[Inflammatory myofibroblastic pseudotumor of the tongue]. / Pseudotumeur myofibroblastique inflammatoire de la langue.

INTRODUCTION: Inflammatory myofibroblastic tumor (IMT) is a new entity recently described, first in the lung. IMT are found throughout the body. CASE: We report a very rare tongue localization in a 22-year-old white woman. After a first diagnosis of fibrosarcoma, a new examination of the slide and immunohistochemical examination led to the definitive diagnosis of inflammatory myofibroblastic tumor of the tongue and not fibrosarcoma. DISCUSSION: IMT are rarely encountered in the head and neck region. Only 2 cases of IMT of the tongue have been reported in the world literature. Diagnosis of IMT is immunohistochemical. Spindle cells were reacted for smooth-muscle actin and vimentin. Treatment is surgical. The contribution of radiotherapy is not clear because of the small population of patients studied.

Extracranial cephalic schwannomas: a series of 15 patients.

The aim of this study was to report a series of extracranial cephalic schwannomas. Fifteen patients with extracranial schwannomas treated between 1981 and 1999 are presented, and their clinical course during a median follow-up of 4.1 years is discussed. There is a female predominance. No specific factors have been identified. Their diagnosis is often delayed (median, 2.6 years). There is no predominant side. The orbit represents the most frequent location of schwannomas (26%). The trigeminal nerve is the most often affected (53%). Computed tomography and magnetic resonance imaging contribute to the diagnosis. Macroscopically, the schwannoma is a well-defined tumor of ovoid form and brownish color. It is formed of soft tissues and is fragmented easily. Diagnosis is often evident on microscopic examination. The only treatment is surgery. It consists of enucleation after opening the epineurium using an operating microscope, without interruption of the continuity of the nerve. The authors have observed only two relapses (the first two patients operated without a microscope). Total excision allows recovery. Nerve injuries have variable prognosis. It is necessary in juvenile populations to search for neurofibromatosis. All schwannomas required surgical treatment using an operating microscope to obtain total recovery.

[Reconstruction of the mouth floor using a musculo-mucosal buccinator flap supplied by facial vessels. Report of ten cases]. / Le lambeau myo-muqueux de buccinateur pédiculé sur les vaisseaux faciaux. Intérêt dans la reconstruction du plancher de la cavité buccale. A propos de 10 cas.

The buccinator muscle is a wide, flat quadrangular muscle. Its medial surface is covered by the oral mucosa. It receives its arterial blood supply from two main arteries: the facial and buccal arteries. A musculo-mucosal flap can be raised on the facial artery with or without the facial vein. In the case of absence of the facial vein, venous drainage is possible into the peri-arterial loose areolar tissue. A nasolabial skin incision facilitates facial artery identification and simplifies flap dissection in the loose areolar plane, superficial to the facial artery. The mean dimensions of the flap are 3.5 cm in width and 7 cm in length. The flap extends from the superior buccal sulcus to the inferior alveolar ridge. Its rotation enables reconstruction of the anterior and lateral floor of the mouth. The donor site is closed in two layers. The authors present a series of ten patients reconstructed with this flap after excision of a squamous cell carcinoma of the floor of the mouth. The results are excellent with perfect tongue function and no esthetic sequelae. The facial artery should be preserved during neck dissection, and the ipsilateral mandibular molar teeth must be extracted. Its simplicity and reliability makes this flap a useful alternative in floor of mouth reconstruction.

[Extracranial cephalic schwannomas. Apropos of 13 cases]. / Les schwannomes exocraniens de l'extrémité céphalique. A propos de 13 observations.

The authors report a series of 13 extracranial cephalic schwannomas, treated between 1981 and 1998. Schwannomas are rare and benign tumors derived from Schwann cells. Cephalic sites represent 2.5% of all schwannomas. Their diagnosis is often delayed, because symptoms mainly consist of compression disorders. There is a female predominance. The age distribution is homogeneous. There are no risk factors. There is no predominant side. The orbit and jugular foramen are the most frequent sites. The trigeminal nerve is usually involved. CT scan and magnetic resonance imaging (MRI) specify the topography and characteristics of the tumor and can contribute to the diagnosis. Macroscopically, schwannoma is a well-demarcated, ovoid or spherical, brownish tumor, off-centered from the nerve. It is composed of soft, easily fragmented tissue. The diagnosis is often obvious on microscopic examination and rarely requires immunohistochemical confirmation. The only treatment is surgical. It consists enucleation after opening the epineurium, using on operating microscope, without disruption of the nerve. Total excision ensures recovery. The authors have observed only one recurrence (first patient operated without microscope). Compression disorders regress completely. Nerve injuries have a variable prognosis. Malignant transformation is exceptional. Type II neurofibromatosis must be excluded in young patients.

[Enormous lingual lymphangioma]. / Lymphangiome lingual monstrueux.

The authors report a huge lymphangioma of the tongue in a sixty-seven years old female patient. The remarkable progression in dimensions of this lesion, leading to the inevitable protrusion of the tongue, led to the realization of an extended glossectomy, with a functional objective in mind. This simple procedure showed an excellent five years follow-up results. From this case report, the authors stress up on the etiopathogenic, pathological, clinical as well as therapeutic aspects of lingual lymphangioma.