Résumé
Leptomeningeal carcinomatosis is defined as the diffuse infiltration of the leptomeninges by malignant cells metastasized from systemic cancer. We report a case of leptomeningeal carcinomatosis presenting bilateral sensorineural hearing loss and dizziness. A 51-year-old woman who was diagnosed with non-small cell lung cancer with leptomeningeal carcinomatosis was referred to our department because of progressive hearing loss and dizziness. Magnetic resonance imaging revealed an abnormal enhancement of the vestibulocochlear nerves within the internal auditory canals bilaterally. The patient received chemotherapy concurrently with an intrathecal methotrexate injection. Leptomeningeal carcinomatosis must be considered in the differential diagnosis of cancer patients with bilateral progressive sensorineural hearing loss.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Carcinomes , Carcinome pulmonaire non à petites cellules , Diagnostic différentiel , Sensation vertigineuse , Ouïe , Perte d'audition , Surdité bilatérale partielle , Surdité neurosensorielle , Imagerie par résonance magnétique , Méningite carcinomateuse , Méthotrexate , Nerf vestibulocochléaireRésumé
BACKGROUND AND OBJECTIVES: Clinical differentiation of peritonsillar abscess (PTA) from peritonsillar cellulitis is sometimes difficult and physicians often rely on blind needle aspiration to locate abscess formation. According to previous studies, intraoral ultrasound is a useful, simple, and noninvasive technique that candifferentiate PTA from cellulitis in clinically equivocal cases, although it may cause some discomfort. The objective of this study was to establish a neck ultrasonographic technique that candifferentiate PTA from cellulitis in borderline cases and thereby to avoid unnecessary needle aspiraton. SUBJECTS AND METHOD: The study population included 44 patients (32 males and 12 females; age range 13 to 59 years) with clinically suspected PTA. These patientsunderwent neck ultrasonography examination before needle aspiration of abscess. RESULTS: On the basis of neck ultrasonography, 38 patients were considered as PTA and 6 as cellulitis. Neck ultrasonography was able to detect peritonsillar abscess in 94.7 per cent of the cases (sensitivity). The specificity of the test was 83.3 per cent, and accuracy was 79.1 per cent. CONCLUSION: Neck ultrasonography is a useful, simple, well-tolerated non-invasive technique that can be used to differentiate PTA from cellulitis in clinically equivocal cases.
Sujets)
Humains , Mâle , Abcès , Cellulite sous-cutanée , Cou , Aiguilles , Abcès périamygdalien , Sensibilité et spécificitéRésumé
An angiomatous polyp originates from a sinochoanal polyp, and may be confused with a vascular neoplasm. Compromise of their vascular supply may occasionally lead to infarction, resulting in clinical, radiological and pathological features that simulate a neoplastic process. Recently, we experienced a case of angiomatous nasal polyp that eroded the anterior wall of maxilla at the time of its presentation in a 15-year-old boy. Angiomatous nasal polyps are poorly documented in clinical literature. Although entirely benign, they may simulate neoplastic processes. Thus, awareness of their existence is of considerable importance.
Sujets)
Adolescent , Humains , Mâle , Cytochrome P-450 CYP1A1 , Hémangiome , Infarctus , Maxillaire , Polypes du nez , Processus néoplasiques , Polypes , Tumeurs vasculairesRésumé
Self-induced pneumoparotitis is a rare cause of swelling of the parotid gland. It has been reported to be a result of psychosomatic disorder, unintentional habit, and it is sometimes self-induced by patients to achieve secondary gain. We report a case of a 18-year-old man who had a self-induced pneumoparotitis complicated by recurrent parotitis, subcutaneous emphysema and pneumomediastinum. With repeated behavior of insufflation, parotid acini may rupture and air may extend into the retropharyngeal space, causing pneumomediastinum or pneumothorax. In self-induced cases, treatment should necessitate psychologic therapy for behavior modification.
Sujets)
Adolescent , Humains , Thérapie comportementale , Insufflation , Emphysème médiastinal , Glande parotide , Parotidite , Pneumothorax , Troubles psychosomatiques , Rupture , Emphysème sous-cutanéRésumé
We report a recently encountered case of angioleiomyoma in oropharynx. The patient was a 26-year-old woman. The main symptoms were feeling of narrowing down of the pharynx and difficulty in breathing in the left supine position. Laryngoscopy revealed a 3.5cm-sized, spherical mass with a smooth surface, originating in the right oropharyngeal wall. The tumor was successfully removed using suspension microlaryngoscopy under general anesthesia. Histopathologically, it was well circumscribed and composed of proliferating smooth muscle fibers and dilated blood vessels. The tumor is a benign nature and recurrence is rare. Complete removal is the treatment of choice with care taken to avoid profuse bleeding.