Recurrent vocal cord granulomas in a twelve-year-old child

Vocal cord granulomas or contact granulomas are benign masses of the vocal fold. They are relatively uncommon. The etiology is usually multifactorial which makes it difficult to treat. The pathogenesis of this condition is still undetermined but can be attributed to three etiological factors: vocal abuse, laryngopharyngeal reflux disease, and laryngeal intubation. Recurrence is high due to the fact that most of the underlying causes are persistent. We report a case recurrent granuloma exacerbated by excision which contributed to its recurrence. Between 2012 to 2017, the patient had multiple microbroncholaryngoscopy [MLB] for excision of the granulomas [twice per year]. Co2 laser was used in some of the procedures. The patient was kept under observation with regular follow-up visits and endoscopies. In May 2018, the patient was symptom free and flexible nasal endoscopy showed normal bilateral vocal cords with disappearance of the granulomas

Piebaldism with a variant gene

Piebaldism is patchy areas of depigmentation on the skin, most frequently on the forehead [producing a white forelock], ventral trunk, elbows, and knees. It is a rare autosomal dominant condition, caused by mutations in the cell-surface receptor tyrosine kinase gene [KIT]. Piebaldism must be differentiated from other pigmentation disorders, such as vitiligo, nevus depigmentosus, and Waardenburg syndrome. We present a preterm baby boy born at 32+ weeks due to antepartum hemorrhage. The birth weight was 1.85 kg. The baby was found to have a white forelock [Piebaldism] and gray eyebrows and eyelashes. His neonatal course was complicated by mild respiratory distress syndrome which was managed by one-day intubation and assisted ventilation [on PTV mode]. The gene panel revealed that the baby carries in exon 16 of KIT the variant of uncertain significance c.2318C>T p.[Ser773Phe] in heterozygous state