1/5. Wegener's granulomatosis with parotid gland involvement and pneumothorax.OBJECTIVE: Wegener's granulomatosis is a systemic vasculitis characterized by necrotizing granulomatous lesions mostly involving the upper and lower respiratory tract. The disease rarely causes parotid gland involvement and pneumothorax. We report a case of Wegener's granulomatosis involving parotid gland, and complicated with a pneumothorax. CLINICAL PRESENTATION: A 45-year-old man admitted with a 3-week history of painful left parotid gland enlargement and hemoptysis. On physical examination a painful and hard mass was detected on the left pre-auricular area. Cervical CT revealed a 2 x 1.5 cm hypodense lesion mimicking an abscess on the left parotid gland. Chest radiograph and thorax CT demonstrated nodular and cavitating opacities on the right and left upper zones. There were numerous erythrocytes in urine sediment. The drained pus material from the parotid abscess demonstrated only gram-positive cocci (staphylococcus aureus). Two weeks treatment with teicoplanin resulted in no improvement. Meanwhile, parotid gland biopsy revealed necrotizing granulomatous inflammation. There was a sixfold increase in serum cANCA levels. With the diagnosis of Wegener's granulomatosis, cyclophosphamide and prednisolone were initiated. However, 1 month later, pneumothorax developed as a complication of rupture of a cavitary lesion. CONCLUSION: parotid gland swelling may be the initial presenting symptom of Wegener's granulomatosis. It can be confused with infectious or malignant diseases of the gland, and the lung involvement may be complicated with pneumothorax.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/5. Factitious illness and the ENT surgeon.Factitious illness' is a recently classified group of diseases characterized by repeated purposeful simulation of physical or mental illness in order to obtain medical or psychiatric treatment. 'munchausen syndrome' is a classical example of this group. The case reported is a 26-year-old Caucasian male who presented with recurrent facial swelling between December 1978 and November 1987. His true condition eluded diagnosis for so long because he presented repeatedly with overt clinical signs which appeared severe enough to justify the symptoms claimed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/5. facial nerve paralysis with benign parotid masses.facial paralysis in the presence of a parotid mass has been associated classically with a presumed diagnosis of malignancy. However, isolated case reports have documented the occurrence of paresis or paralysis secondary to pathologically benign, nonneurogenic parotid lesions. These previous cases have been reviewed and three additional cases are described. Comparisons are made on age, sex, symptoms, physical findings, pathologic findings, and prognosis. Involvement of the seventh nerve may be explained on the basis of compression, especially in association with local inflammation. Although facial paralysis still should be considered indicative of a malignancy, it also may be caused by benign masses, particularly those associated with rapid enlargement and/or infection.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/5. bulimia and parotid enlargement--case report and treatment.bulimia is a behavioral eating disorder affecting young adult women. Parotid enlargement may occur as a result, although the cause of this swelling is as yet unknown. These changes can be irreversible, unresponsive to resumption of normal dietary habits. The physical unattractiveness of this complication can adversely affect the patient's wellbeing, demanding more active treatment. Treatment of this parotid enlargement has not previously been dealt with definitively. A case study is presented wherein such an individual was treated with bilateral superficial parotidectomy with good results, both emotionally and physically. As the incidence of this disorder continues to increase dramatically, the surgeon may gain a place in the treatment of bulimia.- - - - - - - - - - ranking = 2keywords = physical (Clic here for more details about this article) |
5/5. Odontogenic keratocyst of the mandible: an unusual cause of a parotid mass.Odontogenic keratocyst (OKC) of the mandible refers to an uncommon benign lesion of the jaw that originates from dental primordia. Clinically an OKC is characterized by aggressive, local growth. The likelihood of local recurrence following initial treatment is high. The diagnosis of a mandibular OKC may be suspected based on physical examination and plain film radiographic findings. However, histopathological confirmation is required to make the diagnosis with certainty. Complete surgical removal is the preferred treatment. In the current report, we describe the management of a patient with a large mandibular OKC that produced an apparent mass in the parotid gland. In addition, the diagnosis, management, and long-term results of treatment of mandibular OKCs are reviewed.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |