[Adenoid cystic carcinoma of the parotid with facial nerve invasion]

Adenoid cystic carcinoma comprises approximately 10% of all epithelial salivary neoplasms and most frequently involves the parotid. Perineural invasion is a common feature but intraneural invasion and spread is less common. The authors report a case of parotid adenoid cystic carcinoma with invasion and spread via the facial nerve with an emphasis on radiologic features. We report a case of a 47-year-old man presenting with a right submandibular mass evolving for 4 years. On physical examination, the mass was firm painless, well delineated. There was no facial paralysis. The magnetic resonance imaging [MRI] examination showed a right parotid gland solid mass located in the deep lobe of the parotid gland with mastoid bony involvement.The mass was heterogenously enhanced. High resolution non contrast computed tomographie [CT] scan of the temporal bone showed in the axial and coronal cuts, a widening of the mastoid segment of the facial canal with involvement of the facial nerve. Pathologic examination of the resected specimen revealed histological features of adenoid cystic carcinoma with intra neural invasion of the mastoid segment of the facial nerve. The surgical margins were free. The evolution was favourable 5 years later. This study confirms that multiplanar approach of MRI allows rapid detection of adenoid cystic carcinoma. The influence of intraneural invasion and spread on survival remains controversial

[Congenital growth hormone deficiency: etiologic presentation of 13 cases]

Frequency of the congenital growth hormone [CH] deficiency is estimated to /4000 - 1/10.000 births. Its pathogenesis is multiple. We report 13 cases of congenital GH deficiency. Three cases [3 boys] are secondary to stalk interruption and GH deficiency is associated to ACTH deficiency in 2 cases and to gonadotropin deficiency in 2 cases but no patient has diabetes insipidus. shows a pituitary stalk interruption, an anterior pituitary hypoplasia and posterior pituitary ectopia. The causes of stalk interruption remain not clear. For the 10 other patients with congenital GH deficiency, genetic origin is suggested because of the clinical and biological presentation and by the normal MRI. GH deficiency is isolated in 5 cases in 10. We review the main mutations involved in GH deficiency [Prop-1, Pit-1, Lhx3 and Lhx4 genes]