Giant Cell Tumor of the Carotid Body: A Rare Tumor with Malignant Potential.

Introduction: Carotid body tumors (CBTs) are certainly unusual. They are vascular lesions originating from paraganglionic cells, located at the common carotid artery (CCA) bifurcation. They represent less than 0.5% of head and neck tumors, approximately 1-3 cases per million. Malignant CBTs are extremely rare; in the literature, published rates on average are < 10%. The diagnostic criteria for malignancy should be based on the finding of distant metastasis. Due to its unpredictable nature and its malignant potential, diagnosis before metastasis and complete surgical resection are the keys to a favorable prognosis. Case Report: Given little experience in CBTs, its biology and treatment remain uncertain. We present the case of a 48-years-old patient, with a mass on the left side of the neck that was found to be a vast CBT with suspicious histopathology. Its size, rare location, pathologic findings, and management strategy applied for its treatment, illustrate an unusual case that highlights the importance of its publication. Conclusions: CBT is rare, but subject to cure lesion if resected without metastatic or residual disease. This is why surgery should be performed whenever possible and why it is so necessary to study this pathology thoroughly and to take it into account in the differential diagnosis.

Recommendations regarding emergency head and neck procedures during coronavirus disease-2019.

The coronavirus disease-2019 (COVID-19) has spread globally and is considered a world health emergency. Healthcare professionals represent an important percentage of the infected population, with otolaryngologists and head and neck surgeons at particular risk. Elective procedures have been strongly discouraged, but urgent disorders still entail a hazardous setting. We performed a non-systematic review of the publications and guidelines regarding Head and Neck surgical emergencies management in the context of the COVID-19 pandemic. The literature describing management of the disease was also reviewed to adapt conventional treatment to the present circumstances. A concise and specific compilation of practical recommendations was made with the aim of improving management of emergencies involving the head and neck region, while offering a safe alternative for patients and healthcare providers. In addition, we have made a brief summary of how these recommendations were adapted based on our socio-economic background and available health resources.

La enfermedad del coronavirus-2019 (COVID-19) se ha extendido a nivel mundial y se considera una emergencia sanitaria mundial. Los profesionales sanitarios representan un porcentaje importante de la población infectada, y los otorrinolaringólogos y cirujanos de cabeza y cuello corren un riesgo especial. Se han desaconsejado enérgicamente los procedimientos electivos, pero los trastornos urgentes aún implican un entorno peligroso. Realizamos una revisión no sistemática de las publicaciones y guías sobre el manejo de emergencias quirúrgicas de cabeza y cuello en el contexto de la pandemia de COVID-19. También se revisó la literatura que describe el manejo de la enfermedad con el fin de adaptar el tratamiento convencional a las circunstancias actuales. Se realizó una recopilación concisa y específica de recomendaciones prácticas con el objetivo de mejorar el manejo de las emergencias que involucran la región de la cabeza y el cuello, al tiempo que ofrece una alternativa segura para los pacientes y los proveedores de atención médica. Además, hemos hecho un breve resumen de cómo se adaptaron estas recomendaciones en función de nuestros antecedentes socioeconómicos y los recursos de salud disponibles.

Clear cell odontogenic carcinoma: a rare pathology with an innovative resolution.

Clear cell odontogenic carcinoma (CCOC) is an uncommon condition that has been considered malignant since 2005. The clinical presentation usually involves an asymptomatic swelling, which typically affects the anterior mandible in middle-aged women; it has neither clinical nor radiological defining features. Immunohistochemical analysis usually aids diagnosis, as clear cells are also associated with other clear cell carcinomas and benign tumors. Radical surgery is the gold standard of treatment and usually needs microsurgical reconstruction with bone transference for restoration of facial anatomy and adequate function.  We present the case of a young woman with CCOC whose tumor removal and reconstructive surgery were planned virtually and assisted by intraoperative navigation. The novelty of the reconstructive procedure was the replacement of the fibula cutting guides for intraoperative navigation of the osteotomies. We present a brief review of CCOC and the benefits of using computer-assisted surgery (CAS) in high-complexity cases like this one.

Reconstruction of Hind and Mid-Foot Defects after Melanoma Resection Using the Reverse Sural Flap: A Case Series.

Background Melanoma resection creates important soft tissues defects, which are difficult to manage when located on the weight-bearing heel and mid foot. There is little evidence on the use of the reverse-flow sural flap for this type of reconstruction. Objective This study reports our case series on the reconstructive management of the hind and mid-foot defects after melanoma resection using the reverse sural artery flap. Materials and Methods This is a retrospective study of four consecutive patients treated with resection of melanoma of the feet and reconstruction with reverse sural artery flap from 2006 to 2009. Results The mean age of the patients was 54 years, three were females, and one was male. Three of the defects were located on the weight-bearing heel, the other on the mid-foot dorsum. The melanomas were fully resected with wide margins. Three patients were reconstructed primarily, whereas one patient was reconstructed 4 weeks after the resective surgery. This series revealed 100% flap survival and there was no partial necrosis. Major complications were not observed. The four patients completely recovered the function of the affected limb. Conclusion The reverse sural flap is a viable option for the reconstruction of foot defects after melanoma resection.

Carcinoma espinocelular del oído externo con extensión parotídea: a propósito de un caso / Squamous cell carcinoma of the external ear with parotid extension: case report

El pabellón auricular y el conducto auditivo externo constituyen una región anatómica que puede ser asiento de múltiples patologías, entre ellas procesos inflamatorios, infecciosos y neoplásicos, tanto benignos como malignos. Con respecto a los tumores, los diversos tipos suelen presentarse con síntomas y signos similares y en general es difícil inferir la variedad histológica del tumor a través del examen físico, por lo cual es necesario el estudio histopatológico para determinar el diagnóstico. La mayoría de los tumores del oído externo son carcinomas; entre ellos se destacan el carcinoma basocelular, el más frecuente, y el carcinoma espinocelular. Menos frecuentemente se encuentran otros tipos de tumores como los melanomas, adenocarcinomas, carcinomas de glándulas ceruminosas, carcinomas mucoepidermoides, sarcomas, procesos linfoproliferativos, etc. Suelen ocurrir en la edad media y avanzada (50-70 años) y con mayor periodicidad en el sexo masculino. En el presente trabajo se describe un caso clínico de carcinoma espinocelular del oído externo, tratado exitosamente mediante cirugía y radioterapia, así como también se describen las características clínicas de esta enfermedad, con especial atención al compromiso del oído externo por ella.

The pinna and the ear canal are an anatomical region that can be affected by many diseases, including inflammatory, infectious and benign and malignant neoplastic processes. With regard to tumors, various types usually present with similar symptoms and usually is very difficult to know the histological type through physical examination, so histopathological examination is necessary in order to determine the diagnosis. Most tumors are carcinomas; they can be basal cell carcinoma (more frequently), or squamous carcinoma. Less frequently are other types of tumors such as melanomas, adenocarcinomas, ceruminous glands carcinomas, mucoepidermoid carcinomas, sarcomas, lymphoproliferative disorders, etc. They usually present in middle and advanced age people (50-70 years) and are more frequently in men. In this article we present a case of squamous cell carcinoma of the external ear with extention to parotid gland, successfully treated with surgery and radiotherapy, as well as we describe the clinical characteristics of this disease, with special attention to the compromise of the external ear. (AU)

Management Issues in the Treatment of an Ameloblastoma with an Atypical Presentation.

Benign ameloblastoma (BA) is the most common tumor arising from the odontogenic epithelium. Surgical resection with adequate margins is the mainstay of treatment due to the high index of tumor recurrence when not completely excised. Although locoregional spread has been described in the literature, it is very uncommon. We describe the treatment and follow-up of a 22-year-old woman with multiple recurrences and locoregional spread of a mandibular ameloblastoma who was referred to our center after several tumor resections with subsequent reconstructions. After a complete macroscopical removal of a new recurrence, the mandible was primarily reconstructed. A local homolateral recurrence and a second lesion in the contralateral maxilla were detected after 1-year follow-up and accordingly treated. After 4 years the patient showed a new tumor in the temporal fossa and was reoperated. The histopathology was consistent with a BA in all cases. Even though it is rare, locoregional spread of BA has been reported previously. Recurrences discovered during follow-up may require further resections. A close follow-up is mandatory, and treatment of these cases may result demanding requiring a multiple team approach, including oncologists and radiotherapists.