A Case of Direct Invasion of the Parotid Gland by Cutaneous Squamous Cell Carcinoma

Cutaneous squamous cell carcinoma is the second-most common skin cancer and represents 20% of all skin cancers. Cutaneous squamous cell carcinoma often spreads to the parotid gland through lymph nodes, but, direct invasion of an adjacent organ may also occur. We present the case of 78-year-old man with ulcerated mass on the right infra-auricular area. The histopathologic finding was squamous cell carcinoma. There was no evidence of distant metastasis, but the mass was found to invade the superficial lobe of the right parotid gland. The mass was widely excised and superficial parotidectomy was performed while preserving the facial nerve. The defect was covered by primary closure. Postoperative radiotherapy was performed. At 20 months after surgery, our patient had no facial palsy, local recurrence, or metastasis. Cutaneous squamous cell carcinoma involving the parotid gland is an aggressive, rapidly advancing lesion, which if not recognized and treated early will result in high morbidity and mortality. Squamous cell carcinoma of the parotid gland has shown that patients who receive adjuvant radiotherapy have a lower recurrence rate and a higher survival rate than patients treated with surgery alone. The role of elective neck dissection remains controversial.

BBilateral Intranasal Supernumerary Teeth

The presence of an ectopic supernumerary tooth in the nose is an uncommon phenomenon. A supernumerary tooth may be asymptomatic but must be given special attention as it has the potential to cause significant morbidity. Bilateral intranasal supernumerary teeth are an extremely rare disease entity. We report the clinical and radiologic findings of bilateral ectopic supernumerary teeth erupted from the nasal floor.

Acute Visual Loss Caused by Onodi Cell Mucopyocele

Acute visual loss caused by an infected mucocele in an Onodi cell is extremely rare. The Onodi cell is a pneumatized posterior ethmoid cell located laterally and superiorly to the sphenoid sinus and closely related to the optic nerve. Therefore, a mucocele affecting the Onodi cell that has encroached on the adjacent sphenoid bone forming the optic canal can rarely present with visual loss. We describe a rare case of retrobulbar optic neuritis caused by an infected mucocele in the Onodi cell. A 54-year-old male complained of headache and visual loss in his right eye. A computed tomography scan and magnetic resonance image demonstrated a mucocele occupying the Onodi cell on the right side. Surgical treatment with an endoscopic sinus approach was performed, resulting in improvement of visual acuity. A lesion in an Onodi cell may be associated with ocular symptoms even if the lesion is isolated or small. Imaging studies should be considered for the differential diagnosis because early diagnosis and prompt surgical treatment for mucocele are needed for recovery of visual function.