1/38. Transmucosal fine-needle aspiration diagnosis of intraoral and intrapharyngeal lesions.OBJECTIVES: The effectiveness of fine-needle aspiration biopsy (FNAB) for the diagnosis of neck, thyroid, and salivary gland masses is well documented. Very few reports explore the potential of an intraoral FNAB approach for the diagnosis of submucosal lesions. We describe our technique and present case examples of pertinent differential diagnostic entities. We recommend an expanded role for FNAB of the oral cavity and oropharynx. STUDY DESIGN: Retrospective review. methods: A uniform technique was employed for transmucosal FNAB of 76 patients with intraoral masses. In applicable cases, cytology results were compared with traditional biopsy methods and permanent histopathologic specimens for accuracy. RESULTS: Our experience demonstrates the high sensitivity (93%) and specificity (86%) of intraoral FNAB when compared with biopsy by conventional means. FNAB provides distinct advantages for the cytologic diagnosis of submucosal lesions, which may be difficult to reach and adequately sample through conventional biopsy. FNAB of the tonsil and tonsillar fossa provides a safe and effective means of diagnosing both lymphoma and squamous cell cancer. Transmucosal FNAB via the mouth led to rapid diagnosis of a number of benign and malignant lesions. Applying this uniform FNAB technique, we had no significant complications. CONCLUSION: We recommend transmucosal FNAB as an effective means for highly accurate diagnosis of submucosal lesions of the oral cavity and oropharynx. CLINICAL RELEVANCE: Traditional biopsy techniques in the oral cavity may require anesthesia and may have diagnostic difficulties, particularly for submucosal lesions. Transmucosal FNAB overcomes these shortcomings by providing a minimally invasive means to rapid diagnosis of intraoral lesions.- - - - - - - - - - ranking = 1keywords = oral cavity, cavity, mouth (Clic here for more details about this article) |
2/38. Malignant peripheral nerve sheath tumor in the parapharyngeal space: tumor spread through the eustachian tube.SUMMARY: We report the CT and MR findings in a patient with malignant peripheral nerve sheath tumor in the parapharyngeal space who had neither a family history nor stigmata of neurofibromatosis. A high-resolution CT scan of the temporal bone revealed bony erosion and widening of both the foramen ovale and the bony portion of the eustachian tube. A temporal bone MR image showed an intensely enhancing solid mass in the parapharyngeal space, which extended into the middle ear cavity via the eustachian tube.- - - - - - - - - - ranking = 0.0094689122584591keywords = cavity (Clic here for more details about this article) |
3/38. Oral-cavity hair growth after free-flap transfer: case report.It sometimes happens that hair will grow well after a free-flap transfer. But this is a report of an experience of excessive hair growth after reconstruction of a middle pharyngeal defect, using a free, vascularized, radial, forearm flap. This is a relatively rare occurrence.- - - - - - - - - - ranking = 0.037875649033836keywords = cavity (Clic here for more details about this article) |
4/38. Autoamputation of the tongue.Autoamputation is an uncommon phenomenon that has been reported for the fingers, toes, appendix, ovary, spleen, etc. Autoamputation of the tongue has never been reported. An elderly man with carcinoma of lateral pharyngeal wall and tonsil presented with an autoamputated tongue that was attached to the oral cavity with a thin band. The patient required detachment of the tongue and tracheostomy followed by radiotherapy for the primary tumour.- - - - - - - - - - ranking = 0.330968379244keywords = oral cavity, cavity (Clic here for more details about this article) |
5/38. Eagle syndrome produced by a granular cell tumor.Eagle syndrome includes elicitation of pain on swallowing, turning the head, or extending the tongue. The syndrome is thought to be caused by irritation of the glossopharyngeal nerve, most commonly caused by its impingement against an elongated styloid process. We present a rare case of a granular cell tumor presenting as Eagle syndrome. Granular cell tumors orignate from schwann cells and are most common in the subcutaneous tissue of the head, neck, and oral cavity, especially the tongue. A granular cell tumor is typically benign and solitary, rarely malignant. The differential diagnosis, diagnostic algorithm, and treatment are presented.- - - - - - - - - - ranking = 0.330968379244keywords = oral cavity, cavity (Clic here for more details about this article) |
6/38. Squamous cell carcinoma arising in the skin of a deltopectoral flap 27 years after pharyngeal reconstruction.BACKGROUND: Development of a second primary squamous cell carcinoma in the skin of a flap used for pharyngeal reconstruction is rare. methods: A case of squamous cell carcinoma is presented arising in a deltopectoral flap used to reconstruct the hypopharynx 27 years after total laryngectomy. Three previous reports found on review of the literature are summarized. RESULTS: A second primary squamous cell carcinoma may arise in the skin of a myocutaneous flap in the absence of any obvious risk factors. CONCLUSION: We suspect that long-term exposure of the skin of the flap lining the pharynx to saliva may have been a significant factor in the development of this malignancy. Long-term follow up and awareness of this complication is required for patients with soft tissue reconstruction of the oral cavity and pharynx.- - - - - - - - - - ranking = 0.330968379244keywords = oral cavity, cavity (Clic here for more details about this article) |
7/38. Incidentally found and unexpected tumors discovered by MRI examination for temporomandibular joint arthrosis.We examined the frequency of incidentally found or unexpected tumors discovered at the time of magnetic resonance imaging (MRI) examinations in the temporomandibular joint (TMJ) region for patients with suspicion of TMJ arthrosis. Five MR images (T1-weighted transverse scout image and proton density and T2-weighted oblique sagittal images at the open and closed mouth) were acquired. In 2776 MRI examinations of TMJ arthrosis, two tumors were discovered. They consisted of an adenoid cystic carcinoma in the deep portion of the parotid gland, and a malignant tumor extending from the infratemporal fossa to the parapharyngeal space. The rate of incidentally founded or unexpected tumors in TMJ examinations was low (0.072%), but the two tumors found were malignant tumors, and therefore, scout image should be carefully examined, not only used for positing the slice.- - - - - - - - - - ranking = 0.007094862267989keywords = mouth (Clic here for more details about this article) |
8/38. A patient with an epignathus: management of a large oropharyngeal teratoma in a newborn.An epignathus is an oropharyngeal teratoma composed of cells from ectodermal, mesodermal, and endodermal layers. Epignathi that arise from the palate or pharynx and protrude from the mouth result in life-threatening airway obstruction and usually cause asphyxiation shortly after birth. In our reported case, an antenatal ultrasound diagnosis allowed for preparation of an ex utero intrapartum treatment (EXIT) procedure. A tracheostomy was performed at birth with maternal-fetal blood flow still intact through the umbilical cord. Debulking of the large extraoral portion of the tumor, followed by complete intraoral resection, was performed. Masseteric function and swallowing slowly improved over several weeks. cleft palate repair is planned at 10 months of age. In the following report, the histology, classification, and pathogenesis of these "parasitic" tumors are reviewed.- - - - - - - - - - ranking = 0.007094862267989keywords = mouth (Clic here for more details about this article) |
9/38. Balloon cell nevus of the pharynx.BACKGROUND: Mucosal melanotic lesions are rare, and the still rarer balloon cell variant has not been reported in the upper aerodigestive tract mucosa. We report a case of balloon cell nevus of the pharynx. methods: A 35-year-old woman was seen with complaints of a black color in her mouth. physical examination revealed a diffusely pigmented posterior pharyngeal wall. The pigmentation extended superiorly to the posterior edge of the palate, and laterally, it stopped short of the posterior tonsillar pillars. The overlying mucosa was smooth, with no swelling. Flexible endoscopy showed that the lesion extended to the cricopharynx. Findings on histopathologic examination were consistent with balloon cell nevus of the pharynx. Complete excision was not possible, because the lesion was very diffuse. RESULTS: After 2 years of conservative management and regular follow-up examinations, no change in the symptoms and no increase in the lesion have been seen. CONCLUSION: Melanotic lesions in the upper aerodigestive tract mucosa are rare. This case is reported for its rarity, unusual presentation, and characteristic histopathologic features.- - - - - - - - - - ranking = 0.007094862267989keywords = mouth (Clic here for more details about this article) |
10/38. Case report: greater meningeal inflammation in lumbar than in ventricular region in human bacterial meningitis.Differences in the composition of ventricular and lumbar cerebrospinal fluid (CSF) based on single pairs of samples have previously been described. We describe a patient that developed post-surgical recurrent meningitis monitored by daily biochemical and bacteriological CSF analysis, simultaneously withdrawn from lumbar space and ventricles. A 20-year-old Caucasian man was admitted to the ICU after a resection of a chordoma that extended from the sphenoidal sinus to the anterior face of C2. CSF was continuously leaking into the pharyngeal cavity after surgery, and three episodes of recurrent meningitis, all due to pseudomonas aeruginosa O12, occurred. Our case showed permanent ventricular-to-lumbar CSF gradients of leukocytes, protein and glucose that were increased during the acute phase of meningitis, with the greatest amplitude being observed when bacteria were present in both ventricular and lumbar CSF. This might suggest a greater extent of meningeal inflammation in the lumbar than in the ventricular region. Our case also showed that the increase in intravenous antibiotics (cefepim from 8 to 12 g/day and ciprofloxacine from 1.2 to 2.4 g/day) led to an increase in concentration in plasma but not in CSF.- - - - - - - - - - ranking = 0.0094689122584591keywords = cavity (Clic here for more details about this article) |
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