Bilateral chylothorax following neck dissection: a new method of treatment.

Chylothorax is a serious condition with a high rate of morbidity that may lead to death. Although it is encountered more frequently with certain thoracic procedures, it is considered to be a rare complication of neck dissection. Different forms of management have been postulated; however, no consensus of treatment has been achieved. A case of severe bilateral chylothorax that developed after bilateral neck dissection in a patient with laryngeal carcinoma is presented. Somatostatin injection was successful after total parenteral nutrition failed to control the chylothorax. On the basis of this case and the review of the literature discussed here, we advocate the use of somatostatin with other conservative measures in the management of chylothorax.

Skull base meningioma: delayed extracranial presentation.

Meningiomas are common intracranial tumors that rarely extend to extracranial sites. When they occur extracranially near the skull base, their diagnosis and management represent tremendous challenges. Although the extracranial component tends to manifest at the same time as the intracranial component, this is not always the case. In the patient reported in this article, 13 years separated the diagnosis of the intracranial tumor from the appearance of an extracranial component. The clinical presentation, radiologic findings, and management of this large skull base meningioma are discussed with reference to the literature. A high index of suspicion and clinical acumen are needed to ensure that the extracranial component of these frequent tumors is discovered, especially when it presents later than the intracranial component.