular vein. Most of the cases are caused by Fusobacterium necrophorum. Here, we report an unusual variant of Lemierre’s syndrome developed after modified radical mastoidectomy. There was right sigmoid sinus and right internal jugular vein thrombosis along with multiple abscess foci seen in bilateral lung with right pyopneumothorax. The organism isolated from chest foci was Citrobacter freneli. We also briefly review the literature of Lemierre’s syndrome. doi:10.1016/j.ijporl.2009.11.024
V. Kumar a,*, A.P. Singh a, R. Meher a, A. Raj a, S.K. Aggarwal b a Department of Otolaryngology and Head, Neck surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India b Department of Pediatric Surgery, Maulana, Azad Medical College and Lok Nayak Hospital, New Delhi, India
Duplication cyst of the cervical esophagus represents a rare congenital anomaly. The children with esophageal duplication cyst usually present with respiratory distress or as asymptomatic thoracic mass found on incidental chest X-ray. We here present a case of a 3-month-old male infant who presented with noisy breathing and progressive respiratory distress and with no other abnormality. After laryngoscopy, barium esophagography and MRI study, congenital esophageal duplication cyst was diagnosed. Transcervical excision of the cyst was done using a harmonic scalpel. Histopathological examination of the specimen confirmed the diagnosis. The patient remains asymptomatic after one year of follow up.
doi:10.1016/j.ijporl.2009.11.026