Fibrosarcoma of the Thyroid Gland : Report of a Case / 대한이비인후과학회지

Fibrosarcoma is a malignant mesenchymal neoplasm of fibroblasts that rarely affects the thyroid gland and can cause local recurrences or metastasis. We describe a case of primary fibrosarcoma of the thyroid in a 31-year-old man. Microscopically, the tumor showed highly cellular proliferation of spindle cells with cytologic atypia and mitotic figures. Immunohistochemically, the cells only showed immunoreactivity for vimentin and negativity for S-100 protein, CK, CD31, CD34, TTF-1, desmin. Based on clinical, radiological, histological and immunohistochemical findings, the final diagnosis was intra-thyroid fibrosarcoma. The treatment of choice is radical surgery. Radiation therapy is used as adjuvant treatment. So, we review the clinical, radiologic, histologic findings and treatment modalities of the fibrosarcoma of the thyroid gland.

Metastatic Adenocarcinoma of the Temporal Bone Presenting as Facial Paralysis / 대한이비인후과학회지

Metastatic lesions in temporal bones were rare in the past, however, nowadays, they seem to be increasing. The primary sites of metastases to the temporal bones are known to be the breasts, lungs, kidneys, gastrointestinal tract, prostate gland, larynx, and thyroid gland. We present a case with peripheral facial paralysis as the only symptom of a metastasis to the temporal bone in a 73 year-old woman, and that peripheral facial paralysis was the first and only metastatic symptom in that case. This patient was initially diagnosed with Bell's palsy. However, based on the pathologic findings, a further study revealed an adenocarcinoma of the lungs which spread to the temporal bone. Any metastatic diseases to the temporal bone should be considered as possible etiology in patients with a clinical history of malignant neoplasms presenting with common otologic or vestibular symptoms, especially with facial nerve paralysis.

Atypical Presentation of Kawasaki Disease Resembling a Cervical Lymphadenitis: Three Cases / 대한이비인후과학회지

Kawasaki disease (KD) is an acute multisystemic vasculitis, which occurs in children of less than 10 years of age. Recently, KD has become the leading cause of acquired heart diseases in children in the developed world, with coronary artery aneurysms occurring in up to 25% of untreated cases. A number of publications described patients for whom the diagnosis was delayed since the symptoms did not fulfill the required criteria to be diagnosed as KD, and, consequently heightened cardiac complications resulted. These cases are known as atypical or incomplete KD. The following case report describes patients with atypical KD, whose initial presentation mimicked a cervical lymphadenitis. Empiric antibiotics were prescribed in these cases with unsatisfactory response, initially. An awareness of this entity with its manifestations is warranted by otolaryngologists who may well be the first doctor on the scene. Prompt and early treatment with aspirin and intravenous immunoglobulin may decrease morbidity and potential mortality of this enigmatic disease.