ABSTRACT
Ectopic lingual thyroid has been described, however, follicular carcinoma arising within it is an extremely rare entity with only 40 cases reported in the literature. Lingual thyroid carcinoma is undistinguishable from benign enlargement of lingual thyroid, the later should also be differentiated from many oropharyngeal pathologies including but not limited to thyroglossal duct cyst, lipoma, dermoid cyst and salivary gland tumors. Ectopic lingual nature of thyroid tissue can be diagnosed with scintigraphy scan; however, malignant transformation confirms just after pathological examination. Surgical excision remains the best therapy with transoral approach being the most appropriate and favorable among others due to its cosmetic results and lower incidence of infection. Herein, we report a case of an adult female who was diagnosed to have follicular carcinoma of an ectopic lingual thyroid tissue mass. Concerning the size of the mass it was the largest of all reported cases of ectopic thyroid gland.
ABSTRACT
INTRODUCTION: Schwannoma is a benign well circumscribed tumor of the nerve sheath and it is mostly localized in the head and neck. Intramasseteric schwannoma represents a very rare entity and a few cases have been described in the literature. PRESENTATION OF CASE: We present a case of an isolated, asymptomatic and slowly progressive right cheek tumor in a middle aged man. Although multiple investigations, including neck scanner and fine needle aspiration, were done, the diagnosis was obscure and difficult before definite surgical resection. Surgery showed an isolated and well-defined tumor inside the masseter muscle which was completely resected. Histopathologic finding confirmed the diagnosis of schwannoma with the characteristic Antoni A and Antoni B cells. DISCUSSION: Among benign tumors of the peripheral nerves, schwannoma is a specific type that originates from Schwann cells. It is typically slowly growing, neoplasm that is displacing neural structures without direct invasion. History, physical examination, fine needle aspiration, and magnetic resonance imaging are used as diagnostic modalities, however definitive diagnosis and identification of the affected nerve are often difficult up to the time of surgery. CONCLUSION: Herby we describe a very rare localization of schwannoma arising from masseter muscle in a 30â¯year old man who presents with painless neck mass. This rare entity should be considered in the differential diagnosis in any patient presented with cheek mass.
ABSTRACT
Myoepithelial carcinoma is a rare malignancy of the parotid gland that is usually seen in adults. We report the first case in children of myoepithelial carcinoma of the parotid gland with massive invasion of the facial nerve and metastasis to cervical lymph nodes. Due to its rarity, the treatment and the clinical course of this tumor are not well defined yet. We performed a total parotidectomy, a modified neck dissection, and a postoperative radiotherapy in 7-year-old boy. Sparing of the facial nerve was impossible; it was sacrificed and grafted with a sural nerve. Histopathology confirmed the diagnosis of a parotid gland carcinoma and immunohistochemical markers showed that the tumor cells express cytokeratin, epithelial membrane antigen, cytokeratin 7, smooth muscle actin, P63, CEA, and S100. This pattern of immunostaining is consistent with the diagnosis of myoepithelial carcinoma. On the postoperative tenth month he presented with a pulmonary and lumbar vertebra metastasis.
