ABSTRACT
The purpose of this paper is to present and discuss a new case of malignant vagal paraganglioma. A 38-year-old woman was referred for the assessment of a bilateral firm cervical mass. CT scans revealed a left cervical ovoid mass; contralaterally, a mass with a similar enhancement could be observed too. The tumor was surgically removed via a transcervical surgical approach, together with levels I to III lymph nodes. Definitive histopathological examination proved the diagnosis of malignant vagal paraganglioma with contralateral cervical lymph node metastasis. One year after surgery, a PET-CT and a scintigraphy revealed the presence of a cervical recurrence and hepatic metastasis. Three months after a second surgical intervention, the patient died. Malignant vagal paraganglioma is a rare and challenging lesion that has to be carefully assessed to plan an appropriate treatment. A strict follow-up is fundamental for an early diagnosis of eventual recurrences.
Subject(s)
Cranial Nerve Neoplasms/surgery , Paraganglioma, Extra-Adrenal/surgery , Vagus Nerve Diseases/surgery , Adult , Cranial Nerve Neoplasms/pathology , Fatal Outcome , Female , Humans , Liver Neoplasms/secondary , Lymphatic Metastasis , Neoplasm Recurrence, Local/pathology , Paraganglioma, Extra-Adrenal/secondary , Tomography, X-Ray Computed , Vagus Nerve Diseases/pathologyABSTRACT
Thornwaldt cysts are rare and benign congenital cysts in the region of the pharyngeal bursa, formed by a communication between the notochord and the nasopharyngeal endoderm. They result from a mechanical obstruction, inflammation, or abscess of the pharyngeal bursa. They are superficial to the superior constrictor muscle and covered by the nasopharyngeal mucous membrane. Most cases are asymptomatic, and patients may rarely present symptoms such as nasal obstruction, foreign body sensation, hearing loss, and periodic halitosis. Therefore, they are often accidentally diagnosed on MRI. Asymptomatic cysts do not require treatment, whereas symptomatic cases require surgical intervention by endonasal or transoral approach. Marsupialization is the procedure of choice to avoid recurrences. The aim of this article is to present and discuss 2 cases of Thornwaldt cysts.
Subject(s)
Cysts/diagnosis , Nasopharyngeal Diseases/diagnosis , Adolescent , Cysts/congenital , Diagnosis, Differential , Female , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Nasal Obstruction/diagnosis , Nasopharyngeal Diseases/congenitalABSTRACT
Soft tissue giant cell tumor (GCT-ST) of low malignant potential, also called primary giant cell tumor of soft tissue, is usually located in the lower extremities and trunk, whereas it is extremely rare in the head and neck region. It is a rare neoplasm involving both superficial and deep soft tissues that mainly affects young to middle-aged adults, presenting as an asymptomatic, well-circumscribed multinodular mass covered by normal skin or with a fleshy red-brown surface when superficially located. The purpose of this article is to report a case of osteoclast-like giant cell tumors of the lip and to review the literature about GCT-STs involving the head and neck region.
Subject(s)
Giant Cell Tumors/pathology , Lip Neoplasms/pathology , Adult , Buttocks , Female , Giant Cell Tumors/surgery , Humans , Lip Neoplasms/surgery , Soft Tissue Neoplasms/secondary , Soft Tissue Neoplasms/surgeryABSTRACT
Parapharyngeal space (PPS) tumors are rare and benign in 80% of cases. Since surgeons first resected this anatomical region, the surgical approach to PPS bulks has been a hot topic due to their shape and the important structures involved. We present a series of patients treated with a transcervical or transcervical-transparotid approach to benign PPS tumors without mandibulotomy. Between May 2003 and March 2009, 18 patients (11 male and 7 female) with benign PPS tumors underwent a surgical resection, avoiding mandibulotomy. Average age of the patients was 49 years (range 3-76), average tumor size was 5.5 × 4 × 3 cm and histological examination of the resected tumors showed: seven pleomorphic adenomas of the deep parotid lobe, four schwannomas, two mycobacteriosis, two paragangliomas of the vagus nerve, one lipoma, one neurofibroma and one cavernous hemangioma. Seven patients underwent a transcervical approach, while 11 patients underwent a transcervical-transparotid approach. Excision of benign PPS tumors is possible without mandibulotomy even in the case of a large tumor mass, but exposure with the mandible in situ is certainly poor. Avoiding mandibulotomy reduces patient morbidity and hospital stay. In our experience, mandibulotomy can be avoided in most cases of benign PPS tumors leaving this procedure for malignant tumors or in patients with very poor exposure.
