1/30. Recurrent acute suppurative thyroiditis in a child: case report.A 23-month-old girl presented with a history of persistent fever and growing left anterior neck mass following an upper respiratory tract infection. Laboratory studies revealed leukocytosis, elevated levels of the erythrocyte sedimentation rate and c-reactive protein, and a mild impairment of thyroid function. Thyroid scan showed a decreased radioactive iodine uptake of the left thyroid gland. culture of the thyroid aspirate grew the mixed flora, viridans streptococci, prevotella spp, and peptostreptococcus magnus. She was discharged after a surgical drainage and a 14-day course of penicillin-G therapy. Unfortunately, she was readmitted for the resembling problems, the fever and progressing left anterior neck mass 3 months later. culture of thyroid aspirate also grew the viridans streptococci. She recovered after a 14-day course of penicillin-G therapy. A left pyriform sinus fistula was found by barium esophagogram. A selective operation was performed 8 weeks later.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
2/30. A new role for computed tomography in the diagnosis and treatment of pyriform sinus fistula.neck abscess located in or around the thyroid gland should raise the suspicion of acute suppurative thyroiditis, pyriform sinus fistula, a 3rd or 4th branchial cleft anomaly. Differentiating between these entities on a clinical basis is difficult. After treating the initial infection, computed tomography, barium esophagography, ultrasound, and endoscopy can be used in search of the fistulous tract that can be associated with a pyriform sinus fistula or a 3rd or 4th branchial anomaly. We present a case of a pyriform sinus fistula involving the use of oral contrast, combined with computed tomography, to delineate the tract and its surrounding structures. This method, in combination with endoscopy, aided in the removal of this branchial anomaly.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
3/30. Congenital lacrimal sac fistula: a case report and review.The lacrimal system is crucial for vision and comprises the lacrimal glands, which produce tears, and the lacrimal drainage system, which drains tears away from the eyes. While various disease processes affect the lacrimal glands, the lacrimal drainage system is commonly prone to congenital abnormalities such as lacrimal sac fistula. We describe a case with classic findings and review dermatologic manifestations of this entity.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
4/30. Traces of perilymph detected in epipharyngeal fluid: perilymphatic fistula as a cause of sudden hearing loss diagnosed with beta-trace protein (prostaglandin D synthase) immunoelectrophoresis.The incidence of perilymphatic fistula as cause of sudden hearing loss is not known. We present a case with sudden unilateral hearing loss associated with a positive beta-trace protein test of an epipharyngeal fluid sample. The patient presented with sudden sensorineural hearing loss on the right side. A stapedotomy had been performed nine months previously due to otosclerosis. Intravenous therapy for the treatment of sudden hearing loss was unsuccessful. At the time of sudden hearing loss, epipharyngeal fluid was collected using a Raucocel sinus pack. Investigation using rocket immunoelectrophoresis showed the presence of beta-trace protein. Upon repeating tympanoscopy there was no obvious labyrinthine fluid egress, but the oval window was sealed with fibrin sponge and fibrin glue. The patient's hearing improved over a period of five months.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
5/30. Acute suppurative thyroiditis caused by an infected piriform sinus fistula with thyrotoxicosis.We report herein an unusual case of thyrotoxicosis caused by acute suppurative thyroiditis (AST) infected through a piriform sinus fistula (PSF). A 28-year-old man presented with pain over the thyroid gland and elevated serum thyroid hormone levels, a picture similar to subacute thyroiditis. A fine-needle aspiration biopsy from the left lobe showed neutrophil infiltration, and culture from the aspirate grew anaerobic peptostreptococcus. A neck computed tomography (CT) scan showed an abscess in the thyroid gland, and barium swallow revealed the presence of PSF. Appropriate antibiotic treatment ameliorated his symptoms of infection, followed by normalization of thyroid function. Three months later, he underwent fistulectomy and partial left lobectomy. The end of the PSF track was found in the left thyroid lobe. Thus infection of the thyroid gland through the infected PSF was likely the cause of supprative thyroiditis. The unusual clinical features of AST in this patient include the presence of severe thyrotoxicosis, relatively late onset (28-years-old) of infection despite the presence of congenital PSF, and the lack of acute inflammatory signs on the overlying skin of the thyroid gland. It is important to recognize this type of AST, since fistulectomy is required to prevent recurrent AST.- - - - - - - - - - ranking = 4keywords = gland (Clic here for more details about this article) |
6/30. Congenital dermoid fistula of the lower lip.A case of congenital dermoid fistula of the lower lip is presented. The lesion consisted of a major cystic portion, a proximal tubelike extension that opened in the lower lip as a small sinus (pit) near the left commissure, and a distal cordlike extension that entered into the left mental foramen. The cystic cavity was lined with keratinizing stratified squamous epithelium, and many sebaceous glands, sweat glands, and hair follicles were seen subcutaneously. The differential diagnosis and the pathogenesis of the lesion are also discussed.- - - - - - - - - - ranking = 2keywords = gland (Clic here for more details about this article) |
7/30. Recurrent acute suppurative thyroiditis.Recurrent acute left-sided suppurative thyroiditis was observed and treated in an eight-year-old girl. barium swallow performed after the third episode revealed the presence of a pyriform sinus fistula extending to the upper pole of the left lobe. Despite resection of the fistula, she relapsed for a fourth time. The fistula was again seen on esophagogram. A probe was left inside the tract during subsequent surgery, thus facilitating its complete removal. AST occurs most commonly as a result of the persistence of a connection between the throat and the thyroid gland which is otherwise extremely resistant to infection. AST is usually left-sided and not associated with thyroid dysfunction. Recurrences are common unless the congenital fistula is identified and completely excised.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
8/30. Congenital midline sinus of the upper lip. Report of a case.An extremely rare case of congenital midline sinus of the upper lip in a 12-year-old girl is presented. The sinus had a pit-like orifice in the midline philtral area with a duct extending 4 mm posterosuperiorly. It was excised by extraoral elliptical incision. Histopathological examination disclosed that the duct was covered by a stratified squamous epithelium with sebaceous glands. Twelve cases of this rare disease have previously been reported.- - - - - - - - - - ranking = 1keywords = gland (Clic here for more details about this article) |
9/30. A case of aberrant lacrimal gland and fistula.A case of aberrant lacrimal gland and fistula sited extraorbitally is presented in view of its rare incidence.- - - - - - - - - - ranking = 5keywords = gland (Clic here for more details about this article) |
10/30. Giant salivary calculi: an orocervical fistula caused by a submandibular gland calculus.Large calculi of the salivary glands are rare. They may go undetected for many years. The authors report three cases of giant submandibular gland calculi. In one patient, the calculus was an incidental finding. In all patients, the mass was in the substance of the gland; in one, the configuration of the mass was unusual and it had eroded through the floor of the buccal cavity forming an orocervical fistula (the first such report) and in another the mass occupied a small portion of Wharton's duct. The histopathologic findings in all three cases were of nonspecific chronic inflammation. All the patients made a smooth recovery and had no complaints at follow-up.- - - - - - - - - - ranking = 7keywords = gland (Clic here for more details about this article) |
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