Transnasal Endoscopic Resection of a Huge Solitary Fibrous Tumor Originated From Frontal Recess

Solitary fibrous tumor (SFT) is a spindle cell neoplasm that occurs commonly in the pleural space. One-third of SFTs arising from an extrathoracic organ are found in the head and neck region, and they arise rarely in the sinonasal tract. Most of these tumors are benign, but malignant tumors are identified in some cases. Here we report a rare sinonasal SFT arising from the frontal recess. A 32-year-old male patient with chief complaint of headache and left facial pain visited the outpatient clinic. He had suffered from paranasal pain and nasal obstruction for several months, and symptoms became more severe in the previous three months. The mass rapidly increased in size and was protruding from the left nostril when he visited the hospital. After computed tomography and magnetic resonance imaging scans, transnasal endoscopic resection of the tumor was performed, and gross total tumor removal was successfully achieved. We believe this case will be helpful for providing information regarding management of such uncommon huge sinonasal tumors originating from the frontal recess.

A Case Report on the Management of Intractable Chyle Leakage after Left Neck Level V Lymph Node Biopsy / 대한이비인후과학회지

Chyle leakage from the neck, which usually occurs after iatrogenic injury of the thoracic or lymphatic duct, is an uncommon complication of head and neck surgeries, which include neck dissection or thyroidectomy. A small amount of chyle leakage can be treated with conservative approaches, such as nutritional limitation, somatostatin analogues, and wound compression. However, massive or uncontrolled chyle leakage requires surgical exploration of the wound and thoracic duct ligation via the chest or transabdominal thoracic duct embolization can be applied. Here, we report a case of intractable massive chyle leakage in a 78-year-old male after a left neck level V lymph node biopsy, which was not controlled after conservative management and explorative surgery. Various treatment approaches were attempted and successful management of chyle leakage was ultimately achieved by thoracic duct embolization.

Evaluation of Ultrasonography and CT for Imaging of Head and Neck Pilomatricoma in Children and Adolescents / 대한이비인후과학회지

Background and Objectives@#Pilomatricoma is a frequently diagnosed skin lesion of the head and neck that may often be misdiagnosed as other skin lesions. This study evaluated whether ultrasonography (USG) or computed tomography (CT) is the most helpful imaging modality for the accurate preoperative diagnosis of pilomatricoma in head and neck regions of children and adolescents.Subjects and Method A retrospective review was conducted for 59 patients with pilomatricoma under the age of 19 years. All cases were pathologically confirmed with pilomatricoma in the head or neck. @*Results@#Preoperative imaging examinations were performed with USG in six cases and with CT in nine cases. The accuracy of preoperative diagnosis was compared between three groups: 1) with clinical findings only, 2) with USG, and 3) with CT. The correct preoperative diagnosis was made in 18 (30.5%) of the total of 59 cases. Using only clinical findings, 10 (22.7%) out of 44 patients were diagnosed as pilomatricoma. With the addition of USG, pilomatricoma was diagnosed in 1 (16.7%) out of six cases, whereas with the addition of CT, 7 (77.8%) out of 9 cases (77.8%) were diagnosed correctly. Preoperative diagnosis of pilomatricoma with CT imaging was more accurate than clinical findings only (vs. CT; odds ratio [OR]=11.900, 95% confidence interval [CI] 2.126-66.615; p=0.001) or USG (vs. CT; OR=17.500, 95% CI 1.223-250.357; p=0.020). @*Conclusion@#In the preoperative diagnosis of pilomatricoma, imaging modalities such as CT and USG are helpful, with CT offering higher diagnostic accuracy and USG procedural benefits in younger children.

Atypical Lipomatous Tumor/Well-Differentiated Liposarcoma Arising from the Tongue: case report / 고신대학교의과대학학술지

Liposarcomas are common mesenchymal malignant tumors arising from adipose tissue. Although liposarcomas are the most frequent type of soft tissue sarcomas, accounting for approximately 20% of all soft tissue sarcomas, they are rare in the head and neck, particularly in the oral cavity. Oral liposarcomas have been reported to occur mainly on the buccal mucosa, with other sites including the floor of the mouth, tongue, palate, and mandible. This report describes a 76-yearold male patient with an atypical lipomatous tumor/well-differentiated liposarcoma of the tongue that underwent surgical excision. This report also reviews published data on these rare tumors.

A High-Riding Subclavian Artery in the Anterior Neck Masquerading as Thyroid Tumor

Anterior neck mass is a common symptom that is seen in otolaryngology surgery centers. Common types include thyroid tumor and thyroglossal duct cyst. In an elderly patient, a differentiated thyroid carcinoma should be suspected especially if it moves when swallowing. We encountered a typical presentation of a solitary thyroid nodule-like mass without pulsation in an 81-year-old female. We presented a rare diagnosis of pulsatile anterior neck swelling in which a high-riding subclavian artery should be considered as a differential diagnosis. Ultrasonography, Doppler scan, and contrast CT scan revealed that the neck mass corresponds to the high-riding subclavian artery. Therefore, ultrasonography is essential to detect any vascular lesion prior to biopsy or fine needle aspiration cytology as to avoid catastrophic hemorrhage.