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Ectopy of the thyroid gland is an abnormal embryological development. Its occurrence in children is rare. In this study, we report the case of a 12-year-old girl that presented with dysphagia and nocturnal dyspnea. Magnetic resonance imaging confirmed the presence of a lingual thyroid. Thyroid scintigraphy showed intense and elective uptake of radiotracer at the base of the tongue. Hormonal tests revealed hypothyroidism. Treatment consisted of opotherapy based on levothyroxine. Evolution has been favourable and the patient showed significant improvement with reduction of the dyspnea and the dysphagia and normalization of thyroid hormone tests.

Introduction: Inhalation of foreign body in children is a serious accident that may compromise the vital prognosis of the child. The diagnostic was difficult in the absence of a recognizable penetration syndrome. Bronchoscopy is still recommended as the appropriate diagnostic and treatment of foreign bodies. The purpose of this study was to analyze the diagnostic and the treatment result of bronchoscopy and discuss its indications., Material and Methods: [corrected] A retrospective study analyzing data related to 223 children undergoing bronchoscopy due to suspicion of foreign body aspiration over a period of 10 years (2000-2009). The average age of the children was 29 months (range: one month-13 years). Approximately, two thirds of these patients were boys. The penetration syndrome was reported in 79.8% of cases., Results: During bronchoscopy, the foreign body was confirmed only in 57.4%. Foreign bodies were found in the bronchus in 79.7% of cases. Among the foreign bodies, 78.1% were of vegetal origin. The average time of stay of the foreign body was of 16.1 days. Penetration syndrome and abnormal physical exam were the most sensitive parameters (79.7% and 82.8%, respectively) but with low specificity (24.2% and 35.8%, respectively). The combination of clinical and radiological signs suggestive of foreign body was the most specific sign (74.7%). Similarly, we found a statistically significant correlation between positive bronchoscopy and simultaneous suggestive clinical and radiological signs (P=0.03). The multivariate study showed that predictors factors of positivity of the bronchoscopy were: abnormal physical exam (P=0.016), abnormal radiological exam (P=0.003) and type of indication (P=0.005)., Discussion: The diagnosis of laryngotracheobronchial foreign body recures an array of arguments. It is suspected on the clinical interview specially penetration syndrome and on the clinical and radiological presentation. Any suspicion should lead to a bronchoscopy., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Objectives: Para-pharyngeal tumors are located deeply. Imaging is mandatory for their management. We conducted a retrospective study to determine the contribution of imaging for their diagnosis and treatment., Patients and Methods: Imaging was performed for 20 cases of primary para-pharyngeal tumors between 1986 and 2008. We compared the imaging to the anatomic and histological features of these tumors., Results: Computed tomography and MRI confirmed the para-pharyngeal location of tumors. Tumors were located in the prestyloid compartment in eight cases, in the retrostyloid compartment in five cases, and in the retropharyngeal compartment in one case. Six tumors had filled all the para-pharyngeal space. Salivary gland tumors had filled the prestyloid space in two cases, and in two other malignant cases all para-pharyngeal space were invaded. MRI failed to differentiate the nature of tumor and its malignancy except when there was obvious bone erosion. The treatment was mainly surgical. The mean follow-up was 5 years 6 months., Discussion: Imaging contributes to the etiological diagnosis and assesses tumor extension, thus helping to choose the surgical approach. MRI is the most contributive examination; its resolution is more adapted to the diagnosis of deep tumors. CT scan is contributive when studying the bone structure., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Introduction: Primary meningiomas of the sinonasal tract are rare tumors. Their positive diagnosis is difficult to establish. From one case observation, we report the clinical features, the diagnosis difficulties and the therapeutic modalities of primary meningioma of the sinonasal tract., Case Report: A seventeen-year-old girl consulted for a left unilateral nasal obstruction with progressive evolution without episodes of epistaxis, smell disorder or headaches over a year. Physical examination revealed a grayish polypoid tumor in the left nasal fossa. CT scan evidenced an isodense lesion of the left nasal fossa slightly enhanced pushing back the lateral nasal wall without invasion or intracranial connection. Biopsy was in favour of an inverted papilloma. The tumor was resected via endoscopic approach. Pathological examination established the diagnosis of meningothelial menigioma. The prognosis was favourable without recurrence after a six-month follow-up., Conclusion: The positive diagnosis of primary sinonasal meningioma is difficult to establish because of their infrequent occurrence in this ectopic site and of their non-specific clinical appearance. The final diagnosis rests on the histological examination. Immunohistochemical studies are helpful to establish the accurate diagnosis. Imaging confirms the primitive nature of these tumors. Prognosis is excellent after complete surgical extirpation without the necessity of adjuvant therapy., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Introduction: Jugular vein thrombosis is mainly due to infectious, neoplastic and iatrogenic causes. Activated protein C (APC) resistance is an exceptional cause of jugular vein thrombosis., Case Report: A 40-year-old woman consulted for left lateral neck swelling present for two weeks. Neck ultrasound revealed left internal jugular vein thrombosis, which was confirmed by contrast CT. The rest of the examination, including routine clotting assessment and inflammatory work-up, was normal. Further investigations demonstrated APC resistance with Factor V Leiden mutation. Treatment consisted of oral anticoagulants with a good outcome., Discussion: APC resistance is a recently identified and relatively frequent cause of thrombophilia, mostly due to Factor V Leiden mutation. APC resistance is responsible for 20% to 50% of all thrombotic events. The laboratory diagnosis is based on two tests: a phenotypic test based on APTT with and without APC and a genotypic test based on detection of a Factor V Leiden mutation., Conclusion: Screening for APC resistance and Factor V Leiden mutation is now part of the aetiological work-up of thromboses, particularly in subjects younger than 50. Treatment is based on oral anticoagulants., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background: Trichoblastoma is a rare and benign adnexial tumor with characteristic histological features. It occurs on any hair folliclebearing location, and usually presents as a solitary lesion most often less than 2 cm in size. Giant trichoblastoma has been rarely reported in the literature., Aim: To report a new case of giant trichoblastoma, misleading for malignancy., Case Report: A 57-year-old woman presented with a 5 cm-solitary asymptomatic nodular lesion of the scalp, of 28 years. It had been previously excised with recurrence and progressive regrowth. On examination, it was a dome-shaped, erythematous, firm, papillomatous, non infiltrated nodule. Full body work up revealed no metastases. Cutaneous biopsy concluded to trichoblastoma but failed to eliminate malignancy. After excision with secondary skin graft, histological examination confirmed the benignity with clear margins. There was no evidence of recurrence after a 5 year-follow-up period., Conclusion: This case illustrates a rare clinical variant of trichoblastoma with an unusual important size. This can be misleading for malignancy, but the slowly progressive course of the tumour in our patient, together with histological benignity led to the correct diagnosis. This tumour is considered as a distinct entity by some authors.

Objectives: To assess the incidence and impact on treatment and prognosis of occult lymph node metastasis in laryngeal cancer., Patients and Methods: A retrospective study was performed on 164 patients treated for laryngeal cancer, initially classified as N0, with cervical lymph node dissection., Results: Occult metastases were found in 41 neck specimens (12.5%) from 32 patients (19.5%). Involvement per neck level was: 7% level IIa, 2.4% IIb, 4.2% III and 2.7% IV. Lymph node involvement was significantly increased in case of T3T4 tumor or invasion of the pre-epiglottic space or cartilage. Survival was significantly influenced by pN status (pN- = 12 years, vs pN+ = 9 years; P = 0.006)., Conclusion: Level IIb or IV involvement is rare. Superselective neck dissection (IIa, III) seems to be indicated in T1T2 N0 tumor. In case of advanced tumor or pre-epiglottic space or cartilage invasion, functional neck dissection is mandatory., (Copyright © 2010. Published by Elsevier Masson SAS.)