[Extracranial head and neck neurogenic tumors: report of 47 cases]

Extracranial head and neck neurogenic tumors are rare and usually revealed by histological examination. The aim of this study was to review the clinical, radiological and therapeutic particularities of these tumors

Methods: This retrospective study concerns 47 patients with neurogenic tumors of the head and neck, operated on between 1989 and 2011 [22 years period]. All patients had complete physical examination and ultrasonography was performed when a cervical extension was found. CT scan and MRI were performed in 16 cases. Minimum follow up was 4 years

Results: A sinusonasal tumor was found in 9 cases and a cervical mass was seen in 28 cases. Parapharyngeal extension was observed in two cases

Two patients had tympano-jugular glomic tumors and 8 of them had a cervical soft tissue tumor

Complete surgical resection was performed in 46 patients

Histological examination revealed a benign tumor in 91% of cases [n=43], 24 of them were schwannomas. Malignant tumors were seen in 4 cases: esthesioneuroblastoma [3 cases] and malignant schwannoma [1 case]. These patients received post operative radiotherapy

After surgery, two patients had Claude Bernard Horner syndrome and one had a definitive facial nerve palsy

Conclusion: Extracranial head and neck neurogenic tumors may have several aspects depending on their localisation and their histological type. Surgery, when performed, should be complete with minimum complications

[Primary psoas abscesses of the psoas muscle in children]

Primary psoas abscesses of the psoas muscle are relatively rare in childhood and can determine problems of diagnosis and therapeutic assumption. To demonstrate that ultrasonography is an excellent means in diagnosis and treatment of psoas abscess in children limiting the use of CT more costly and radiant and the surgery that is decaying. Over a 15 years period [January 1995-december 2009], 16 children with psoas abscess were studied retrospectively. The diagnosis gait was based on questioning, clinical examination and imaging techniques and, in first sight, ultrasonography. Median age of our patients was 6.4 years [extremes 18 months-14 years] and mean delay of evolution was 12 days. Fever and lumbar pain were both constants, associated with another signs like painful boitery, psoitis, mictional burns and lumbar mass. The ultrasonography made in 16 patients allowed to the diagnosis in all cases. The tomodensitometry, made in 3 patients, confirmed the ultrasonography. Echo guided percutaneous drainage, made in 14 cases, was successful in 12. The examination of pus showed S Aureus in 11 cases and E coli in the other. Ultrasonography is a very important means in the primary psoas abscess in children. In addition to give diagnosis, this technique allows the drainage and the cure of the collection, limiting the open surgery to some particular cases

[US guided biopsy in the early diagnosis of prostatic cancer: a series of 66 cases]

Our study's aim is to evaluate the reliability of digital rectal examination and serum PSA in the indication of prostatic biopsy. 66 patients with abnormal digital rectal examination and arised PSA levels had prostatic biopsies. The sextant technique was practiced. The digital rectal examination had a sensitivity of 65%, a specificity of 45% and a positive predictive value [PPV] of 34.3%. The serum PSA had a PPV of 25%. The association if these two parameters arised the PPV to 395%. Cancer detection rate was estimated to 30.3%. Prostatic biopsies should be indicated according to the result of digital rectal examination and serum PSA

[CT findings in otosclerosis: a series of 11 cases]

Our study's aim is to evaluate the reliability of computed tomography in diagnosis, extension and post-surgical follow-up of otosclerosis. A group of 11 patients was examined during a period of 25 months from 2002 to 2004. All of them had clinically and audiometrically suspected otosclerosis with bilateral conductive hear loss in 7 cases [3 had surgical management], unilateral in 2, and mixed earing loss in 2. High resolution CT was performed once in 8 patients and twice in the 3 operated. CT showed otosclerosis foci in all our study's patients, which was bilateral in 9 and unilateral in 2. The extension of the Lesions varied from type 1A to type 4B according to the otosclerosis staging. Computed tomography is, so far, the most efficient imaging modality in otosclerosis, showing otosclerosis foci when the clinical features are doubtful, allowing an accurate extension of the lesions and detecting complications during post-surgical follow-up