[Florid cemento-osseous dysplasia of the jaws]

INTRODUCTION

Florid cemento-osseous dysplasia is a benign and rare tumor of the jaws. It is more commonly seen in middle-aged black women. Most cases are asymptomatic and are found during routine radiographic examination.

OBSERVATIONS

We report two complicated cases of florid cemento-osseous dysplasia, one with facial deformity and the other with chronic osteitis.

DISCUSSION

The diagnosis of florid cemento-osseous dysplasia is based on clinical and radiological features. The lesions are commonly bilateral and symmetrical.

[Primary extranodal ENT tuberculosis]

OBJECTIVES

The aim of this sinusonasal study was to study several locations of ENT extranodal tuberculosis.

MATERIAL AND METHODS

Our study focused on eight cases of tuberculosis in the cervicofacial region gathered in the ENT department of the Rabat Specialization Hospital (Morocco) between August 2004 and August 2006. They comprise two cases of rhinopharyngeal tuberculosis, two cases of tuberculosis, two cases of endobuccal tuberculosis (mandibular and lingual locations), and two cases of glandular tuberculosis (thyroid and parotid locations).

RESULTS

These locations are rarely affected by tuberculosis. The clinical signs as well as radiology and endoscopy are not specific. The final diagnosis is based on histology. Bacillus cultures are necessary when caseum tuberculosis is not found, causing problems of differential diagnosis with granulomatous and malignant lesions. PCR provides quick bacterial antigen detection when cultures are negative. The treatment provides a quick and complete recovery while recurrences are infrequent.

CONCLUSION

ENT tuberculosis is rare if excluding the nodal locations. It should be mentioned as a differential diagnosis, especially in endemic areas. Most often, this is a surprise diagnosis.

[Papillary adenocarcinoma on ectopic thyroid tissue]

OBJECTIVES

To report a case of papillary adenocarcinoma occurring on ectopic thyroid tissue in the hyoid bone region.

MATERIAL AND METHODS

A 57-year-old patient consulted for a cervical mass appearing 1 year before, with no signs of compression. The thyroid function was normal.

RESULTS

The examination showed a firm tumefaction, fixed on the hyoid bone, with undetermined limits, measuring approximately 8 cm. The thyroid gland was in the normal pretracheal position. The cervical tomodensitometry objectified an osteolytic process centered on the hyoid bone with a fleshy zone of tissue density and calcifications. Cervical MRI provided a more precise assessment of the extension of the mass and confirmed the integrity of the other structures, in particular the endo-larynx. The tumor was totally resected via a cervical approach. The pathologic study suggested a papillary adenocarcinoma on ectopic thyroid tissue. The treatment was completed by a total thyroidectomy with normal histological results.

CONCLUSIONS

Papillary adenocarcinoma on ectopic thyroid is a very rare situation. Its diagnosis is histological. Its treatment is primarily surgical, sometimes associated with radioiodine I-131 therapy.

[Temporomandibular osteomyelitis secondary to progressive necrotizing otitis externa]

INTRODUCTION

Osteomyelitis of the temporomandibular joint is a rare complication of invasive external otitis, often occurring after inappropriate initial treatment of the causal affection.

OBSERVATION

A 65-year-old diabetic man was treated for invasive otitis externa complicated by destructive osteomyelitis of the ipsilateral temporomandibular joint. The diagnosis was suspected clinically and confirmed by imaging. The course was favorable with medical treatment.

DISCUSSION

Osteomyelitis is an extremely unusual complication of invasive otitis externa. Diffusion of the infection toward the temporomandibular joint can be secondary to an osteitis of the bony canal or spread via congenital dehiscences of the external auditory canal. Pain, limitation of mouth opening and auricular swelling are the main clinical signs. Treatment is essentially medical, based on adapted antibiotic therapy.

[Mastoid eosinophilic granuloma: a case report]

OBJECTIVES

Langerhans cell histiocytosis is a proliferating cell disease that may take various forms characterised by bone, skin lymph nodes and visceral lesions. Eosinophilic granuloma is a localised form of histiocytosis X, or Langerhans' cells histiocytosis, a benign form with unknown aetiology. At the head and neck level, it is usually located on the temporal, and usually occur in association with multifocal disease; however, isolated lesions may occur in the mastoid bone alone.

METHODS

The author's present a case of a patient with unifocal eosinophilic granuloma limited to the mastoid treated in ENT and radiotherapy departments.

RESULTS

CT scan demonstrated an osteolytic lesion of the mastoid. The biopsy and immunohistochemical study confirmed the diagnosis. A surgery followed by a radiotherapy (20 Gy) have stabilised the situation. There is no recurrency after one year.

CONCLUSION

Unifocal eosinophilic granuloma of the temporal bone is a benign lesion of langerhans' cell histiocytosis. Its diagnosis is difficult when the disease remains isolated. Its treatment depend on its extension and its risks. The excellent prognosis does not dispense on regulary follow up.

[Laryngeal papillomatosis in adults: report on 4 cases]

Laryngeal papillomatosis is well-known as one part of benign lesions of the larynx in children under 15 years. Cases of papillomatosis are extremely rare in adults.

OBJECTIVES

To report our experience about 4 cases.

MATERIAL AND METHOD

It concerns 3 females and 1 male, who are in good health and without any disease in relation of upper respiratory tract or viruses. For all patients there is no familiar viral disease (especially cutaneous or genital). The age of patients is between 28 and 72 years. All clinical signs at the diagnosis aren't specific and are observed in other laryngeal diseases. Direct micro-laryngoscopy is mandatory in order to establish the right diagnosis and to perform the first stage of local treatment. Micro-instruments are used to remove these benign nipple-like without CO2 laser or local medicines or injections.

RESULTS

Our study mentions a frequent association of gastro-oesophageal reflux (3 cases). The average follow-up is 5 years and half and in this period, there is no malignant evolution.

CONCLUSION

The authors also review the literature and in particular the potential cause of laryngeal papillomatosis and new ideas on treatment of this unusual condition.

[Non-Hodgkin lymphoma of the infratemporalis fossa: a case report]

Extranodal non-Hodgkin lymphoma of the head and neck is usually seen in the Waldeyer's ring. Localizations in the infratemporalis fossa are rare and to date, only seven cases have been reported. The clinical and radiographic features of non-Hodgkin lymphoma is non-specific. Positive diagnosis requires a pathologic examination, generally guided by immunohistochemistry results. We report a case and discuss the epidemiological, diagnostic, therapeutic and prognostic features of these tumors.

[Wegener's granulomatosis. Apropos of a case]

A rare case of granulomatosis of Wegener is rapported in this study. One patient presented with ENT and pulmonary symptoms. The differential diagnosis with tuberculosis was raised. Based on a literature review, the authors discuss clinical, pathological and imaging features of the condition and its management.

[Papillary carcinoma on the site of a thyroglossal duct cyst: report of a case]

The thyroglossal tractus cysts are uncommonly the site of malignant tumors. The detection of such located cancer is always histologic. No clinical sign makes thought the malignant degeneration of a thyroglossal tractus cyst. The authors report here one case of papillary carcinoma of thyroïdal origin developed on thyroglossal tractus cyst. At total thyroïdectomy which was carried out three weeks later, a thyroïd papillary carcinoma was found to be present. So, we think that it is interesting to do a literature review about the malignant degeneration of these cysts, based mainly on relationship between this tumor and an eventual lesion of the thyroïd body. The therapeutical management of cancers of cysts is solely surgical and in general the prognosis of these cancers is excellent.