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Abstract Background The sinonasal inverted papilloma is a rare benign tumor, characterized by local aggressiveness, a high rate of recurrence after surgical resection, and the possibility of malignant transformation. The aims of this study are to analyze diagnostic strategy and therapeutic modalities and to evaluate results after surgery. Methods We report a retrospective study, including patients operated for inverted sinonasal papilloma in our department. Preoperatively, all patients were assessed by CT scan (computed tomography), 9 of them by MRI (magnetic resonance imaging). Results The average age of our patients was 52 years with a male predominance. The most common symptom was unilateral nasal obstruction. The endoscopic appearance was suggestive of inverted papilloma (IP) in 75% of cases. Thirty-two patients underwent an exclusive endonasal endoscopic surgery; one patient was operated with a combined approach. Two patients underwent external approaches. A recurrence was observed in 4 patients (11%). Conclusion Preoperative investigation for IP is essentially based on MRI, also required in case of recurrence. Histological examination of the entire tumor is crucial to rule out an associated carcinoma. The “all endoscopic” management is not always achievable for these tumors.

Abstract Background Lymphatic malformations are rare benign tumors that result from congenital and acquired alterations of the lymphatic vessels. They occur most commonly on the head and neck region. The aim of this study is to describe clinical profiles of lymphatic malformations of the head and neck (LMHN) as well as to study therapeutic modalities through our series and review of the literature. Results This is a retrospective record-based descriptive study conducted in the ENT and the Radiology departments over a 17-year period. Our study included twelve patients, aged between 8 months and 52 years. Two swellings were present at birth and had not been prenatally diagnosed in both cases. One patient was affected by TRISOMY 21. All patients consulted for a painless mass of the head or neck. Seven masses were located in the suprahyoid region and five in the infrahyoid region. Ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) were realized to establish the diagnosis and assess the extent of the lesions. Surgical excision was performed in 7 patients. It was complete in 6 patients. Five patients were treated with sclerotherapy. The sclerosing agents used were Aetoxisclerol 2%, hypertonic saline, and absolute alcohol. One patient had a reversible paresis of the left mental nerve after surgery. An excellent response to sclerotherapy with complete resolution was obtained in 3 cases with no recurrence of the disease. Conclusions Surgical excision has been the management option of choice for LMHN. The recent advances in sclerotherapy make it safe and effective as a primary treatment modality for these lesions.

INTRODUCTION: Les carcinomes nasopharyngés (CNP) sont relativement fréquents dans le pourtour méditerranéen. La survie a été largement améliorée avec les nouvelles techniques d´irradiation et les nouvelles molécules de chimiothérapie. L´objectif de notre étude est d´analyser les résultats thérapeutiques et décrire les facteurs pronostiques des CNP. METHODES: il s´agit d´une étude rétrospective menée entre Janvier 1995 et Décembre 2014, des observations de patients traités et suivis dans notre service pour un carcinome du nasopharynx. Le recueil des données a été réalisé à partir d´une fiche type. L´analyse statistique a été réalisée à l´aide du logiciel SPSS. La survie a été calculée selon la méthode de Kaplan-Meier. RESULTATS: soixante-treize cas de CNP ont été colligés. L´âge moyen était de 48 ans. Une prédominance masculine a été notée. La majorité des tumeurs (56%) étaient localement avancées (T3-T4). Après un recul moyen de 45,5 mois, le taux de récidives locorégionales était de 19,4%. Trois patients (4%) ont présenté des métastases osseuses. La survie globale à 5 ans était de 65%. Les facteurs influençant positivement la survie globale à l´analyse étaient le stade TNM précoce et le fractionnement de 1,8 Grays/séance de la radiothérapie. Les taux de récidives locales et ganglionnaires étaient respectivement de 13,8% et 5,5 %, essentiellement pour des tumeurs classées T4 N2. Les séquelles thérapeutiques étaient dominées par les otites séromuqueuses (42,7%), le trismus (38,7%) et la xérostomie (32%). CONCLUSION: la survie globale des CNP s´est améliorée particulièrement avec l´avènement de la radio-chimiothérapie concomitante néanmoins la toxicité tardive invalidante demeure non négligeable. Les facteurs de bon pronostic retrouvés dans cette étude était le stade tumoral précoce ainsi que la modalité de fractionnement de la radiothérapie.

Carcinoma of the thyroid gland is one of the most commonly encountered endocrine malignancies. Papillary carcinoma is the most common histological type and its pattern of metastasis are usually lymphatic. Lymphatic metastasis to parapharyngeal space is rare and have been reported, so we report a case of 50-year-old male patient who had an occult papillary carcinoma of the thyroid presented as right lateral node of the neck and a nodal involvement of the right parapharyngeal space.

Mucoceles are slow-growing paranasal sinus cystic masses whose clinical presentation varies according to the affected sinus. Diagnosis is often radiological, based essentially on CT scan. The aim of this work was to study the radiologic characteristics of mucoceles on CT scan and MRI. We conducted a retrospective study of patients with mucoceles explored by imaging and operated on in our department. In our series, fronto-ethmoidal sinuses were the most frequently affected (81%). Facial scan confirmed the diagnosis in the majority of cases. Magnetic resonance imaging (MRI) was performed in 4 cases. Eleven patients were operated on by endonasal approach, three by external approach and one by combined surgical approach. Recurrence was observed in two patients after an average delay of 24 months. CT scan is considered the method of choice in the investigation of mucoceles. MRI is indicated in some cases to assess any orbital or intracranial extension.

Le carcinome parathyroïdien est une tumeur maligne, très rare, de la glande parathyroïde. Cliniquement, ce cancer se présente souvent par un tableau d'hyperparathyroïdie primaire sévère. Le diagnostic est histologique mais n'est pas toujours aisé. Le traitement est basé sur la chirurgie. Femme âgée de 59 ans, aux antécédents d'hypertension artérielle, et de lithiases rénales récidivantes, consultait pour des douleurs osseuses diffuses avec asthénie. L'examen du cou a trouvé une tuméfaction basi-cervicale dure et à bord inférieur non palpable. A la biologie: hypercalcémie à 4,1 mmol/l, une hyperparathyroïdie avec valeur de parathormone (PTH) très élevée à 1088 pg/ml soit 13 fois la normale. La scintigraphie au Technétium-99m-sestamibi a montré une plage de fixation anormale de MIBI en projection de la parathyroïde inférieure gauche. Une parathyroïdectomie inférieure gauche, avec évidement médiastino-récurrentiel homolatéral ont été réalisés. Les suites opératoires étaient marquées par la normalisation de la calcémie et de la PTH. L'anatomopathologie était en faveur d'un carcinome parathyroïdien. Le diagnostic de carcinome parathyroïdien est généralement établi sur la conjonction de signes radiologiques biologiques et histologiques. La gravité de cette pathologie est due à l'hypercalcémie sévère et au risque de récidive et de métastases à distance justifiant la surveillance prolongée.

Complications occur in 3% of the cases of frontal sinusitis. These are mainly oculo-orbital, intracranial and osteomyelitis. Our aim is to describe the contribution of different imaging modalities in the diagnosis of these complications and their post-treatment monitoring. within a 15 years period (2000-2014), 10 patients with complicated frontal sinusitis were included into this retrospective study. 10 patients (9 males) aged 9 to 70 year old (mean 28). Two of these patients (20%) had a history of craniofacial trauma. Frontal headache was present in all cases (100%), frontal swelling in 8 cases (80%) and unilateral palpebral edema in 3 cases (30%). A CT scan of the face and brain was performed in all cases and revealed frontal osteomyelitis in 6 cases (60%), extradural empyema in 3 cases (33%), intracranial frontal abscess in 2 cases (20%) and occulo-orbital complications in 3 cases (30%). Magnetic resonance imaging was performed in one patient and demonstrated thrombosis of the upper longitudinal sinus. 40% of our patients associated 2 complications. Cross-sectional imaging is important in early and accurate diagnosis of complicated frontal sinusitis.