Facial palsy caused by otitis media with effusion in a 9-year old child

We report the case of a 9 years old child diagnosed as right otitis media with effusion associated to homolateral and peripherical facial palsy, fact very uncommon in the reviewed literature. The patient was treated by miringotomy and insertion of transtympanic drainage recovering his facial function totally after 9 weeks.     

Osteal complications as first manifestation in a patient with primary Sjögren's Syndrome and with associated distal tubular acidosis (type 1) and chronic renal insufficiency

Abstract: Renal affection is among the complications associated with the Sjögren's Syndrome. Tubulo‐interstitial nephritis constitutes the most frequent renal lesion and distal tubular acidosis (Type 1) is the most important clinical manifestation of this tubular dysfunction, although the occurrence of chronic renal insufficiency is not an uncommon finding in the presence of distal renal tubular acidosis. Osteomalacia is a clinical consequence of tubular acidosis caused by buffering of H⁺ in the bone. We present the case of a woman with osteal complication a year before being diagnosed with primary Sjögren's Syndrome and with distal tubular acidosis and renal insufficiency associated at diagnosis.     

Recidived medullary thyroid carcinoma with neck metastases and tracheal invasion

Medullary carcinoma represents about 5% of all malignant tumors located in thyroid gland and it can appear as sporadic or hereditary form. We report the case of a 58-year-old female who was initially operated by General Surgery Department of an infiltrating medullary carcinoma with cervical metastasic nodes having its origin on left thyroid lobe (LTL). The patient did not want any kind of control and 5 years later she suffered dyspnea due to the tumoral recurrence with invasion of the trachea and recurrential left palsy. Our ENT Service only performed a tracheostomy on fourth tracheal ring because the woman did not accept another surgical intervention. For 6 years she has been followed and reviewed in our consults beeing on alive up to now.     

Olfactory neuroblastoma in an old patient. Report of a case

Olfactory neuroblastoma or esthesioneuroblastoma is a rare embrionary tumor, much more in old patients, which uses to present as a pollipoid mass with nasal obstruction, epistaxis and anosmia of long evolution. We report the case of a 82-year-old male with such symptoms diagnosed by biopsy as neuroblastoma class III according the histologic Hyams grading. Due to the age of the patient and grade of the tumor we did not perform surgery and, although a chemotherapy-radiotherapy treatment was suggested, the patient was not agree with it and he has not been attended or followed in our consulting rooms.     

Association between primary hyperparathyroidism and Paget's disease. Report of a case

Although the association between hyperparathyroidism and Paget's disease is known, in the clinical practice occurs very rarely. We report the case of a 68 years old female who was diagnosed as such disease more than 5 years ago and later she got an increment of PTH levels and hypercalcemiajoint to other biochemical disorders that made to suspect a primary hyperparathyroidism. Besides the osteoarticular manifestations, clinically the patient suffered recurrent kidney lithiasis. She was operated by removal of one adenoma (1,5 cm) located in lower right parathyroid gland and her evolution was satisfactory without complications.     

Thyroglossal duct cysts and fistulae. Review of 30 consecutive operated patients

Thyroglossal duct cysts represent a very common pathology among the benign neck masses. An own review of 30 consecutive operated patients between 1994-2003 by our ENT Department is reported. There have been analysed different parameters like age, sex, personal antecedents, clinical symptoms, complementary explorations, surgical treatment, evolution and anatomopathologic result (AP). We think the Sistrunk procedure is the best operatory technique or strategy to perform to avoid recurrences.     

Late suprasternal and neck base abscess. Report of a case and literature review

Deep suprasternal infections secondary to cardiac surgery are uncommon but can compromise the life ofthe patient. After a sternotomy it is possible to find late cervico-thoracic abscesses specially in the presence of risk factors. We are reporting the case of a diabetic female of 67 years old with aortocoronary bypass who was diagnosed of suprasternal and neck base abscess in relation to her intervention 11 years later. It was necessary to practice drainage of the collection and wide spectrum antibioticotherapy with good evolution. 4 months after the surgery she was admitted again suffering a thoracic abscess that required treatment by Cardiac Surgery. The clinical follow-up was 3 years and no new recurrences have been detected.     

Multiple and synchronous neck metastasis from 4 different malignant tumors. Report of a case

Multiple neoplasms are increasing in clinical practice mainly due to the longer survival of the patients with cancer. Besides, procedures as radiotherapy that are used for the treatment of different diseases and tumors can associate with the future occurrence of carcinomas. The synchronous presentation of two or more histological kind ofneoplasms is uncommon. We report and analyse the clinical case of a 71 years male who presented, after a functional neck disection, metastatic lymph nodes of 4 malignant cell types: Lymphocytic lymphoma, anaplasic clear cells carcinoma, epidermoid carcinoma and thyroid papillary carcinoma.     

Glossopharyngeal neuralgia. A propos of one clinical case

Glossopharyngeal or the 9th cranial nerve neuralgia is an uncommon pathology characterized by severe paroxysmal attacks of pain in the base of the tongue, posterior pharynx and tonsillar fossa some times associated with pain irradiated to the ear. It's Carbamazepine is the first choice of medical treatment while the microvascular decompression is considered the main surgical procedure.     

Changes in the number of CD80(+), CD86(+), and CD28(+) peripheral blood lymphocytes have prognostic value in melanoma patients

Our aim was to evaluate whether the number of circulating lymphocytes expressing costimulatory molecules can be associated with melanoma prognosis. We determined the concentration of peripheral blood lymphocytes, which expressed the CD80/CD86 or CD28/CTLA-4 molecules, in 38 patients with cutaneous melanoma and 27 controls. The number of each cell subset was compared between patients and controls, as well as between groups of patients stratified according to Breslow thickness of the primary tumor (< or = 2 mm vs > 2 mm) or to survival after 3 years. The concentration of circulating lymphocytes expressing the CD80/CD86 molecules was not significantly different between patients and controls. There was a lower number of CD3(+)CD8(+)CD28(+) cells, as well as a higher CD3(+)CD8(+)/CD3(+)CD8(+)CD28(+) cell ratio, in melanoma patients than in controls. Melanoma patients with thinner tumors and those surviving revealed an increase of CD19(+)CD80(+) and CD19(+)CD80(+)CD86(+) cells, as well as a higher concentration of CD3(+)CD4(+)CD28(+) cells. CD80(+) B cells and a low CD8 suppressor/cytolytic cell ratio correlate with a good prognosis in melanoma. Our findings support our conclusion that CD80(+) B cells may be important antigen presenting cells that can contribute to an antimelanoma immune response and are candidates to be monitored in melanoma patients.