Thyroid tuberculosis associated with papillary microcarcinoma: case report and review of literature.

Introduction: Thyroid tuberculosis (TB) is extremely rare. Infection may first occur in the thyroid gland or may be secondary to TB in other parts of the body. The diagnosis is rarely made clinically because the disease's variable presentation often resembles that of a malignancy or an euthyroid nodular goiter. Case report: We present the case of a 40-year-old woman, who presented multiple thyroid nodules in both lobes. Two of these nodules were classified as EU-TIRADS V (European Thyroid Imaging and Reporting Data System). The ultrasound also found an adenopathy of the inferior part of the jugular lymphatic chain, in favor of malignancy. The histopathological examination after total thyroidectomy showed thyroid TB, associated to a papillary microcarcinoma of the right thyroid lobe, and the final examination of the adenopathy showed similar granulomas with caseous necrosis, and no signs of metastasis. Clinical discussion: Thyroid TB is very rare. Its diagnosis is difficult due to a lack of specific signs and symptoms, which is why the diagnosis is most commonly made on pathological examination after thyroid surgery. It is well known that mycobacterial infection creates an environment of chronic and persistent inflammation, with possible DNA damage. This can create a microenvironment that is highly conductive to carcinogenesis, which could explain the discovery of papillary microcarcinoma in addition to thyroid TB in our patient. Conclusion: This report presents a rare case of malicious growth development of thyroid nodules and thyroid TB. Therefore, physicians must always be vigilant when managing thyroid nodules, as there is always the possibility of malignant lesions associated to an inflammatory or infectious cause.

A rare case of headache in a 4-year-old child: sphenoiditis.

BACKGROUND: Isolated sphenoidal sinusitis is an uncommon cause of headaches in children and adolescents. Recognizing the condition on physical examination alone can be challenging, and delayed diagnosis often occurs. CASE PRESENTATION: A 4-year-old child presented with symptoms of headache, fever, and vomiting. Nasal endoscopy, computed tomography (CT), and magnetic resonance imaging (MRI) were used to confirm the diagnosis of isolated sphenoiditis. The patient was treated with antibiotics and steroids. However, the patient developed meningoencephalitis as a complication of the untreated isolated sphenoiditis. CONCLUSION: Isolated sphenoidal sinusitis can lead to serious complications if left untreated. Adjunctive imaging and prompt treatment are essential to prevent such complications in children and adolescents. This case highlights the importance of considering isolated sphenoiditis in the differential diagnosis of pediatric headaches and the need for early diagnosis and treatment.

Odontogenic myxoma of the maxilla: A rare case report and review of the literature.

Introduction: Odontogenic myxoma (OM) is an uncommon benign odontogenic tumor arising from the jaw bone. The diagnosis poses a challenge because its clinical features overlap with those of other benign and malignant neoplasms. Although surgery is usually the choice treatment, there is still some controversy concerning surgical techniques and proper indications. Case report: We present the unusual case of an odontogenic myxoma involving the maxilla, diagnosed in a 31 years old patient presenting to our department for facial swelling through computed imaging and pathological analysis. After careful consideration, the patient was treated with conservative surgery, with a satisfying end result. Discussion: Because of its slow growth, odontogenic myxoma is often asymptomatic. The diagnosis is based on clinical, radiological and histological caracteristics. Complete surgical excision is the treatment of choice, but it can be challenging because of the tumor's indistinct margins. Conclusion: Though there are still no clear guidelines for the management of OM in the head and neck region, the general consensus is that the surgical excision should be complete, and patients treated in a conservative manner should benefit from regular follow-ups.

Unusual Location of a Fungus Ball: The Concha Bullosa, a Review of the Literature.

INTRODUCTION: The fungal balls of the paranasal sinuses are usually seen in the maxillary and sphenoid sinuses. Although, the lesion of the concha bullosa, without sinus participation, is very uncommon. We report the case of a fungal ball of concha bullosa in an 88-year-old patient. OBJECTIVE: The objective of our review of literature is to investigate the epidemiological, clinical, paraclinical, and therapeutic characteristics of patients diagnosed with fungus ball in concha bullosa. METHODS: A case of a patient who was diagnosed with concha bullosa of a fungus ball is reported. Demographic data, clinical presentation, imaging, and treatments were recorded. Key images were obtained. A review of the literature was also performed. RESULTS: A total of 12 cases have been reported so far in the literature revealed by different symptoms. The mean age was 38.8 years and the gender ratio was ∼12 (female):1 (male). The endoscopic surgical approach was the most frequently used treatment and provides good outcomes. Neither postoperative complications nor recurrences were noted, however, there is insufficient follow-up data. CONCLUSION: Concha bullosa fungal ball is a rare diagnosis that can be revealed by different symptoms. It should be considered in patients with and unexplained chronic facial pain. A preoperative computed tomography scan is an essential tool in making a diagnosis. Endoscopic surgery is the treatment of choice, with a low morbidity and recurrence rate.

Huge pilomatrixomas of the scalp: A case report.

Pilomatrixoma is a rare benign skin tumor differentiating toward hair matrix cells usually encountered in the head and neck region. It is most frequently appearing in the first and second decades of life. Histopathological examination is essential to make definitive diagnosis. Herein, we present an atypical case of multiple pilomatrixomas. A 69-year-old man with multiple voluminous masses over the scalp. Among the three lesions, one was clinically suspicious for malignancy, it measured 17 cm and was ulcerated in places. Histopathology confirmed the diagnosis of pilomatrixoma. The tumors were removed surgically with free margins. Otolaryngologist should be familiar with this benign tumor when evaluating soft-tissue mass in the head and neck region.

Specific aspects of tympanoplasty in children: A retrospective cohort study of 95 cases.

BACKGROUND: Paediatric tympanoplasty is now a common surgical procedure. The age from which it could be proposed varies regarding children specificities such as Eustachian tube dysfunction, the high incidence of upper airway infections and the immaturity of the immune system. The aim of this study is to describe the specific constitutional, epidemiological and operative aspects as well as the anatomical and functional results of tympanoplasty in children. METHODS: From 2014 to 2018, a cohort of 95 patients with ages between 6 and 16 years, operated for a type I tympanoplasty, was reviewed by analysing the medical history, the epidemiological and clinical parameters, in addition to the operative features and the functional results. RESULTS: The mean age at surgery was 11,7 years. The main risk factors of tympanic perforation were recurrent otitis (78,9%), auricular trauma (16,8%) and tonsillar and adenoid hypertrophy (7,4%). Good anatomical postoperative results with a closed and reinforced neo-tympanic membrane were seen in 90 (94,7%) cases, while a significant improvement of the hearing loss was observed in 87 (91.6%) patients, with a mean value of 34,23 dB HL before and 21,9 dB HL after surgery (p < 0,0001). CONCLUSIONS: The indications of type I tympanoplasty in the paediatric population remain a subject of debate, but still offer good anatomical and functional results as long as it is adapted to each particular case.

An atypical presentation of a bilateral nasolabial cyst: a case report.

The nasolabial cyst is a rare, non-odontogenic, soft tissue cyst that develops submucosally in the anterior nasal floor. This cyst accounts for 0.7% of all non-odontogenic cysts. Bilateral nasolabial cyst represents only 10% of the cases. This cyst originates from the remnants of embryonic nasolacrimal duct tissue. Generally, patients present with swelling and facial deformity and rarely local pain. The definite diagnosis should be based on clinical, radiological and above all histopathologic findings. The treatment is enucleation of the cystic tissue. Following is a case report of a bilateral nasolabial cyst in a 40-year-old woman who presented with a chronic nasal obstruction.

An unusual presentation of a nodular hidradenoma: A case report and review of the literature.

Nodular hidradenoma is a rare benign adnexal tumor. It is most frequently encountered in the head and neck region, trunk, and extremities. This tumor exhibits a high recurrence rate, and an association with malignancy.Many names have been used to describe this pathology.We report the case of a nodular hidradenoma in a 30-year-old moroccan woman who presented with a 2-year history of a swelling in her right preauricular region. Histological examination revealed the typical appearance of a nodular hidradenoma. The tumor was excised and one year after the initial presentation, there was no sign of recurrence. We emphasize the importance of wide surgical excision with appropriate margins to prevent local recurrence. A close follow up of the patients is recommended.

Mucosal hirudiniasis presenting as palatal mass: A case report and review of the literature.

This paper presents the case of a 5-year-old child who presented with an 15-day history of a swelling over the palatal region and blood stained saliva. Intraoral examination showed dark red circular mass rising from the hard palate. Diagnosis of mucosal hirudiniasis have been made. The parasite has been extracted under local anesthesia using a blunt forceps, it has been identified as an adult Limnatis nilotica. Leech endoparasitism must be suspected in case of bleed from throat, dysphagia or any other related symptom, especially in pediatric patients who have been exposed to freshwater. Prevention remains the best medicine.