Case Reports in Otolaryngology The latest articles from Hindawi Publishing Corporation © 2014 , Hindawi Publishing Corporation . All rights reserved. Multiple Congenital Epulis in Alveolar Ridges of Maxilla and Mandible in a Newborn: A Rare Case Report Tue, 08 Apr 2014 00:00:00 +0000 Congenital granular cell lesion (CGCL) or congenital epulis is an uncommon benign of the oral cavity tumor appearing at birth with typical clinical and pathologic features. It predominately affects females, mainly on the anterior maxillary alveolar ridge, and occurs usually as a single mass, although sometimes as multiple. The left side incisor area is the most common site. The etiology and histogenesis of the lesion remain obscure. Though it is a benign lesion, the tumor may cause feeding and respiratory problems if there are too large or multiple tumors. We report a case of a three-day-old, female newborn, who was referred to our hospital with multiple congenital oral swellings arising from the maxilla and mandible. The tumors caused a feeding problem and, hence, they were resected by surgical excision under general anesthesia. Nader Saki and Somayeh Araghi Copyright © 2014 Nader Saki and Somayeh Araghi. All rights reserved. Primary Pleomorphic Adenoma of the External Auditory Canal: A Case Report and Review of the Literature Mon, 07 Apr 2014 06:33:56 +0000 Background. Pleomorphic adenoma (PA) is a benign tumour that mainly arises from salivary glands, and PA of the external auditory canal (EAC) is very rare. The objective of this study was to clarify the clinical presentation and treatment of PA of the EAC. Method. The authors present a case of PA arising from the EAC together with a literature review. Results. A 40-year-old man complained of hearing loss and foreign-body sensation of the right ear. Clinical and radiological examinations revealed a well-defined tumour limited to the EAC, with no connection to the parotid gland. Preoperative fine-needle aspiration cytology findings were characteristic of PA. The tumour was removed en bloc with the overlying skin. Conclusion. PA of the EAC is very rare, and methods to rule out malignancy before treatment are lacking. Thus, long-term follow-up is necessary, because malignant tumours are common in the EAC and PA has malignant potential. Chizu Saito, Takeharu Kanazawa, Takehiko Yamaguchi, Ken-ichi Nakamura, and Keiichi Ichimura Copyright © 2014 Chizu Saito et al. All rights reserved. Transoral Robotic Surgery: Step-by-Step Radical Tonsillectomy Sun, 06 Apr 2014 12:22:50 +0000 Introduction. Transoral robotic surgery (TORS) radical tonsillectomy is an emerging minimally invasive surgical procedure for the treatment of cancer of the tonsil. The detailed surgical technique and claims for its reproducibility have been previously published. Case Presentation. We present a patient with a T2N2bM0 epidermoid carcinoma of the tonsil to illustrate step by step the surgical procedure for TORS radical tonsillectomy. Neck dissection and TORS were staged. No surgical reconstruction of the defect was required. No tracheostomy was necessary. The patient could eat without any feeding tube and was on full oral diet on the fifth postoperative day. Discussion. The transoral approach offers the benefits of minimally invasive surgery to patients with cancer of the tonsil. The excellent exposure and high precision provided by robotic instrumentation allow the surgeon to closely follow and accomplish the surgical steps, which is the best warranty for safety and effectiveness. Jose Granell, Ivan Mendez-Benegassi, Teresa Millas, Laura Garrido, and Raimundo Gutierrez-Fonseca Copyright © 2014 Jose Granell et al. All rights reserved. Impending Carotid Blowout Stabilization Using an LT-D Tube Tue, 01 Apr 2014 09:14:59 +0000 Adequate stabilization of a patient presenting with a carotid blowout is one of the most challenging issues an on-call ENT surgeon can be confronted with. Reducing the bleeding and securing the airway are essential before more definitive management. We present the case of a 72-year-old patient with head and neck cancer who arrived at the emergency room with a carotid blowout and who was successfully stabilized using a King LT-D ventilation tube. G. Desuter, A. Gregoire, Q. Gardiner, and P. M. Francois Copyright © 2014 G. Desuter et al. All rights reserved. Multiple Cranial Nerve Palsies as the First Presentation of Sarcoidosis Wed, 26 Mar 2014 11:18:06 +0000 Sarcoidosis is a disease process which predominantly affects the lungs but can involve virtually any organ in the human body. Neurosarcoidosis is a rare manifestation which can present in a variety of ways. There is no single diagnostic test for sarcoidosis; hence, the diagnosis is based on combined clinical, laboratorial, and radiological grounds. We describe a rare case where a patient presented with dysphagia, hoarseness, hearing loss, and unsteadiness. Oliver Rose, Zahoor Ahmad, and Barry Snow Copyright © 2014 Oliver Rose et al. All rights reserved. Grisel’s Syndrome: A Rare Complication following Adenotonsillectomy Mon, 24 Mar 2014 09:37:53 +0000 Grisel’s syndrome is a nontraumatic atlantoaxial subluxation which is usually secondary of an infection or an inflammation at the head and neck region. It can be observed after surgery of head and neck region. Etiopathogenesis has not been clearly described yet, but increased looseness of paraspinal ligament is thought to be responsible. Patients typically present with painful torticollis. Diagnosis of Grisel’s syndrome is largely based on suspicion of the patient who has recently underwent surgery or history of infection in head and neck region. Physical examination and imaging techniques assist in diagnosis. Therefore, clinicians should be aware of acute nontraumatic torticollis after recently applied the head and neck surgery or undergone upper respiratory tract infection. In this paper, a case of an eight-year-old male patient who had Grisel’s syndrome after adenotonsillectomy is discussed with review of the literature. Abdulkadir Bucak, Sahin Ulu, Abdullah Aycicek, Emre Kacar, and Murat Cem Miman Copyright © 2014 Abdulkadir Bucak et al. All rights reserved. Malignant Peripheral Nerve Sheath Tumour of the Maxilla Tue, 18 Mar 2014 08:52:35 +0000 A 38-year-old man was diagnosed with malignant peripheral nerve sheath tumour of the maxilla. He was treated with total maxillectomy. Histopathological examination of the resected specimen revealed a close resection margin. The tumour was of high grade with an MIB-1 labelling index of almost 60%. At six weeks following the surgery, he developed local tumour relapse. The patient succumbed to the disease at five months from the time of diagnosis. The present report underlines the locally aggressive nature of malignant peripheral nerve sheath tumour of the maxilla which necessitates an early therapeutic intervention. A complete resection with clear margins is the most important prognostic factor for malignant peripheral nerve sheath tumour in the head and neck region. Adjuvant radiotherapy may be considered to improve the local control. Future research may demarcate the role of targeted therapy for patients with malignant peripheral nerve sheath tumour. Puja Sahai, Bidhu Kalyan Mohanti, Devajit Nath, Suman Bhasker, Subhash Chander, Sameer Bakhshi, and Chirom Amit Singh Copyright © 2014 Puja Sahai et al. All rights reserved. Chondroid Syringoma of the Medial Canthus Tue, 11 Mar 2014 12:34:04 +0000 Chondroid syringoma, or pleomorphic adenoma of the skin, is a rare, benign skin adnexal tumor. It is usually exhibited as a slowly growing intradermal or subcutaneous nodule, typically located in the head and neck region. Because of the unremarkable clinical symptomatology of this rare tumor, the diagnosis is exclusively made retrospectively based on histological confirmation of the surgically excised tumor. We present a rare case of a chondroid syringoma located in the left medial canthus of a 58-year-old man. The patient had no symptoms and decided to excise it for cosmetic reasons only. Local excision with a macroscopic wide cuff of normal tissue was done, without destroying the aesthetic and functional structures, since the defect was restored by a finger flap. One year postoperatively, the patient has remained disease-free. Chondroid syringoma usually appears in the face but the location in the medial canthus is not mentioned in the literature for the last twenty years. Konstantinos Paraskevopoulos, Angeliki Cheva, Giorgos Koloutsos, Ioannis Matzarakis, and Kostas Vahtsevanos Copyright © 2014 Konstantinos Paraskevopoulos et al. All rights reserved. Relapse of Non-Hodgkin’s Lymphoma Involving the Trachea: Acute Subglottic Obstruction Tue, 04 Mar 2014 08:45:08 +0000 Relapsing lymphoma involving the trachea causing tracheal obstruction is exceedingly uncommon. Despite its rarity, it should be considered in the differential diagnosis when a patient with known lymphoma presents with signs of airway obstruction such as stridor. We report an unusual case of relapsing non-Hodgkin’s lymphoma with tracheal involvement in a 57-year-old female and review the relevant literature. It is highly unusual for relapsing lymphoma to involve the trachea causing tracheal obstruction. Despite its rarity, it can present with life-threatening airway obstruction which may be rapidly progressive requiring immediate surgical intervention such as tracheostomy. Allen Y. Wang, Jeffrey T. Wang, Yi Shen, and Brett Levin Copyright © 2014 Allen Y. Wang et al. All rights reserved. Cervical Spine Osteomyelitis and Epidural Abscess after Chemoradiotherapy for Hypopharyngeal Carcinoma: A Case Report Tue, 04 Mar 2014 08:28:47 +0000 Osteomyelitis of mandible as a delayed adverse event following radiation therapy has been widely reported; however, osteomyelitis of the cervical spine has rarely been reported. In this study, we reported our experience with a case of cervical spine osteomyelitis and epidural abscess after concurrent chemoradiotherapy (CCRT) for hypopharyngeal carcinoma. The case involved a 68-year old man who underwent radical CCRT after a diagnosis of stage IVb, T4bN2cM0 posterior hypopharyngeal wall carcinoma. At 7 months after completing the initial therapy, the patient complained of severe pain in the neck and both shoulders and reduced muscular strength in the extremities. A large defect was found on the mucosa of posterior hypopharyngeal wall. On cervical magnetic resonance imaging, cervical spine osteomyelitis and an epidural abscess were observed. Because antimicrobial therapy was not effective, hyperbaric oxygen therapy was administered. Abscess reduction and improvement of the mucosal defect were observed. Because cervical spine complications after CCRT can be fatal upon worsening, adequate attention must be given. Yushi Ueki, Jun Watanabe, Shigehisa Hashimoto, and Sugata Takahashi Copyright © 2014 Yushi Ueki et al. All rights reserved. Giant Myoepithelioma of the Soft Palate Mon, 03 Mar 2014 13:36:01 +0000 Myoepitheliomas are benign salivary gland tumors and account for less than 1% of all salivary gland tumors. They are usually located in the parotid gland. The soft palate is very rare affected site. The differential diagnosis of myoepitheliomas should include reactive and neoplastic lesions. The treatment of myoepitheliomas is complete removal of the tumor. Herein, we report a case with giant myoepithelioma of the soft palate, reviewing the related literature. Murat Oktay, Huseyin Yaman, Abdullah Belada, Fahri Halit Besir, and Ender Guclu Copyright © 2014 Murat Oktay et al. All rights reserved. A Case of Nasal Glial Heterotopia in an Adult Thu, 20 Feb 2014 11:35:30 +0000 We report a rare case of nasal glial heterotopia in an adult. After the surgery, frontal lobe cerebral hemorrhage developed. A 58-year-old man had unilateral nasal obstruction that progressed for one year. He had been treated for hypertension, chronic heart failure, and cerebral infarction with aspirin and warfarin. A computed tomography scan showed that the tumor occupied the right nasal cavity and the sinuses with small defect in the cribriform plate. The tumor was removed totally with endoscopy. After the operation, the patient developed convulsions and frontal lobe cerebral hemorrhage. The hemorrhage site was located near a defect in the cribriform plate. Nasal glial heterotopia is a rare developmental abnormality, particularly rare in adult. Only few cases were reported. We could not find any report of adult nasal glial heterotopias that developed cerebral hemorrhage as a complication of the surgery. Akira Hagiwara, Noriko Nagai, Yasuo Ogawa, and Mamoru Suzuki Copyright © 2014 Akira Hagiwara et al. All rights reserved. Late Prevertebral and Spinal Abscess following Chemoradiation for Laryngeal Squamous Cell Carcinoma Wed, 19 Feb 2014 09:53:24 +0000 Objective. Advanced primary supraglottic tumors (i.e., T3 or T4) have traditionally been treated surgically and postoperative radiotherapy. In the last 2 decades, some patients were treated with chemoradiation avoiding surgery. Case Report. We describe a 55-year old female who presented with respiratory distress and paraplegia seven years after treatment for a T3N0M0 supraglottic squamous cell carcinoma. CT scan showed prevertebral and intraspinal air descending from C4 to D3 vertebras. Epidural and prevertebral abscesses were confirmed by neck exploration. Necrosis was observed in the retropharyngeal, prevertebral, and vertebral tissues. Conclusion. Prevertebral and spinal abscess may result from chemotherapy and radiotherapy to the head and neck. Physicians caring for head and neck cancer patients treated with chemotherapy and radiation should be aware of this rare severe complication. Jawad Hindy, Ilan Shelef, Yuval Slovik, and Ben-Zion Joshua Copyright © 2014 Jawad Hindy et al. All rights reserved. Long-Term Outcomes of Balloon Dilation for Acquired Subglottic Stenosis in Children Wed, 19 Feb 2014 07:52:51 +0000 Objectives. Balloon dilation laryngoplasty has been suggested as an alternative treatment to open surgical treatment of acquired subglottic stenosis in children. We describe long-term outcomes of balloon dilation for acquired subglottic stenosis in children. Methods. The medical charts of children who had balloon dilation for subglottic stenosis secondary to intubation were reviewed. Data included demographics, relevant history and physical examination, diagnostic workup, and management. Outcomes of balloon dilation were assessed based on improvement in preoperative symptoms, grading of stenosis, complications, and need for additional procedures. Results. Three children (2 male, 1 female, age range: 14 weeks–1 year) underwent balloon dilation for acquired subglottic stenosis. Patients presented with stridor and increased work of breathing. Duration of intubation ranged from 2 days to 3 weeks. Patients became symptomatic 5 days to 6 weeks after extubation. Grade of subglottic stenosis was II in 2 patients and III in one. Subglottic stenosis patients had 2-3 dilations within 2–10 weeks. All patients were asymptomatic during 14–21-month follow-up. Conclusions. Serial balloon dilation was safe and successful method to manage acquired subglottic stenosis in this group of children. No recurrence was noted in a follow-up more than a year after resolution of symptoms. Aliye Filiz and Seckin O. Ulualp Copyright © 2014 Aliye Filiz and Seckin O. Ulualp. All rights reserved. Primary Cervical Leiomyoma with Remarkable Calcification and Ossification Tue, 18 Feb 2014 13:28:23 +0000 We encountered a patient with primary cervical leiomyoma with remarkable calcification and ossification. A 68-year-old man presenting with induration and swelling of the left submandibular region was found to have nodular lesions with calcifications in the left submandibular region and the upper mediastinum on CT. Fine needle aspiration biopsies (FNAB) of the left submandibular lesion revealed no malignancy. Resection was performed for definitive diagnosis and treatment. The resected specimen contained a solid tumor, which was markedly calcified and ossified on the cut surface. Histopathological examination showed proliferating spindle cells in a tangled and crossed arrangement. Immunohistochemically, the spindle cells were stained intensely with -SMA and h-caldesmon, consistent with smooth muscle cells. These findings led to a definitive diagnosis of leiomyoma with calcification and ossification. This is extremely rare and the preoperative differentiation from other tumors of the head and neck was very difficult. By resection of the submandibular tumor, both definitive diagnosis of leiomyoma by histopathological and immunohistochemical analyses and treatment could be carried out. However, as the tumor in the upper mediastinum was most likely to be leiomyoma with calcification, he did not wish to undergo its biopsy and resection immediately. We have continued the follow-up. Takahiro Yamanishi, Kaname Sakamoto, Hiroyuki Watanabe, Takaaki Yonaga, Naoki Oishi, Ryohei Katoh, and Keisuke Masuyama Copyright © 2014 Takahiro Yamanishi et al. All rights reserved. Partial Laryngectomy with Cricoid Reconstruction: Thyroid Carcinoma Invading the Larynx Mon, 10 Feb 2014 16:11:58 +0000 Laryngotracheal invasion worsens the prognosis of thyroid cancer and the surgical approach for laryngotracheal invasion is controversial. In this paper, partial full-thickness excision of the cricoid cartilage with supracricoid laryngectomy and reconstruction of existing defect with thyroid cartilage are explained in a patient with papillary thyroid carcinoma invading the thyroid cartilage and cricoid cartilage without intraluminal invasion. Surgical indication should not be established by the site of involvement in thyroid carcinomas invading the larynx, as in primary cancers of the larynx. We think that partial laryngectomy according to the involvement site and the appropriate reconstruction techniques should be used for thyroid cancer invading the larynx. Kerem Ozturk, Serdar Akyildiz, and Ozer Makay Copyright © 2014 Kerem Ozturk et al. All rights reserved. Mumps, Cervical Zoster, and Facial Paralysis: Coincidence or Association? Thu, 06 Feb 2014 13:19:39 +0000 The association of mumps with peripheral facial paralysis has been suggested, but its pathogenesis remains unclear. An 8-year-old girl simultaneously developed left peripheral facial paralysis, ipsilateral cervical herpes zoster, and bilateral mumps sialadenitis. Elevated anti-mumps and anti-varicella zoster virus IgM antibodies in serological testing indicated recent infection of mumps and reactivation of VZV. Molecular studies have provided mounting evidence that the mumps virus dysregulates the host’s immune system and enables the virus to proliferate in the infected host cells. This dysregulation of the immune system by mumps virus may have occurred in our patient, enabling the latent VZV infection to reactivate. Kenji Kondo, Kaori Kanaya, Shintaro Baba, and Tatsuya Yamasoba Copyright © 2014 Kenji Kondo et al. All rights reserved. Subacute Histoplasmosis with Focal Involvement of the Epiglottis: Importance of Differential Diagnosis Wed, 05 Feb 2014 12:44:18 +0000 Histoplasmosis is an endemic mycosis of the Americas, Africa, and Asia. In Spain, it is the most common imported endemic mycosis appearing in the literature, and its incidence is on the rise. Proper differential diagnosis of the disease must be taken into consideration by otorhinolaryngologists, as the clinical manifestations of histoplasmosis may simulate more prevalent diseases such as cancer or tuberculosis. We present the case of a Spanish patient with focal involvement of the larynx and offer a review of the relevant literature. F. Ahumada, D. Pérez, M. de Górgolas, B. Álvarez, A. Ríos, A. Sánchez, and JM. Villacampa Copyright © 2014 F. Ahumada et al. All rights reserved. Fungal Malignant Otitis Externa with Facial Nerve Palsy: Tissue Biopsy Aids Diagnosis Wed, 05 Feb 2014 09:21:41 +0000 Fungal malignant otitis externa (FMOE) is a serious and potentially life-threatening condition that is challenging to manage. Diagnosis is often delayed due to the low sensitivity of aural swabs and many antifungal drugs have significant side effects. We present a case of FMOE, where formal tissue sampling revealed the diagnosis and the patient was successfully treated with voriconazole, in addition to an up to date review of the current literature. We would recommend tissue biopsy of the external auditory canal in all patients with suspected FMOE in addition to routine microbiology swabs. Jenny Walton and Chris Coulson Copyright © 2014 Jenny Walton and Chris Coulson. All rights reserved. Management of Tonsillar Lipoma: Is Tonsillectomy Essential? Tue, 04 Feb 2014 09:08:10 +0000 Tonsillar lipomas are rare benign tumors, with only a limited number of cases reported in the literature. Excision of the lipoma along with tonsillectomy has been proposed as the usual treatment option. We report a case of tonsillar lipoma which was managed by excision of the lesion without the need for a tonsillectomy. No recurrence was reported at a 2-year followup. A worldwide literature review was done to better define the clinical and histopathological features of these lesions. The authors propose that routine tonsillectomy is not required for these benign lesions and that simple excision of the stalk of the lipoma is sufficient. Sohit P. Kanotra and Joel Davies Copyright © 2014 Sohit P. Kanotra and Joel Davies. All rights reserved. Migration of a Swallowed Blunt Foreign Body to the Neck Thu, 30 Jan 2014 11:11:57 +0000 Ingestion of foreign bodies is a common problem in the otolaryngology practice. Reports of extraluminal migration of the foreign bodies from the upper aerodigestive tract are rare. Penetration and extraluminal migration of ingested foreign bodies may cause severe vascular and suppurative complications, even death. We report a 4-year-old girl who presented with a mass and partial extrusion of a foreign body in the neck. She had a history of ingesting the plastic top piece of a knitting needle approximately 1 year ago. She had been asymptomatic until the present time. The examination revealed a red, blunt, rectangular plastic foreign body half embedded in the skin of the right neck. Esophagography with barium swallow, cervical X-rays, and computed tomography scans were obtained. The foreign body was easily removed under general anesthesia. Primary closure and direct laryngoscopy was also performed. The patient recovered very well without any complications. Kerem Ozturk, Goksel Turhal, Sercan Gode, and Atilla Yavuzer Copyright © 2014 Kerem Ozturk et al. All rights reserved. Rapid Spontaneous Resolution of Fibromatosis Colli in a 3-Week-Old Girl Sun, 12 Jan 2014 00:00:00 +0000 Fibromatosis colli is an uncommon benign, congenital fibrous tumor or pseudotumor of the sternocleidomastoid muscle that manifests in infancy. In some of these patients tightening of the muscle results in torticollis. We report the case of a 3-week-old child, who presented with a neck mass localized in the left side with reduced mobility of the head. The diagnosis of fibromatosis colli was raised by ultrasound sonography. The mass regressed spontaneously within 3 months without surgical or physical treatment. Paolo Adamoli, Piero Pavone, Raffaele Falsaperla, Roberta Longo, Giovanna Vitaliti, Claudio Andaloro, Serra Agostino, and Salvatore Cocuzza Copyright © 2014 Paolo Adamoli et al. All rights reserved. Epithelial Cyst in the Posterior Triangle of the Neck: Atypical Branchial Cyst or Cystic Lymph Node Metastasis? Sun, 12 Jan 2014 00:00:00 +0000 We report the case of a 66-year-old man with a cervical neck mass located behind the left sternocleidomastoid muscle. To exclude malignancy, a full workup, including clinical, radiological, and cytological examination, was performed but failed to provide a definitive diagnosis. Histological analysis following excisional biopsy revealed a benign epithelial cyst, consistent with an atypically located branchial cyst. We describe an approach to the management of these neck masses and discuss several theories of the etiology of branchial cysts and how they may come to be abnormally located. Domenic Vital, Gerhard F. Huber, Thomas F. Pézier, Matthias Rössle, Rudolf Probst, and Gian-Marco Widmer Copyright © 2014 Domenic Vital et al. All rights reserved. Germinoma in the Internal Auditory Canal Mimicking a Vestibular Schwannoma Mon, 06 Jan 2014 17:14:38 +0000 The appearance of a primary germinoma in the central nervous system but not on or near the midline or within the brain is exceptional. It may occur at any age; however, it is rare in patients over 50 years old. Only a handful of cases of germinomas located in the cerebellopontine angle were presented, but to our knowledge, there has been no description of an isolated germinoma in the internal auditory canal. We report a case of germinoma in the internal auditory canal in a 51-year-old man simulating the clinical and radiological characteristics of a vestibular schwannoma. Rubén Martín-Hernández, Diego Hernando Macías-Rodríguez, Ángel Muñoz-Herrera, Juan Carlos Del Pozo-de Dios, Santiago Santa Cruz-Ruiz, and Ángel Batuecas-Caletrío Copyright © 2014 Rubén Martín-Hernández et al. All rights reserved. A Case of Heroin Induced Sensorineural Hearing Loss Mon, 06 Jan 2014 12:13:02 +0000 A case of a 31-year-old male who developed profound sensorineural hearing loss following a heroin overdose is presented. The patient subsequently had a full recovery of his hearing. Other cases of this rare phenomenon are reviewed and management options are discussed. Ricardo Mario Aulet, Daniel Flis, and Jonathan Sillman Copyright © 2014 Ricardo Mario Aulet et al. All rights reserved. Persistent Primitive Trigeminal Artery: An Unusual Cause of Vascular Tinnitus Sun, 29 Dec 2013 10:41:25 +0000 Pulsatile tinnitus is generally of vascular origin and can be due to arterial, venous, or systemic causes. While certain congenital anatomical variants and arterial vascular loops have been commonly found in symptomatic patients undergoing imaging, persistent primitive trigeminal artery in association with isolated tinnitus is unusual. Thus we report a patient with unilateral isolated pulsatile tinnitus who was evaluated with magnetic resonance angiography and was found to have a persistent primitive trigeminal artery. We also briefly discuss vascular tinnitus as well as the embryology, imaging, and classification of persistent primitive trigeminal artery with the clinical implications. Ananya Panda, Arundeep Arora, and Manisha Jana Copyright © 2013 Ananya Panda et al. All rights reserved. Partial Recovery of Audiological, Vestibular, and Radiological Findings following Spontaneous Intralabyrinthine Haemorrhage Tue, 24 Dec 2013 09:05:49 +0000 The diagnosis, work-up, and treatment of sudden sensorineural hearing loss and sudden vestibular loss vary widely between units. With the increasing access to both magnetic resonance imaging and objective vestibular testing, our understanding of the various aetiologies at hand is increasing. Despite this, the therapeutic options are limited and without a particularly strong evidence base. We present a rare, yet increasingly diagnosed, case of intralabyrinthine haemorrhage (ILH) together with radiological, audiological, and vestibular test results. Of note, this occurred spontaneously and has shown partial recovery in all the mentioned modalities. Thomas Pézier, Krisztina Baráth, and Stefan Hegemann Copyright © 2013 Thomas Pézier et al. All rights reserved. Cervical Thymic Cyst Mimicking Laryngocele Tue, 17 Dec 2013 19:10:57 +0000 Cervical thymic cysts are nearly 0.3% of all congenital cervical cysts. Thymic cysts are asymptomatic, but they rarely complain of dysphagia or tracheal obstruction symptoms. A soft, mobile, and painless mass increasing with valsalva maneuver directs the diagnosis of laryngocele. There has not been any study in the literature in which thymic cyst presenting like laryngocele. We hereby present a case of thymic cyst mimicking laryngocele that has not been reported so far. Kayhan Ozturk, Cagdas Elsurer, Serap Bulut, Mutlu Duran, and Serdar Ugras Copyright © 2013 Kayhan Ozturk et al. All rights reserved. Renal Clear Cell Carcinoma and Tonsil Metastasis Tue, 17 Dec 2013 11:28:54 +0000 Renal cell carcinoma is the most common renal tumor in adults. Clear cell carcinoma represents 85% of all histological subtypes. In February 2012 a 72-year-old woman came to our department due to the appearance of massive hemoptysis and pharyngodinia. Previously, this patient was diagnosed with a renal cell carcinoma treated with left nephrectomy. We observed an exophytic, grayish, and ulcerated mass in the left tonsillar lodge and decided to subject the patient to an immediate tonsillectomy. Postoperative histology showed nests of cells with highly hyperchromatic nuclei and clear cytoplasm. These features enabled us to make the diagnosis of renal clear cell carcinoma metastasis. Only few authors described metastasis of renal cell carcinoma in this specific site. Dario Marcotullio, Giannicola Iannella, Gian Franco Macri, Caterina Marinelli, Melissa Zelli, and Giuseppe Magliulo Copyright © 2013 Dario Marcotullio et al. All rights reserved. Delayed Diagnosis of Nasal Natural Killer/T-Cell Lymphoma Sun, 15 Dec 2013 14:50:22 +0000 Midline destructive lesions of the face have multiple possible etiologies. The majority of these cases are found to be due to an extranodal lymphoma of natural killer/T-cell-type non-Hodgkins lymphoma (NKTL). Unfortunately, diagnosis is often delayed. With variable presenting complaints, including nonspecific issues like chronic rhinosinusitis or nasal congestion, initial treatments are aimed at these presumed diagnoses. Only as the lesion progresses do overt signs of destruction occur. As with our patient, who was initially treated for presumed infection and abscess, final diagnosis often does not occur until several months, and several antibiotic courses, from initial presentation. As such, it is important for this rare entity to remain in the clinician’s differential diagnosis for nasal lesion. Jennifer A. Villwock, Kristin Jones, Jason Back, and Parul Goyal Copyright © 2013 Jennifer A. Villwock et al. All rights reserved.