Myxofibrosarcoma of the thyroid gland

INTRODUCTION

Myxofibrosarcoma of the thyroid is exceptional: a Medline search found a single case report. We report a new case which raised diagnostic and therapeutic problems.

OBSERVATION

We report the case of a 74-year-old woman who presented with swelling of the left thyroid lobe and ipsilateral cervical lymphadenopathy. Total thyroidectomy with cervical lymph-node dissection was performed. Histological analysis diagnosed myxofibrosarcoma. Evolution was marked by rapid local recurrence, and chemotherapy based on doxorubicin and ifosfamide was introduced.

DISCUSSION/CONCLUSION

Head and neck myxofibrosarcoma is rare. MRI is essential and should always precede treatment. Diagnosis is histological. There is elevated risk of local recurrence after resection, accompanied by worsening tumor grade, whence the need for accurate diagnosis, appropriate treatment and regular MRI follow-up.

[Intractable epistaxis in Osler-Rendu-Weber syndrome]

INTRODUCTION

Osler-Rendu-Weber syndrome is an inherited disorder characterized by mucocutaneous and visceral telangiectasia. It is often revealed by recurrent epistaxis. It is sometimes profuse and intractable. Hemostasis may be problematic.

CASE STUDY

A 61-year-old male patient presented with severe epistaxis due to Osler-Rendu-Weber syndrome. Embolization of the external carotid branches was needed for hemostasis.

DISCUSSION

Embolization of external carotid artery branches can be an effective therapeutic alternative when usual treatments fail.

Chronic rhinorrhea revealing an actinomycotic rhinolithiasis with ectopic tooth

Intranasal ectopic tooth is a rare nidus for a rhinolith where local infection may be concomitant. No description of the triple association 'actinomycotic rhinolithiasis ectopic tooth' could be found in the medical literature. Classically, the Actinomyces species are sensitive to regimens of penicillin from 6 to 12 months or longer. Immunocompetent patients can benefit from shorter courses of antibiotic therapy, such as ciprofloxacin, with a favourable outcome. The authors describe the case of a 25-year-old man who presented with an actinomycosis chronic discharge revealing actinomycosis associated with rhinolithiasis and ectopic tooth. They attempt to explain the likely mechanism of occurrence of this triple association.

[Primary nasal tuberculosis: a case report]

We report a case of a 36 year old woman who presented a chronic rhinitis and a hypertrophy of the inferior turbinates. Primary nasal tuberculosis was discovered by chance after the inferior turbinectomy. Primary nasal tuberculosis is very rare and is more frequent in women. Symptomatology is often unilateral with nasal obstruction, anterior rhinorrhea or epistaxis. The clinical examination may discover ulceration or a polyp located generally in the nasal septum or the inferior turbinate. Diagnosis relies on the anatomopathologic and bacteriological examinations. The treatment is mainly medical based on antituberculosis drugs. In the light of this case report, a review of the literature was made.

Laryngeal leiomyosarcoma

Laryngeal leiomyosarcoma is rare. The authors report the case of a 48-year-old patient who presented with progressive hoarseness. This symptomatology was associated with a laryngeal tumour. Immunohistopathological study indicated a leiomyosarcoma. Acute dyspnoea resulted in an urgent tracheostomy, followed by total laryngectomy without neck dissection later. In the light of this observation and a literature review, histopathological characteristics, clinical aspects and therapeutic indications will be discussed for this localisation.