A rare case of follicular thyroid carcinoma metastasis to the sacral region: A case report with literature review.

INTRODUCTION: Follicular thyroid carcinoma (FTC) is the second most common thyroid cancer subtype after papillary thyroid cancer (PTC), and it accounts for approximately 10% of all thyroid cancers, the incidence of distant metastasis in FTC has been reported to be 6-20%, bones and lungs are the most frequent sites of distant metastases. Most occult thyroid carcinomas are papillary carcinoma. CASE PRESENTATION: We describe an extremely rare case of a 74-year-old woman who had a history of right thyroid lobectomy 20 years ago, was referred to our hospital for metastatic thyroid follicular carcinoma to the sacral region confirmed by the biopsy of the sacral mass. The patient was treated by analgesic radiotherapy, surgical totalisation of thyroidectomy, and Radioactive Iodine, with thyroid replacement by levothyroxine. In the follow up we noticed a significant symptom reduction leading to a much better quality of life. CONCLUSION: Increasing importance should be given to rare metastases in DTP patients. Early detection will help in the early diagnosis and treatment of the disease, thereby improving the patient's survival rate and quality of life.

An unusual combined glomus vagale and jugular tumor: A case report.

INTRODUCTION: and importance: Head and neck paragangliomas are slowly growing benign tumors and they originate from specialized neural crest cells. We report an unusual combined glomus vagal and jugular tumor that was rarely described in the literature to the best of our knowledge. CASE PRESENTATION: A 51 years old female with no pathological history was presented to our ENT department with 6 months' history of a right latero cervical swelling gradually increasing in size associated with a swallowing difficulties and hoarseness. Preoperatively clinical examination had found vagal and hypoglossal nerve paralysis. Cervical CT scan and MRI had shown glomus jugular tumor. The patient underwent a surgical excision with severe swallowing difficulties and facial palsy in the immediate postoperative period with a mild recovery afterwards. CLINICAL DISCUSSION: Paragangliomas of the mesotympanum and jugular foramen most commonly present as a vascular middle ear mass. The most common presenting symptom is pulsatile tinnitus occurring in 80% followed by hearing loss (60%). Dysfunction of cranial nerves traversing the jugular foramen may be commonly encountered with resultant abnormalities of speech, swallowing and airway function. Vagal paragangliomas are the least common of the three primary craniocervical paragangliomas. The most common presenting sign is the presence of a painless neck mass accompanied occasionally by dysphagia and hoarseness. The association of both glomus vagal and jugular tumor is rarely described in the literature to the best of our knowledge. CONCLUSION: Head and neck paragangliomas are slowly growing benign tumors and they originate from specialized neural crest cells. Vagal paragangliomas are the least common of the three primary craniocervical paragangliomas. The association of both glomus vagal and jugular tumor is rarely described in the literature to the best of our knowledge. The choice of treatment depends on the location, size, and also biologic activity of the tumor as well as the physical condition of the patient.

Intermittent dysphagia revealing a lateropharyngeal neurofibroma in a child: Case report: A case report.

INTRODUCTION: Neurofibromatosis type 1 (NF1) is an disorder characterised by various phenotypic features like hyperpigmented spots, neurofibromas, Lisch nodules, skeletal abnormalities and tendency to develop neoplasms. CASE PRESENTATION: We present the case of a 12-year-old patient referred by his pediatrician for intermittent dysphagia and a sensation of food attachment, in whom several café-au-lait spots on the body had been found, and a case of type 1 neurofibromatosis in the patient's siblings. The decision was to closely follow-up the patient, the progression of his symptoms and the size of the cervical neurofibroma. The patient's current follow-up has been two years, with a minimal increase in the frequency of episodes of dysphagia, and with Ct-scan performed every year. No major growth of the cervical mass was noted. DISCUSSION: Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder characterised by various phenotypic features like hyperpigmented spots, neurofibromas, Lisch nodules, skeletal abnormalities and tendency to develop neoplasms. CONCLUSION: The treatment is not codified and abstention therapeutic may be a wise decision.

Primary Non-Hodgkin Lymphoma of the temporal bone: A rare case report.

INTRODUCTION: Primary lymphoma of the temporal bone is extremely rare, difficult to diagnose and to manage. It is essential that the clinician keeps in mind the possibility of this pathology as a differential diagnosis with the infections resistant to the usual treatment. CASE REPORT: We report a rare case of a diffuse large B-cell lymphoma in a 70-year-old- woman, with history of diabetes. The pathological study was in favor of a Non-Hodgkin Lymphoma of the Temporal Bone. DISCUSSION: Lymphomas defined as malignant monoclonal proliferation of lymphoid cells, are not uncommon in the head and neck region. Literature presents with few cases. CONCLUSION: The aim of this article is to report a rare case of a diffuse large B-cell lymphoma with primary mastoid and external auditory canal infiltration without systemic involvement initially presented as a benign ear infection.

A rare cause of cervical swelling: Solitary plexiform neurofibroma.

INTRODUCTION: Plexiform cervical neurofibromas are benign neoplasm, extremely rare, difficult to diagnose and to manage. Only some cases have been reported in the literature. CASE PRESENTATION: We report the case of a 60-year-old man admitted for a lateral neck mass, for which the surgical indication was the increase in volume of this mass, as well as the aesthetical impairment, the surgical exploration found the tumor attached to the cervical plexus. The excision of the mass was performed without damaging nerve. The pathological study was in favor of a plexiform neurofibroma. DISCUSSION: Even though Plexiform cervical neurofibroma are extremely rare, and their diagnosis are not often primary evoked in front of any growing mass of this region, the surgeon must keep in mind the existence of these neoplasms as a differential diagnosis of a neck tumor. CONCLUSION: Surgery remains the gold standard in the treatment of these locally invasive tumors. It is essential that the surgeon keep in mind the possibility of these tumors as a differential diagnosis of a neck tumor.

Synovialosarcoma of the pharynx: A case report and literatture review.

INTRODUCTION: Synovial sarcoma is a rare tumor to be encountered in the head and neck region and is always a challenge in terms of diagnosis, treatment, as our case. PRESENTATION OF CASE: We present a 23-year old female patient with synovial sarcoma of posterolateral pharyngeal wall. The radiological and clinicopathological features along with various diagnostic tests and treatment options are discussed. DISCUSSION: The objective of this study is to describe - from a clinical case reported from our institution, and from literature review- the clinical, radiological and histological features of pharyngeal synovial sarcoma and to discuss its therapeutic management. CONCLUSION: Synovial sarcoma of pharynx is extremely a rare tumor in current practice.

AGGRESSIVE PAPILLARY CARCINOMA OF THE LATERAL ABERRANT THYROIDE: A CASE REPORT AND REVIEW OF THE LITERATTUREggressive papillary carcinoma of the lateral aberrant thyroide: A case report and review of the literatture.

INTRODUCTION: Ectopic thyroid tissue can be found in many sites. Ectopic thyroid tissue may also be involved in the same processes as normal thyroid gland. These processes include tumors, inflammation and hyperplasia. The appearance of such tissue in rare locations may lead to diagnostic and therapeutic dilemmas. PRESENTATION OF CCASE: We report a rare case of primary papillary carcinoma in an ectopic thyroid in the jugulocarotid regionbased on the bifurcation of the carotid artery, in a 62-year-old woman with history of diabetes and high blood pressure, with a normal thyroid gland. DISCUSSION: The origin of lateral ectopic thyroid tissue is not fully understood and controversial.The lateral localisation is a rare entity and debated extensively in the literature. CONCLUSION: Though rare, the possibility of an ectopic thyroid carcinoma must always be considered by the surgeon in cases of a pathological mass in the neck.

Buccal region's Kimura disease in a pediatric patient: A case report and review of the literatture.

INTRODUCTION: Kimura disease is a chronic inflammatory disorder that mainly manifests as a swelling in the neck region AlGhamdi et al. (2016). However, its occurrence in the oral cavity is extremely rare Lee et al. (2017). It usually affects young men of Asian race but it is rare in other races Fouda et al. (2010). We report an extremely rare case of Kimura disease of the buccal region in a pediatric patient. The treatment consists of surgery combined with systemic steroid therapy. DISCUSSION: The etiology of KD is unknown. Although the presence of eosinophilia and increased IgE, tumor necrosis factor (TNF)-a, interleukin (IL)-4, IL-5, IL-13 levels, and mast cells in peripheral blood, as well as in the affected tissue, were observed in patients Sun et al. (2008). No specific antigens have been identified. The optimal management strategy for KD has not yet been established. The treatment is variable Fouda et al. (2010) and Su et al. (2019). It includes surgical excision, regional, or systemic steroid therapy, and radiotherapy Sun et al. (2008). CONCLUSION: KD is a rare chronic inflammatory disorder of unknown etiology Fouda et al. (2010) and Kim and Szeto (1937). The diagnosis can be only confirmed by histopathological features.

Endoscopic resection of solitary fibrous tumor of the ethmoid: Case report review of the literature.

INTRODUCTION: Solitary fibrous tumour (SFT), as are benign neoplasms of fibroblastic cells. Nasosinusal localisation is exremely rare, difficult to diagnose and to manage. CASE REPORT: We report a rare case of Solitary fibrous tumour in the nasal cavity in a 47-year-old- woman, with complete surgical resection. DISCUSSION: SFTs are of mesenchymal origin, mainly from serous membranes. The head and neck region is affected with a percentage ranging from 5 to 27%. On the other hand, LTS unusually affects the nasal tract (NTS). Because of this rarity and its variable morphological appearance, it is difficult to distinguish TNS from other mesenchymal lesions. CONCLUSION: Although there are no standard clinical guidelines, the preferred treatment for FLS is radical surgical resection.