Subject(s)
Carcinoma, Squamous Cell , Maxillary Sinus Neoplasms , Humans , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/surgery , Maxillary Sinus Neoplasms/pathology , Maxillary Sinus Neoplasms/diagnostic imaging , Maxillary Sinus Neoplasms/surgery , Male , Tomography, X-Ray Computed , Cholesteatoma/surgery , Cholesteatoma/pathology , Cholesteatoma/diagnostic imaging , Middle Aged , FemaleABSTRACT
El colesteatoma congénito (CC) es una lesión benigna de epitelio escamoso queratinizado que puede afectar diferentes aéreas del hueso temporal con predominio en el oído medio. El CC es una patología poco frecuente que se presenta en pacientes pediátricos y clínicamente se manifiesta como una lesión blanquecina detrás de un tímpano indemne. La mayoría de los pacientes no presenta historia de hipoacusia, otorrea, infección, perforación o cirugía otológica previa. Se analiza el caso de un prescolar con CC que consultó con trastorno de sueño sin sintomatología otológica, pero con otoscopía alterada como hallazgo clínico. En la resonancia magnética nuclear (RMN) con secuencia de difusión, se evidenciaron hallazgos sugerentes de lesión colesteatomatosa en oído medio. Se realizó tratamiento quirúrgico endoscópico combinado con remoción completa de la lesión compatible histológicamente con CC y reconstrucción funcional con prótesis inactiva con resultado auditivo satisfactorio. El CC requiere alta sospecha diagnóstica por pediatras y otorrinolaringólogos, siendo imprescindible realizar un examen físico acucioso que incluya otoscopía de rutina, aunque el paciente no manifieste síntomas otológicos. El tratamiento es quirúrgico y debe considerar uso de endoscópico para asegurar una extracción completa de la lesión. En algunos casos es requerido realizar una reconstrucción auditiva para asegurar un óptimo resultado funcional.
Congenital cholesteatoma (CC) is a benign lesion of keratinized squamous epithelium that can affect different areas of the temporal bone, predominantly in the middle ear. CC is a rare pathology that occurs in pediatric patients and clinically manifests as a white lesion behind an intact eardrum. Most patients do not have a history of hearing loss, otorrhea, infection, perforation, or previous otologic surgery. The following, is the case of an infant with CC who consulted with a sleep disorder without otological symptoms but with altered otoscopy as a clinical finding. Nuclear magnetic resonance (NMR) with diffusion sequence with findings compatible with a cholesteatomatous lesion in the middle ear. Endoscopic surgical treatment was performed combined with complete removal of the lesion histologically compatible with CC and functional reconstruction with inactive prosthesis with satisfactory hearing results. CC requires high diagnostic suspicion by paediatrics and otorhinolaryngologists, and it is essential to perform a thorough physical examination that includes routine otoscopy even if the patient does not show otological symptoms. Treatment is surgical and endoscopic use should be considered to ensure complete removal of the lesion. In some cases, hearing reconstruction is required to ensure optimal functional results.
Subject(s)
Humans , Female , Child, Preschool , Cholesteatoma/congenital , Cholesteatoma, Middle Ear/congenital , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Cholesteatoma/diagnostic imaging , Cholesteatoma, Middle Ear/diagnostic imagingABSTRACT
Resumen El colesteatoma congénito es una entidad que puede manifestarse con una amplia variedad de síntomas o ser silente durante largo tiempo y constituir un hallazgo incidental. Una vez diagnosticada es importante valorar su extensión y el compromiso de estructuras adyacentes, para lograr una adecuada planificación quirúrgica, eliminando la enfermedad y manteniendo la mejor funcionalidad posible. Se presenta un caso de colesteatoma congénito infantil.
Abstract Congenital cholesteatoma is an entity that can manifest with a wide variety of symptoms or be silent for a long time and constitute an incidental finding. Once diagnosed, it is important to assess the extension to apply the most efficient treatment, eliminating the disease and providing functionality if possible. A case of congenital cholesteatoma in a child is presented.
Subject(s)
Humans , Female , Child, Preschool , Cholesteatoma/congenital , Cholesteatoma/diagnostic imaging , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Cholesteatoma/surgery , Mastoidectomy/methods , MastoidABSTRACT
We report the case of a 57-year old patient with complex cystic image in right kidney. Following radical nephrectomy, the pathological study established the diagnosis of renal cholesteatoma. We discuss the frequency, pathogenesis, clinical presentation, propedeutics, histological findings and proposes for intervention observed in the literature.
Subject(s)
Cholesteatoma/diagnosis , Kidney Diseases/diagnosis , Cholesteatoma/diagnostic imaging , Cholesteatoma/surgery , Humans , Kidney Diseases/diagnostic imaging , Kidney Diseases/surgery , Male , Middle Aged , Tomography, X-Ray ComputedABSTRACT
A 7-month-old male child is reported with congenital cholesteatoma of the external auditory canal. We describe the clinical features, computed tomography finding and surgical treatment. Congenital cholesteatomas can occur within the temporal bone. There are six places of location: (1) petrous apex, (2) mastoid, (3) middle ear, (4) both middle ear and mastoid, (5) external ear canal and (6) within the squamous portion of the temporal bone. Congenital cholesteatoma of the external auditory canal is rare. Generally, it appears in the canal floor without lesions in the tympanic membrane. Computed tomography completes the study. Treatment consists of excision of the mass.
Subject(s)
Cholesteatoma/congenital , Cholesteatoma/diagnostic imaging , Ear Canal/abnormalities , Ear Canal/diagnostic imaging , Ear Neoplasms/congenital , Ear Neoplasms/diagnostic imaging , Cholesteatoma/surgery , Ear Canal/surgery , Ear Neoplasms/surgery , Humans , Infant , Male , RadiographyABSTRACT
Cholesteatoma of the external ear canal is rare in otological practice. The case of a 62-year-old woman with local extension but scant symptoms or signs is reported. The literature is reviewed and the cause and treatment are discussed.
Subject(s)
Cholesteatoma/surgery , Ear Canal/surgery , Aged , Cholesteatoma/complications , Cholesteatoma/diagnostic imaging , Diagnosis, Differential , Ear Canal/diagnostic imaging , Female , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/etiology , Humans , Keratosis/diagnosis , Tomography, X-Ray ComputedABSTRACT
The computerized tomography (C.T.) of 18 patients with sellar tumours were analysed. The C.T. made before surgery in 6 cases was positive in 3 and the type of tumour suggested by C.T. was confirmed in 3. Twelve patients had a C.T. investigation after surgery and the examination suggest recurrent tumour in 5. Two of these were re-operated. One patients with cholesteatoma had the recurrent tumour verified by surgery and the other, with a pituitary adenoma during re-operation was noted only cicatricial tissue at sellar region.