Darier-Ferrand dermatofibrosarcoma protuberans of the face: Case report and literature review.

INTRODUCTION: Darier Ferrand Dermatofibrosarcoma (DFSP) is a rare skin tumor, characterized by its local aggressivity and high potential of recurrence. It affects mainly young and middle-aged adults. Its location in the head and neck region represents nearly 12.5 % of all DFSP. CASE DESCRIPTION: We report a rare case of a 68-year-old patient who was treated for a DFSP of the cheek's lower part with reconstruction using a pectoralis major musculocutaneous flap. The postoperative course was uneventful and the aesthetic result was good. DISCUSSION: DFSP is a tumor of intermediate malignancy. Its optimal management is based on complete surgical excision requiring various reconstruction procedures for large defects. The treatment of unresectable lesions remains difficult despite the targeted therapies proposed and the improvement of radiotherapy techniques. CONCLUSION: The ideal management of a DFSP is based on surgical excision passing largely in healthy tissues. This situation requires early diagnosis and is the guarantee of disease-free survival without major sequelae in head and neck locations.

Explanatory factors for the evolution of children's allergic rhinitis.

INTRODUCTION: Allergic rhinitis (AR) in children is a common condition that is a public health problem. Despite a well-codified treatment, clinical improvement is not the rule. AIM: To identify factors affecting the improvement of allergic rhinitis in children under symptomatic treatment. METHODS: A 12-year retrospective descriptive study that included children aged 3 to 15 years, followed for allergic rhinitis. The search for explanatory factors for improvement under treatment was done using a binary logistic regression model. RESULTS: 52 children were included, with a mean age of 7 years (±3). A familial atopy history was present in 37 patients (71%). The presence of factors aggravating allergy was noted, including antibiotic consumption: 31 patients (60%) and overweight: 15 patients (29%). Associated asthma was noted in 42 patients (81%). The allergenic profile has regained a predominance of dust mite allergy (71%) and a significant frequency of multiallergies (79%). Management included therapeutic education and drug treatment. There was improvement in rhinitis in 27 patients (52%) and improvement in asthma in 26 patients (50%). Overweight and high consumption of antibiotics had a negative impact on the therapeutic outcome. A good therapeutic education had a favorable impact. CONCLUSION: AR is a debilitating condition requiring prolonged therapeutic education and drug treatment. The prescription of antibiotics in children with allergic rhinitis should be sparing and weight monitored.

Surgical Approaches to Parapharyngeal Space Tumors: An Example and Review of the Literature.

Parapharyngeal space tumors (PPS) are rare. They represent less than 1% of all head and neck tumors. They are of various histologies. Pleomorphic adenomas originating from the parotid (prestylian parapharyngeal space) are the most frequent. We report the case of a 50-year-old patient treated for a pleomorphic adenoma (PA) of PPS. His initial complaints were apnea and dysphagia. The correct diagnosis was preoperatively suspected by magnetic resonance imaging (MRI). The surgery was carried out using two approaches: transoral and cervical transparotid approaches. Definitive histology was consistent with encapsulated pleomorphic adenoma. In the present work, we reviewed clinical, radiological, and histological features of parapharyngeal space tumors. We tried to summarize the common surgical approaches. The chosen approach is, in fact, scheduled taking into account several parameters including tumor volume and purpose of the surgery.

Petrous metastasis of a lung small cell carcinoma.

Malignant tumors of the temporal bone are rare. They include a wide histological variety. They are mostly primary tumors with an estimated incidence of 0.8-1.0 per 1,000,000 inhabitants per year [1]. Metastases form an uncommon subgroup. The clinical features of these temporal bone metastases are nonspecific and predominantly consist of hearing loss, vertigo, facial palsy, tinnitus, headache, otalgia or otorrhoea [2]. The aim of our publication is to report a rare case of metastasis in the temporal bone as initial manifestation of lung cancer. Our patient was a 44-year-old man who presented for a right mastoid swelling with a grade VI right facial nerve palsy. Imaging and biopsy confirmed the diagnosis of small cell lung carcinoma petrous metastasis. The treatment was palliative. An osteolytic lesion of the temporal bone in an elderly patient may fit with a primary tumor of the temporal bone. It must, also, suggest the diagnosis of metastasis. The malignant tumor most frequently responsible is breast cancer, but lung cancer must also be considered in smoking patients.

Oncologic outcomes of early glottic cancers with anterior commissure involvement treated with advanced laser cordectomies.

INTRODUCTION: The contribution of transoral laser microsurgery (TLM) in the management of early glottic cancer is now well established. The anterior commissure (AC) is a delicate anatomic subsite due to its difficult access and the high risk of tumour spread from this site to the thyroid cartilage, the subglottis and the pre epiglottic space. These reasons make the endoscopic approach controversial in case of AC involvement. METHODS: This is a single centre retrospective study performed between the years 2012 and 2015. Eighteen patients treated with advanced Va laser cordectomies were included. RESULTS: All tumours were staged T1 (78% were T1a and 12% T1b). After laser surgery 4 patients (22.22%) had positive margins. These patients were candidate to second look procedure allowing detection and treatment of residual disease.  Oncologic outcomes were studied. Two patients experienced local relapses within a mean delay of 7 months. The local control rate was 88.9% while the local control using laser only was 83.33%. One patient underwent a total laryngectomy (TL) followed by adjuvant radiation therapy (RT) after a massive recurrence in the AC with infiltration of the thyroid cartilage. The laryngeal preservation rate was 94.44%. The 3 years overall survival rate reached 100% while the 3 years disease free survival was 88.9%. CONCLUSION: the TLM offers acceptable oncologic outcomes in the treatment of T1 laryngeal cancer with AC involvement.

Laryngocele after Subtotal Laryngectomy.

INTRODUCTION: Laryngocele is an air-filled dilatation of the laryngeal saccule that extends upward within the false vocal folds. Different etiologies lead to laryngocele congenital malformation, weakness of the laryngeal tissues and increased intralaryngeal pressure. Laryngocele may be a secondary iatrogenic complication following subtotal laryngectomy. CASE REPORT: We report the case of a 61-year-old patient who presented an external laryngomucocele 8 years after a supracricoid partial laryngectomy with cricohyoidoepiglottopexy (SCPL-CHEP). We focus on the clinical aspects and therapeutic attitude, then discuss the physiopathological conditions that could generate this late complication. CONCLUSION: Laryngocele after subtotal laryngectomy should be considered a late iatrogenic complication. Histological examination is necessary after surgical management of laryngocele, as the association with cancer is frequent.