Supraclavicular lymph node metastases from distant primary tumors: Case reports and review of the literature.

Cervical lymph nodes are a common site of metastases for malignant tumors, most commonly developed from head and neck primary tumors. But, they can also be secondary to distant primary tumors. We report the case of two patients treated in our Otorhinolaryngology and Head and Neck department for chronic supraclavicular lymphadenopathies, for whom further investigations showed lymph node metastasis originating from distant tumors. Thus, careful clinical examination, imaging tools, and if possible pathological analysis are necessary to establish an early diagnosis for adequate treatment.

Entirely endoscopic resection of a complicated juvenile psammomatoid ossifying fibroma of the paranasal sinusitis: Case report and review of the literature.

INTRODUCTION: Juvenile ossifying fibroma (OF) is a benign fibro-osseous tumor, affecting the bones of the face. It's locally very aggressive, with a strong tendency to recur. We report a case of a juvenile psammomatoid ossifying fibroma (JPOF) complicated with exophthalmos undergoing an entirely endoscopic resection. CLINICAL PRESENTATION: A 14-years-old, young woman presented with a 7 months history of headache and right chronic tearing complicated with exophthalmos. Nasal endoscopy revealed a polylobed mass filling the right nasal cavity, the ophthalmic examination showed an isolated exophthalmos. CT scan revealed a well-limited benign mass covered by a thick shell of bone, pushing out the orbital lamina papyracea responsible for a grade 1 exophthalmos. On the facial MRI, we excluded intracranial or intraorbital involvement. A biopsy of the mass describes a psammomatoid juvenile ossifying fibroma. The patient underwent endoscopic transnasal approach with image-guided neuro-navigation system. CLINICAL DISCUSSION: JPOF is an aggressive variant of ossifying fibroma occurring predominantly in children with a predilection for the paranasal sinuses. CT scan images show a characteristic well-limited benign expansile mass covered by a thick shell of bone, but sometimes it's mistaken for a mucocele. MRI helps with excluding intracranial or intraorbital involvement. Endonasal endoscopic approaches have been increasingly used and it tends to become the new standard of care. CONCLUSION: Treatment consists of complete surgical removal; incomplete resection is associated with a high local recurrence rate. Clinician should keep in mind the need for clinical and radiological follow-up for many years.

Predictive factors of cervical nodal metastases in N0 squamous cell carcinomas of the mobile tongue - A cohort study.

Squamous cell carcinoma (SCC) of the tongue is one of the most common cancers in the oral region, most frequently associated with lymph nodes metastases which influence the most the prognosis. The identification of predictive factors of occult cervical nodal metastases for N0 tumors will allow to adapt the treatment to the patient, avoiding over or under management. From 2014 to 2019, a cohort of 26 patients with SCC of the mobile tongue was reviewed by analysing the medical history, the epidemiological and clinical parameters, the tumor sites, aspects, diameters, depths of invasion, pathological degree, degree of differentiation, T classification and results of neck dissections. The incidence of occult cervical nodal metastases was up to 26,92% and a significant correlation was only found with the tumor depth invasion and the muscular invasion (p < 0,05). Presently, a low differentiated, highly graded tumor with a high depth and muscular invasion should warn from the high incidence of occult cervical nodal metastases and should recommend an elective neck dissection in all cases of N0 tongue SCC.

Treatment and evaluation of recurrence for antrochoanal polyps by endoscopic large middle meatal antrostomy, clinical case series of 25 patients.

INTRODUCTION: The Endoscopic approach for complete removal of antrochoanal polyp is considered a safe and effective procedure with the best control of the attachments of antrochoanal polyps. The mains of our study are to review the clinical features and evaluate the recurrence in the patients affected by antrochoanal polyps (ACPs) and surgically treated by endoscopic middle meatal antrostomy. METHODS: The present research is a retrospective study. it includes the clinical data of subjects affected by ACPs, and referred to ENT Department, Face and Neck Surgery, Hospital 20 August 1953, between January 2016 and January 2019. RESULTS: All patients have been treated surgically with endoscopic middle meatal antrostomy under general anesthesia. Recurrence occurred in 3 cases (12%), in these three recurrent cases, the site of attachment originated from the lateral wall. CONCLUSION: FESS was the first-choice treatment for APCs in the present series; our recurrence rate was encouraged for the practice of the endonasal endoscopic approach. A focus on the detection of the exact origin of the polyp and the resection of the periostium on the point of attachment considered the key to prevent recurrence.