Topiramate-induced Acute Transient Myopia and Angle Narrowing.

Sulphamate drugs, widely prescribed for various systemic conditions, are reported to have rare ocular adverse-effects, usually within weeks of initiation of treatment. Medical and drug history in such cases are of pivotal importance in reaching a proper diagnosis. This study reports three cases, which developed topiramate-induced ocular side effects. In one of the cases, although the angles were narrow in both eyes, yet intra-ocular pressure (IOP) was not high. Also, in the third case, there were no macular striae. Topiramate was immediately withheld and all cases were improved without any permanent ocular damage. Key Words: Sulphamate, Topiramate, Angle closure glaucoma, Myopia.

Parapharyngeal Alveolar Soft Part Sarcoma in a 5-Year-Old Child.

Alveolar soft part sarcoma (ASPS) is a rare malignancy of head and neck region; orbit and tongue being most common subsites affected by this rare tumor. A 5-year-old female presented with computed tomography scan evidence of right-sided prestyloid parapharyngeal mass. Complete excision was performed through trans-cervical approach. Histopathology, special stain, and immunohistochemistry of the resected specimen confirmed the diagnosis of ASPS. Three-year follow-up did not reveal any local recurrence or distant metastases. Review of the English-language scientific literature did not reveal any documented case of parapharyngeal space ASPS in pediatric age. Only 1 clinical report of ASPS in a 42-year-old female has been documented.

Near-Total Laryngectomy for Extranodal Infiltration from Papillary Cancer to Larynx and Hypopharynx.

Papillary thyroid cancer usually presents with limited loco-regional disease. Rarely extrathyroidal extension to the surrounding vital structures is seen. It is rarer for metastatic node from papillary thyroid cancer to directly infiltrate into the larynx or pharynx. We report a rare case where an extranodal extension from a metastatic papillary thyroid cancer infiltrated into the larynx and pyriform sinus in a 56-year-old female. Near-total laryngectomy with partial pharyngectomy was done for gross removal of the disease to achieve long-term locoregional disease-free survival. Although locally advanced thyroid cancer is rare, once noted, it presents challenge to the surgeon to achieve gross total removal of the tumor. Initial radical resection should be done to achieve gross total removal of the cancer.

Double Pyramidal Lobe of the Thyroid Gland a Rare Variation: Case Report.

Knowledge of the variations of the pyramidal lobe of the thyroid is important for surgeons to perform complete resection of the functional thyroid tissue. Complete excision of the thyroid tissue surgery reduces the chances of recurrence in both the benign and the malignant diseases. It is important to remove all functioning thyroid tissue especially in the differentiated thyroid cancer so the postoperative radioiodine ablation is more effective and serum thyroglobulin acts as an efficient marker. We report a case of the double pyramidal lobe of thyroid gland in a woman of age 63 years with follicular thyroid cancer. Our literature search revealed only three documented cases of the double pyramidal lobe. Knowledge and recognition of such a rare variation is essential to perform safe and effective thyroid surgery.