Larynx cancer diagnosed as Ewing Sarcoma in a 41-year-old man: A case report.

Introduction: Sarcoma as a cause of laryngeal cancer is rare and is even rarer to have an Ewing sarcoma out of the bone presents as laryngeal cancer. In this report, we present this extremely rare case. Case presentation: A 41-year-old man was seen at the ENT clinic complaining of chronic hoarseness and a lump in his neck. Flexible laryngoscopy showed a large mass occupying the left side of the larynx and then a computerized tomography scan proved it. For further evaluation, the laryngoscopy was performed and the frozen section revealed a malignancy. Consequently, the surgical decision was taken and a total Laryngectomy and thyroidectomy were carried out. A final diagnosis of Ewing sarcoma was established using histological examination and immunohistochemical staining. The patient was referred for adjuvant chemo-radiotherapy as recommended by the oncology service. Clinical discussion: laryngeal cancer is rarely diagnosed as Ewing sarcoma. The defined diagnosis should be made based on histological study and immunohistochemical staining besides the clinical presentation and other examinations. Our patient was a candidate for surgical treatment and negative surgical margins were achieved. He was referred for adjuvant chemo-radiotherapy as some studies demonstrated the efficacy of multimodal therapy in treating Ewing sarcoma. Conclusion: Because of the lack of similar studies and documented data in the medical literature about this rare case, Ewing sarcoma should be included in the differential diagnosis in laryngeal cancer cases.

Rhabdomyoma in the base of the tongue : A case report.

INTRODUCTION: Rhabdomyomas are benign and rare mesenchymal tumors. They are classified into cardiac and extracardiac. However, the majority of adult subtype, which are extracardiac, tend to occur in the head and neck region. PRESENT OF CASE: A 57-year-old man with dysphagia, dysphonia and stertor one year ago. Head and neck endoscopy was the first step to detect a smooth mass at the base of the tongue, after that CT-scan showed great lobuled mass measured 7 × 5 × 6 cm. However, complete surgical excision was done and the histopathological examination play a central role to reveal an adult-type rhabdomyoma. DISCUSSION: the tongue base is absolutely one of the rarest sites of oral adult-type rhabdomyoma (ARM), because since 1948 to 2021 there were only four English-language articles which described ARM in the base of the tongue, anyway this type mimics malignant tumors on CT-scan because of its unclear borders and The golden diagnosis depends on histopathological examination and immunohistochemistry staining when the desmin markers are positive after that the tumor was completely excisioned as the best treatment. CONCLUSION: Base of the tongue is a very rare location for adult-rhabdomyoma which must be considered in the differential diagnosis of head and neck lesions.

Schwannoma of the sympathetic trunk: A case report.

INTRODUCTION AND IMPORTANCE: Schwannomas are benign tumors commonly found in the cranial vault at the cerebellopontine angle. Schwannomas could arise from any nerve that has Schwann sheath. Their most common extra-cranial localization is the parapharyngeal space. Schwannomas do not usually metastasize, and recurrence is uncommon. CASE PRESENTATION: We present a case of a sympathetic trunk schwannoma in a patient that presented with dysphagia and a painful neck mass. Oro-pharyngeal examination revealed the presence of a mass filling-up the left tonsillar fossa, and pushing the uvula to the right side. The larynx was also deviated to the right due to the mass effect. The mass was resected en-bloc with the involved part of the sympathetic trunk. The patient developed Horner's syndrome postoperatively. CLINICAL DISCUSSION: The occurrence of Sympathetic trunk Schwannomas is very rare. The majority of patients presented with a cervical mass and non-specific symptoms. The most effective treatment is surgical resection. Our experience suggests sympathetic trunk Schwannomas as a differential diagnosis of slow-growing neck masses and asserts that the surgical resection is the main treatment. CONCLUSION: The occurrence of Schwannomas in the sympathetic trunk is rare. High clinical suspicion is required to achieve the preoperative diagnosis. The optimal management is the total surgical resection. Recurrence is uncommon when the mass is totally resected.

Synovial sarcoma of the maxillary sinus - A rare condition managed with a rationalized surgery.

INTRODUCTION: and importance: Synovial sarcoma is a type of spindle cell tumors with unknown cellular origin. It can present anywhere throughout the body; however, its onset in the maxillary sinus is an extremely rare condition, making it hard to diagnose. This tumor occurs equally, without predilection for males or females, and the incidence peaks in the age of 35. The diagnosis is confirmed by histopathological study, and the main treatment is complete surgical excision. CASE PRESENTATION: We are reporting a case of a 53-year-old male with a left sided hearing loss accompanied by a left sided nasal block and a vague facial and dental pain. CLINICAL DISCUSSION: Magnetic Resonance Imaging (MRI) showed a heterogeneously enhancing tumor in the maxillary sinus that extended to the pterygopalatine fossa and other surrounding structures, and a biopsy showed the tumor to be a synovial sarcoma. The tumor was managed with a less aggressive curative surgery, and was put on an adjuvant radiotherapy, and is being followed regularly; with no recurrence 5 months after therapy. CONCLUSION: In conclusion, we are writing this report to introduce a case of synovial sarcoma in a rare location that was managed by a "cosmetically oriented" curative surgery, satisfactory results and prognosis.

Myxofibrosarcoma metastasis to the pterygopalatine fossa: A case report.

INTRODUCTION: Myxofibrosarcoma (MFS) is a rare subtype of a malignant soft tissue tumor that occurs mainly in adults, and peaks at the age of 70. It typically presents as a slow growing, painless mass in the proximal part of the extremities. It is characterized with a high recurrence rate and a low rate of distant metastases; the most common metastases site is the lungs, and in some extremely rare cases it was mentioned that there was metastases to the head and neck region. We here report the first case of a myxofibrosarcoma metastasized from the gluteal region to the pterygopalatine fossa, which is the first report in the literature of this rare metastatic spread of myxofibrosarcoma. CASE PRESENTATION: a 70 year-old male presented with diplopia and limited right eye movement. His medical history was significant for myxofibrosarcoma in his gluteus maximus. Magnetic resonance imaging showed a low signal mass in the pterygopalatine fossa. The tumor neither invaded the maxillary bone nor the maxillary sinus; the therapy plan was resection of the mass by partial maxillectomy followed by adjuvant radiotherapy. CONCLUSION: Metastasis to the pterygopalatine fossa should be considered in a patient with myxofibrosarcoma history presents with neuro-opthalmic symptoms. Partial maxillectomy in tumors that do not infiltrate into adjacent structures should be considered as a minimally invasive therapy.