Hydatid Cyst of Parotid Gland: An Unusual Case Diagnosed by Fine Needle Aspiration Biopsy.

Hydatid disease is a zoonotic disease caused by the parasite Echinococcus granulosus. This infection frequently infects the liver and the lung and even in endemic regions rarely occurs in the head and neck region. This is also true for the parotid gland. The diagnosis relies on imaging techniques and the medical history. Another method that is helpful in the diagnosis is serological tests. Fine-needle aspiration biopsy is usually not recommended due to the potential risk of anaphylactic shock or spreading of daughter cysts. The preferred treatment method of hydatid cysts in the salivary gland is surgical excision. We introduce a rare case of hydatid cyst in the parotid gland diagnosed preoperatively by fine-needle aspiration biopsy and discuss the differential diagnosis.

Malignant epitheloid angiomyolipoma of the kidney in a child treated with sunitinib, everolimus and axitinib.

The malignant variant of epithelioid angiomyolipoma (EAML) of the kidney is uncommon, extremely aggressive and behaves like a renal cell carcinoma. We present a case of a 12-year-old male with malignant EAML who was treated according to adult treatment protocols. To our knowledge, axitinib has not been used before in children. We conclude that adult protocols, in this rare case, could be safely used in rare childhood malignancies.

Obesity related measurements and joint space width in patients with knee osteoarthritis.

BACKGROUND: The aim of this study is to analyze the relationship between body mass index and obesity related measurements and tibiofemoral joint space which have been the principal method of radiographic evaluation in progression and therapeutic trials of knee osteoarthritis. METHODS: Fifty-five female patients with the diagnosis of osteoarthritis in knees according to the criteria of American College of Rheumatology in knees were included in the study. The mean age of patients was 57,42+/-8,60(SD) years with a range of 42-77. Medial and lateral compartment joint space widths were measured on antero-posterior knee radiography. Body mass index, triceps, biceps, subscapular and suprailiac skinfold thickness, waist and hip circumference were measured. Body composition was determined by dual energy X-ray absorpsiometry (DEXA) (Norland XR 46) and total lean mass (g), total fat mass (g), trunk lean mass, trunk fat mass, abdomen lean mass, abdomen fat mass measurements were recorded. RESULTS: Patients with body mass index>30 were accepted as obese patients. According to these criteria 33 of the 55 patients were obese. Tibial medial compartment and tibial lateral compartment measurements of obese patients were significantly lower than nonobese patients (p=0,000, p=0,003 respectively). Body mass index was correlated with total lean mass, total fat mass, trunk fat mass, abdominal fat mass, leg fat mass. Tibial medial compartment and tibial lateral compartment space measurements were negatively correlated with body mass index. CONCLUSION: Our results revealed significant difference in both medial and lateral joint spaces of obese and nonobese patients with knee osteoarthritis. Medial and lateral joint spaces of obese patients were narrower than nonobese osteoarthritis patients. The more body mass index had the patients the narrower joint space they had displayed. However body composition analysis and obesity related measurements did not show additional correlation with tibial compartment measurement.

Bronchiolitis obliterans organizing pneumonia associated with sulfasalazine in a patient with rheumatoid arthritis.

Pulmonary toxicity and blood dyscrasias are rare side effects of sulfasalazine. Pulmonary pathology is variable, the most common being eosinophilic pneumonia with peripheral eosinophilia, and interstitial inflammation with or without fibrosis. We here present the case of a 68-year-old female patient treated for 6 months with sulfasalazine for rheumatoid arthritis. On laboratory examination, eosinophil count was 97 x 10(3) mm(3). Thorocoscopic biopsy was performed. Histopathologic diagnosis was bronchiolitis obliterans organizing pneumonia (BOOP). This is the first case in the literature to present with sulfasalazine-induced BOOP in a patient with seronegative RA.

Ultrasound-guided versus 'blind' intraparotid injections of botulinum toxin-A for the treatment of sialorrhoea in patients with Parkinson's disease.

OBJECTIVE: To investigate the efficacy and safety of intraparotid botulinum toxin-A (BTX-A) injections into parotid gland using ultrasound-guided versus nonguided techniques for the treatment of sialorrhoea in patients with Parkinson's disease (PD). METHODS: 15 patients with PD and sialorrhoea were included and divided into two groups. Group A patients (n=8) were injected with BTX-A using ultrasound guidance. Group B patients (n=7) were injected with BTX-A without ultrasound guidance. Saliva secretion was assessed quantitatively at baseline and at weeks 1, 4, and 12. Patients and/or caregivers also assessed the saliva secretion using visual analog scale (VAS). RESULTS: All patients except one reported subjective improvement in sialorrhoea at the first week. Group A patients showed significantly higher rate of saliva reduction at the first week, whereas in Group B the reduction was not statistically significant from baseline at the first week (P>0.05). Comparisons of quantitative saliva assessments at each follow-up visit also showed that ultrasound-guided injections were superior to blind injections for saliva reduction. VAS scores showed an improvement in the mean rate of saliva secretion in each group at first week (P<0.05). Two patients suffered from dry mouth in mild severity lasting 1 month. CONCLUSION: Intraparotid BTX-A injections using ultrasound guidance may be an effective, easy, and safe treatment for parkinsonian sialorrhoea.