1/23. Salivary duct carcinoma in the mandible: report of a case with immunohistochemical studies.Salivary duct carcinoma is rare. We describe a 56-year-old man who developed salivary duct carcinoma in the mandible 10 years after removal of the right second and third molars. The tumour originated in the retromolar gland or the ectopic minor salivary gland in the mandible. The panoramic radiograph showed a radiolucent, poorly circumscribed area about 40 x 30 mm in size and distal to the lower right first molar. This tooth, together with all neoplastic tissue, was removed, and histopathological examination showed it to be a salivary duct carcinoma in the mandible. On immunohistochemical staining, keratin antibodies stained the ductal structure, 1A4 antibody stained myoepithelial cells, but S-100 protein and vimentin were not seen. The patient was well and with no sign with recurrence 6 years postoperatively.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
2/23. Ectopic thymus presenting as a solid submandibular neck mass in an infant: case report and review of literature.Solid ectopic cervical thymus is an extremely uncommon etiology of a neck mass in an infant. It occurs in the line of descent of the thymus from the angle of the mandible to the superior mediastinum. Nine cases of ectopic cervical thymus in infants have been reported in the literature. Only two of nine cases were solid, the remaining seven were thymic cysts. A preoperative diagnosis is seldom considered and is often misdiagnosed as a possible malignancy or a lymph node. We present a case of a 2-month-old infant with an asymptomatic enlarging right neck mass. Patient underwent complete excision of the mass.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
3/23. Heterotopic neuroglial tissue causing airway obstruction in the newborn.BACKGROUND: Heterotopic neuroglial (brain) tissue is a rare cause of airway obstruction in newborns. Fewer than 30 cases have been reported in the English literature. brain heterotopias can mimic more common congenital anomalies of the head and neck. OBJECTIVE: To review our experience in the diagnosis and treatment of children with heterotopic pharyngeal neuroglial tissue. DESIGN: Case series. SETTING: Tertiary care children's hospital. patients: Four newborns with airway obstruction caused by heterotopic neuroglial tissue. RESULTS: All patients were infants (3 full-term girls and a 32 weeks' gestation boy) who had airway obstruction in the newborn period. All patients underwent preoperative computed tomography and magnetic resonance imaging, which revealed a heterogeneous mass involving the pharynx, neck, and parapharyngeal space. Bony deformities of the skull base and mandible were present in all patients, although intracranial connection was absent. Multiple surgical procedures were performed in all 4 patients. tracheotomy was performed in 2 patients, gastrostomy tube placement was required in 3, and a nasopharyngeal tube was used in 1. Combined cervicofacial and transoral approaches were used for resection, preserving vital structures. Histopathologic evaluation revealed mature glial tissue and choroid plexus-like structures. CONCLUSIONS: Heterotopic neuroglial tissue must be considered in the differential diagnosis of airway obstruction in the newborn. Management is surgical resection, with attention to vital structures and function-analogous to surgery for lymphangioma. Multiple surgical procedures might be necessary in the treatment of these patients.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
4/23. Retropharyngeal aberrant thymus.INTRODUCTION: Upper airway obstruction from a retropharyngeal mass requires urgent evaluation. In children, the differential diagnosis includes infection, trauma, neoplasm, and congenital abnormalities. Aberrant cervical thymic tissue, although occasionally observed on autopsy examination, is rarely clinically significant. We present the case of an infant with respiratory distress attributed to aberrant thymic tissue located in the retropharyngeal space. CASE: A 6-week-old infant was brought to the emergency department for evaluation of stridor associated with periodic episodes of cyanosis. Lateral neck radiograph revealed widening of the retropharyngeal soft tissues. The patient's symptoms did not improve with intravenous ampicillin-sulbactam. magnetic resonance imaging (MRI) performed on the seventh day of hospitalization revealed a retropharyngeal mass that extended to the carotid space. The mass was easily resected using an intraoral approach. Microscopic examination demonstrated thymic tissue. A normal thymus was also observed in the anterior mediastinum on MRI. The patient recovered uneventfully and had no further episodes of stridor or cyanosis. DISCUSSION: Aberrant cervical thymic tissue may be cystic or solid. Cystic cervical thymus is more common, and 6% of these patients present with symptoms of dyspnea or dysphagia. Aberrant solid cervical thymus usually presents as an asymptomatic anterior neck mass. This case is unusual in that solid thymic tissue was located in the retropharynx, a finding not previously reported in the English literature. Additionally, the patient presented in acute respiratory distress, and the diagnosis was confounded by the presence of mild laryngomalacia. In retrospect, our patient likely had symptoms of intermittent upper airway obstruction since birth. The acute respiratory distress at presentation was likely the result of laryngomalacia exacerbated by the presence of aberrant thymic tissue and a superimposed viral infection. Aberrantly located thymic tissue arises as a consequence of migrational defects during thymic embryogenesis. The thymus is a paired organ derived from the third and, to a lesser extent, fourth pharyngeal pouches. After its appearance during the sixth week of fetal life, it descends to a final position in the anterior mediastinum, adjacent to the parietal pericardium. Aberrant thymic tissue results when this tissue breaks free from the thymus as it migrates caudally. Therefore, aberrant thymic tissue may be found in any position along a line from the angle of the mandible to the sternal notch, and in the anterior mediastinum to the level of the diaphragm. In an autopsy study of 3236 children, abnormally positioned thymic tissue was found in 34 cases (1%). The aberrant thymus was most often located near the thyroid gland (n = 19 cases) but was also detected lower in the anterior neck (n = 6 cases), higher in the anterior neck (n = 8 cases), and at the left base of the skull (n = 1 case). The presence of thymic tissue in the retropharyngeal space in our patient is more unusual given the typical embryologic origin and descent of the thymus in the anterior neck to the mediastinum. Children with aberrant thymus may have associated anomalies. Twenty-four of 34 children (71%) with aberrant thymus detected at autopsy had features consistent with digeorge syndrome, and only 5 of the remaining 10 patients had a normal mediastinal thymus present. Our patient had normal serum calcium levels after excision and a mediastinal thymus was visualized on MRI. Biospy is required for diagnosis of cervical thymus and should also be considered to exclude other causes. MRI is helpful in delineating the presence, position, and extent of thymic tissue. Immunologic sequelae or recurrence after resection of an aberrant cervical thymus has not been reported.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
5/23. Ectopic cervical thymus: case report and review of the literature.The authors present a case of ectopic cervical thymus in a 4-month-old child. Ectopic cervical thymus is an uncommon etiology of a neck mass in a child. It is often misdiagnosed preoperatively as a possible malignancy. It is usually located along the embryologic course of thymus migration from the angle of the mandible to the superior mediastinum. Its treatment is surgical since malignant transformation and respiratory infection have been described. No case of immune deficit after total thymectomy has been described in the literature.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
6/23. Massive bleeding from an ectopic lingual thyroid follicular adenoma during pregnancy.Ectopic thyroid is a rare developmental anomaly. It can be found anywhere between the foramen cecum and the normal position of the thyroid gland. Massive bleeding from an ectopic lingual thyroid is unusual and occasionally fatal. We present a case of a 22-year-old woman who had a large mass at the base of the tongue for over 6 years. In the sixth month of pregnancy, the patient experienced massive bleeding from the tongue base mass. A thyroid scan revealed that this mass was the only functioning thyroid tissue. Because of massive bleeding and her shock status, the patient received an emergent embolization of the bilateral lingual arteries. Then the huge lingual thyroid was subsequently excised via a mandible swing approach to prevent further episodes of bleeding. pathology analysis indicated ectopic thyroid tissue with follicular adenoma. She delivered without complications in the 36th week and had a normal baby. This case was a very rare one in our review. Although ectopic lingual thyroid usually is not managed surgically, excision of ectopic lingual thyroid can be life-saving when it is causing bleeding or airway obstruction.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
7/23. Ectopic salivary gland tissue in the anterior mandible: a case report.Ectopic salivary gland inclusions in the mandible are a rare phenomenon. Classically as described by Stafne they have been found in the posterior mandibular region. Cases affecting the anterior mandible are even more unusual. We report a case of ectopic salivary gland tissue in the anterior mandible. In our discussion we emphasise the need for a thorough history, examination and relevant investigations. Mandibular radiolucencies can prove a pitfall for the unwary.- - - - - - - - - - ranking = 1keywords = mandible (Clic here for more details about this article) |
8/23. Parapharyngeal neuroglial heterotopia presenting as a growing single locular cyst: MR imaging findings.Heterotopic brain presenting as a giant, growing, single locular cyst at the parapharyngeal space has not been reported before, to our knowledge. We present such a case, with MR imaging findings, in a 13-month-old girl. A well-demarcated giant cystic mass was noted in the left parapharyngeal space from the skull base to the submandibular region. Airway compression and deformity of the left mandible with subluxation of the temporomandibular joint were noted. The cyst contained a clear fluid that was isointense to CSF with all pulse sequences. Wall enhancement was noted on contrast-enhanced T1-weighted images. No connection to intracranial structures was noted. Histologic findings were compatible with neuroglial heterotopia.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
9/23. Two cases of ectopic cervical thymus: case reports and a review of the literature.Ectopic cervical thymic tissue has rarely been reported in the medical literature. However, it should be included in the differential diagnosis of neck masses, and especially for children. This lesion generally occurs in the descent line of the thymus from the angle of the mandible to the superior mediastinum. The preoperative diagnosis of ectopic cervical thymus is seldom considered and this is often misdiagnosed as a possible tumor or as a lymph node. We report here on two cases of ectopic cervical thymus for which the patients underwent complete excision of the masses.- - - - - - - - - - ranking = 0.14285714285714keywords = mandible (Clic here for more details about this article) |
10/23. Central adenoid cystic carcinoma of the mandible: case report and literature review of 16 cases.Central intraosseous adenoid cystic carcinoma (ACC) of the mandible, formerly known as cylindroma, is a rare neoplasm with only 16 cases reported in the literature. We describe the diagnosis, etiology, and treatment of a central ACC located in the mandibular premolar region. We also review the literature. This case illustrates 2 key facts regarding the diagnosis and etiology of ACC. First, central salivary gland tumors should be considered in the differential diagnosis of cystic lytic lesions in the mandible. Second, even though the origin of this type of tumor is still unknown, the presence of ectopic tissue anterior to the submandibular gland in the submandibular area indicates that this tumor might be made up of ectopic embryogenic inclusions.- - - - - - - - - - ranking = 0.85714285714286keywords = mandible (Clic here for more details about this article) |
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