Kimura’s disease presenting as bilateral parotid masses

Kimuras disease, a unique angiolymphoid proliferative disorder with unknown cause, is apparently more prevalent in a young Oriental males, but also occurs rarely in Western people. It has occasionally been misdiagnosed as malignant tumor or other serious diseases, leading to unnecessary radical surgery. Hence, clinicians should be made aware of this disease. The most common presentation is a unilateral soft-tissue mass in the head and neck region. Kimuras disease of bilateral parotid involvement has been reported rarely. We encountered a rare case of Kimuras disease presenting as bilateral parotid region masses and treated it successfully with surgery.     

Zenker’s diverticulum — a case report

A Zenker’s diverticulum is a blind pouch that branches off the cervical esophagus. Affected individuals may suffer from long-standing swallowing difficulties, regurgitation, bad breath, weight loss, and even aspiration.. Here we report a 80-years-old male presenting with dysphagia and regurgitation. Barium swallow reported the presence of a Zenker’s diveticulum. In view of the patient’s age, endoscopic diathermy was considered as a therapeutic option for the management.     

Giant cell tumor of the temporal bone – a case report

Background

We aimed to find some new indicators for tonsillectomy (TE) in adults with recurrent tonsillitis (RT) by exploring whether the frequency of tonsillitis episodes and the length of morbidity period are associated with the macroscopic signs of sclerotic process in tonsils and microbiological data assessed by culture, molecular (PCR) and transmission electron microscopy (EM) methods.

Methods

The study involved 62 RT patients admitted for TE (age range 15–35, median 22 years) and 54 healthy volunteers (age range 18–24, median 20 years). The index of tonsillitis (IT) was calculated by multiplying the number of tonsillitis episodes per year by the morbidity period in years. On oropharyngeal examination the presence or absence of three sclerotic signs was evaluated: tonsillar sclerosis, obstruction of tonsillar crypts and scar tissue on the tonsils. The occurrence of Streptococcus pyogenes was assessed by culture and PCR methods in 24 tonsillar core specimens. The samples for EM investigation of crypt epithelium were taken from 10 removed tonsils.

Results

The IT values were in positive correlation with the number of sclerotic signs on oropharyngeal examination (r = 0.325, P = 0.010). Based on the IT values and the presence or absence of tonsillar sclerosis and obstruction of tonsillar crypts the receiver-operating curve (ROC) was constructed. It revealed that an IT score of 36 is an optimal cut-off value for prediction of sclerotic type tonsils. S. pyogenes was never found by culture, but its presence by PCR in nearly one third (29%) of diseased tonsillar tissue specimens was tightly associated with longer morbidity. EM revealed coccoid forms of intracellular bacteria in the crypt epithelium, which was accompanied with the damage of tight junctions between epithelial cells.

Conclusion

The index of tonsillitis ≥36, being a combination between the frequency of tonsillitis and the length of morbidity period, predicts the sclerotic process in recurrently inflamed tonsils. Therefore, the high IT values could serve as an indicator for TE in adults. The correlation between the longer morbidity period and the presence of S. pyogenes by PCR suggests that persistent infection may have a role in maintenance of recurrent inflammation in tonsils.     

Fronto-ethmoidal mucormycosis — a case report

A fifty year-old female patient suffering from Mucormycosis of fronto-ethmoidal region wot successfully treated by surgical debridement and oral antifungal therapy.     

Familial antrochoanal polyposis—a case report

Antrochoanal polyps are rare lesions. Since Killians first report in 1906, several pathogenic mechanisms have been described. However, the aetiological factors are still not fully understood. In this paper we present the first report of antrochoanal polyps occurring in siblings, suggesting a possible familial aetiology.     

Tonsillar lymphangiomatous polyp — a case report

Tumors which are benign in origin in palatine tonsils are not uncommon. They may create anxiety in patients and pose difficulty in differentiating from malignancy. We report a case of tonsillar polyp of lymphangiomatous origin.     

Primary isolated nonhogkin’s loymphoma of the tonsil -a case report

Malignant lymphoma (Non-hodgkin’s lymphoma) is a primary malignant tumor of lymphoid tissue composed of lymphocytic or reticulocytic derivatives of varying degree of differentiation. The tumor frequently occurs in the extranodal sites including the gastrointestinal tract and the Waldeyer’s ring. Amongst the non-Hodgkin’s Lymphomas, the small cell type is the relatively uncommon lymphoma (4%) whereas others include follicular type (40%) and the high grade type (40–65%). This case report is of a case of primary isolated non-Hodgkin’s lymphoma of the tonsil of small cell type.     

Rhinosporidiosis on HIV — a case report

Rhinosporidiosis is a chronic disease that classically presents with the involvement of nose and nasopharynx. However, it can be present in various other sites including conjunctiva, vulva, vagina, larynx and scalp. We report a case with a Rhinosporidial mass in the nose extending to oropharynx and multiple cutaneous lesions of Rhinosporidiosis in a patient with HIV, This case is the first of its kind where HIV has been associated with Rhinosporidiosis.     

Basal cell adenoma of the parotid gland: a clinicopathological study of nine cases—basal cell adenoma versus pleomorphic adenoma and Warthin’s tumor

The aim of this study is to investigate the clinical and pathological characteristics of basal cell adenoma (BCA) and to compare the diagnosis/treatment of BCA with those of Warthin’s tumor (WT) and pleomorphic adenoma (PA). Among 192 patients with benign tumors of the parotid gland who underwent surgery, 9 had BCA. All of these tumors showed a benign pattern on computed tomography and magnetic resonance imaging. The accuracy of fine needle aspiration biopsy (FNAB) for diagnosis of BCA was slightly lower than for PA and WT. Most PA and BCA lesions developed in the upper part of the parotid gland. Considering the gender difference, tumor site, and age, it is necessary to differentiate BCA from PA rather than from WT. There were no significant differences in the duration of surgery, the blood loss, and the incidence of transient facial paralysis between surgical resection of BCA and surgery for PA or WT. BCA is the third most common of the benign parotid tumors, following WT and PA, although its incidence is low. When PA and WT are ruled out by FNAB after a tentative diagnosis of benign tumor has been based on imaging findings, BCA should be considered.     

Basaloid squamous carcinoma of the nasal cavity — a case report

Basaloid squamous carcinoma is a rare variant of squamous carcinoma and is known for its aggressive behavior. Its presentation in the nasal cavity is uncommon . A case of this tumor arising from the nostril and showing good response to concomitant radiotherapy and cisplatinum is presented.     

Castleman’s disease (giant lymph node hyperplasia) of the neck: a case report

Castleman’s disease (giant lymph node hyperplasia) is an uncommon cause of neck mass. Its cause and pathogenesis are still unknown. Giant lymph node hyperplasia (GLH) usually presents as an asymptomatic solitary mass and can occur anywhere in the head and neck. Diagnostic test results are always inconclusive. Excision and histopathological evaluation are the only ways to make a definitive diagnosis. The disease is curable by surgical excision. A case of GLH presenting as a solitary neck mass in a 68-year-old man is reported. There has been no recurrence during about 7 months. Received: 25 May 1999 / Accepted: 7 September 2000     

Quincke’s oedema of the uvula associated with mucous retention cyst-a case report

We report a rare case of recurrent angioedema of uvula (Quincke’s Oedema), causing air way obstruction. A brief review of literature and treatment options are alto included. The histoloigical specimen showed an associated mucous retention eyst, which in conjunction with Quinckc’s oedema has not been previously reported.     

Heusinger–s syndrome-a case report

Heusinger’s syndrome or Branchio-oto-renal dysplasia is a rare congenital anomaly. One such case with external ear anomalies, branchial fistula and renal abnormality is presented. The patient underwent successful excision of the branchial fistula. The case is discussed with review of relevant literature.     

An unusual tracheal foreign body — a case report

Foreign bodies in the laryngopharynx can occur without discrimination of age or sex. Their occurrence is influenced by mode of living, customs, habits and environment. T.M. Paramciwaran(1977) reported 56 cases of foreign bodies of tracheobronchial tree in the span of 5 years. A.S.A. Abdel-Salam and Alan G. Gibb (1980) mentioned that the vast majority of cases occur in young children. They have reported that undiagnosed foreign bodies cause mechanical effects, chemical reactions and may present as chronic pulmonary infection, allergic asthma, bronchiectasis, lung collapse or lung abscess. They present as emergencies and require skilful management.     

Identification of early-stage Meniere’s disease as a cause of unilateral tinnitus

Introduction:Meniere’s disease(MD)is characterized by episodic symptoms,including vertigo,hearing loss,and tinnitus.Objectives:in this study,cases of unilateral tinnitus were investigated for MD.Method:Twenty-two patients who presented with chronic unilateral tinnitus on puretone audiograms showing an average threshold better than 25 dB HL and thresholds in the lower frequencies worse than those in the higher frequencies by more than 10 dB were suspected to have early-stage MD and underwent electrocochleography(ECochG).Patients showing ECochG findings conclusive for MD were compared to a control group of patients presenting with chronic unilateral tinnitus on pure-tone audiograms showing an average threshold better than 25 dB and thresholds in the higher frequencies worse than those in the lower frequencies by more than 10 dB.Results:Eighteen of the 22 patients included in this study showed elevated summating potential amplitude to action potential amplitude ratios in ECochG(suggestive of endolymphatic hydrops due to MD)and were followed up for 2 months;14 of them experienced at least two attacks of vertigo or unsteadiness.In contrast,only one patient in the control group reported two or more attacks of vertigo or unsteadiness in the 2 month observation period.The incidence of this finding in the two groups was significantly different.Conclusion:Patients with early-stage MD can present with only unilateral tinnitus.Thus,the addition of“pure-tone audiograms showing lower-frequency thresholds worse than higher-frequency thresholds”to the probable MD category in the globally.     

Dual ectopic thyroid mimicking as a thyroglossal cyst – A case report and review of literature

Ectopic thyroids are very rare condition. However, they can be confused with more common conditions like colloid cyst or thyroglossal cysts. We present the case of a 15-year-old Indian female who was clinically diagnosed with thyroglossal cyst and was posted for surgery. However, on further investigation, the condition was found out to be a dual ectopic thyroid following computed tomography and was confirmed by Tc-99m thyroid scan. The patient was put on follow up and no surgical intervention was performed. Hence midline swellings of neck should be thoroughly examined before performing surgery, keeping the possibility of ectopic thyroids in view.     

Synchronous bilateral epithelial–myoepithelial carcinoma of the parotid gland: case report and review of the literature

Synchronous bilateral malignancy in the parotid glands is extremely rare. The English literature reveals nine case reports. The most common synchronous bilateral malignancies are acinic cell carcinoma. Epithelial–myoepithelial carcinoma is an uncommon neoplasm comprising 1% of all salivary gland tumours. In this case report, we describe, to our best of knowledge, the first case of a patient with a synchronous bilateral epithelial–myoepithelial carcinoma of the parotid gland. The clinical histopathological and immunohistochemical peculiarities are elucidated. Imaging studies like ultrasonography are mandatory for both parotid glands and upper necks in the clinical presence of a unilateral parotid gland tumour.