ANCA-negative associated vasculitis initially presenting with pulmonary embolism.

Antineutrophil-cytoplasm antibodies (ANCA)-associated vasculitis are severe inflammatory pathologies that, although rare, may induce significant morbidity or death. Their impact on multiple organ systems implies an important variability in their clinical presentation, which might delay the diagnosis. In this setting we report on a case of ANCA-negative-associated vasculitis, initially presenting as pulmonary embolism with severe pulmonary infarction and digestive involvement. Literature is then discussed on these complications and their implications for therapy.

[Incidence of head and neck cancers in Belgium: comparison with world wide and French data ]. / Incidence des cancers ORL en Belgique en regard des données mondiales et françaises

The squamous cell carcinomas of the upper aerodigestive tracts are frequent neoplasia,with as much as 466,831 and 168,368 cases diagnosed in 2008 among men and women worldwide,respectively. As such, they make up the sixth most frequent neoplasia among men and the eighth among women. Their frequency shows interesting variations covering the last 20 years, with an ascending tendency among women, which is higher in Europe, and a descending tendency in men, maximal in the USA. The comparison with the Belgian official data reveals a striking elevation of incidence of these cancers between both sexes, with important regional differences in Belgium. Finally, when we compare Belgian and French data, these cancers seem more frequent in France in men, but there is an opposite tendency among women, in which the carcinoma of the larynx is most represented in Belgium. Although the limited quality of the data limits the interpretation of these data, they seem to be partly in line with the evolution of the risk factors of these pathologies.

Bisphosphonate-induced osteonecrosis of the jaw: a review of 2,400 patient cases.

PURPOSE: Bisphosphonates (BPs) are bone-remodeling inhibitors that are used to manage bone metastases and osteoporosis. Osteonecrosis of the jaw, however, can occur during treatment. This complication is poorly understood and is called "bisphosphonate-induced osteonecrosis of the jaw" (BIOJ). METHODS: We performed a PubMed-based review of all of the described cases of BIOJ from January 2003 (the year of the first description) to September 2009. Issues of clinical relevance, such as the primary diagnosis and type of treatment, were evaluated for each patient case. RESULTS: We retrieved 2,408 cases, 88% of which were associated with intravenous therapy, primarily with zoledronate. Of the total number of cases, 89% were associated with the treatment of a malignant condition, particularly multiple myeloma (43% of the cases). Of all the BIOJ cases, 67% were preceded by tooth extraction and only 35% of patients were cured. CONCLUSION: Prevention is better than treatment, and the establishment of meticulous oral hygiene and surgical procedures prior to commencing BP treatment is important for preventing BIOJ. Our review summarizes the current knowledge about this severe complication. Future studies, especially basic research studies, are needed to better understand this devastating disease.

Maxillary sinusitis caused by the migration of a silastic implant used for an orbital floor reconstruction: a case report.

OBJECTIVE: The authors report on a patient whose unilateral chronic maxillary sinusitis was caused by the migration of a silastic implant used for orbital floor repair. CASE REPORT: A 32-year-old woman presented with a three-year history of right-sided maxillary discomfort that was associated with a purulent discharge. Her medical history included chronic allergic rhinitis and the placement of a silastic implant after a right orbital floor fracture at the age of 14. The silastic implant was then removed endoscopically in a right maxillary sinus meatotomy. The symptoms improved within three weeks after surgery. CONCLUSION: Orbital implant migration is a rare cause of chronic unilateral sinusitis, and it must be suspected on the basis of a careful anamnesis, appropriate clinical examination, and sinus computed tomography. Misdiagnosing such a condition may increase patient morbidity by leading to inappropriate treatment.

Second branchial cyst in the parapharyngealspace: a case report.

OBJECTIVE: We report the clinical findings and management of a large retro- and parapharyngeal branchial cyst in a 54-year-old man whose only complaint was a 12-month history of snoring. METHOD: Case report and a review of the world literature concerning parapharyngeal cysts are presented. RESULTS: On computed tomography (CT) images, a well-marginated cystic mass was observed in the left retro- and parapharyngeal spaces, with displacement of the left internal and common carotid arteries. The cyst contained thick, sterile, yellowish pus, without malignant cells. We performed a transoral resection without any surgical complications. No recurrence was observed 2 years later. CONCLUSION: Parapharyngeal branchial cysts are rare and often paucisymptomatic. The transoral approach can provide good exposure allowing complete resection without significant post-operative complications or cervical scarring.

[Bisphosphonates and osteonecrosis of the jaw]. / Bisphosphonates et ostéonécrose maxillomandibulaire.

Today, bisphosphonates are very frequently used to relieve patients suffering from various bone diseases, mainly bone metastases and osteoporosis. They have been associated with numerous cases of maxillar and mandibullar osteonecrosis, a severe affection characterized by a high morbidity and for which no consensual treatment has been found yet. After a short update, the authors reviewed indications for bisphosphonates and its pharmacological properties. The pathogenesis, predisposing factors, symptoms, and clinical evaluation of this particular necrosis are described. Preventive and therapeutic managements are suggested.