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This case report details a rare presentation of cervical Ewing's sarcoma in a 4-year-old female, emphasizing its clinical presentation, diagnostic process, and treatment challenges. The patient initially presented with a rapidly growing neck mass and neurological symptoms; MRI confirmed a well-defined mass at the C5-C6 vertebral level, and histopathological examination verified the diagnosis of Ewing's sarcoma. Treatment involved neoadjuvant chemotherapy, followed by surgical resection with clear margins, and the patient is currently being monitored for recurrence with a guarded prognosis. This case underscores the need for a multidisciplinary approach, early intervention, and thorough surgical planning in managing rare and aggressive tumors in complex anatomical locations, contributing valuable insights to the limited literature on this uncommon malignancy.

Carotid body tumors (CBTs), or chemodectomas, are rare, especially in the pediatric population. They often present with minimal symptoms, making timely diagnosis challenging. This case report and systematic review highlights a distinctive presentation and summarize the current evidence on pediatric CBTs. We report a case of a 13-year-old girl presenting with neck pain and a left-sided neck mass. After extensive evaluation, a Shamblin type III tumor was identified and removed surgically. Postoperatively, the patient experienced transient hypertension and significant dysphagia, both of which resolved within a few weeks with no permanent sequelae. Histology confirmed a benign paraganglioma. A systematic literature review of PubMed identified 29 cases from 23 published studies spanning from 1968 to 2024. The average age at diagnosis was 12.6 ± 3.6 years. The most common symptom was a neck mass or swelling, reported in 75% of cases (n = 21). Tumor sizes ranged from 1.3 to 8.0 cm, with Shamblin III being the most frequent classification. Gross total resection (n = 25 [89.3%]) alone or in combination with preoperative embolization (n = 10 [35.7%]) were the most common methods of management. In 62.1% of cases, there were no permanent complication or sequelae. The proximity to vital neurovascular structures and high vascularity in pediatric patients necessitates careful perioperative interdisciplinary management. Owing to their rarity and nonspecific presentation, CBTs often remain undiagnosed for years. They respond well to treatment, but can be fatal if untreated, underscoring the importance of including CBTs in the differential diagnosis of pediatric neck masses.

Carcinoma showing thymus-like differentiation (CASTLE) is a rare malignant tumor that accounts for 0.1%–0.15% of all thyroid cancers. More than half of the patients have tumor extension to adjacent organs, including the recurrent laryngeal nerve, trachea, and esophagus. The diagnosis of CASTLE is based on histology and immunohistochemistry. A 58-year-old female patient complained of hoarseness for one and half years. Right side vocal cord palsy was diagnosed by fiberscopy. Thyroid sonography revealed right thyroid tumors, which were reported to be papillary thyroid carcinoma through FNAC. Total thyroidectomy with central lymph node dissection was performed. Pathologist found 2 isolated malignancy tumors. One patient in the right thyroid lobe had papillary thyroid carcinoma features. The other extrathyroid tumor seemed to be separated from the first tumor and invaded the thyroid capsule. After multiple immunohistochemical studies, PTC synchronous CASTLE was the final diagnosis. Coexisting PTC and CASTLE is very rare. This is the first report to describe a case showing PTC at first, while subsequent pathologic examination revealed the presence of CASTLE in addition to PTC. Since the prognosis of CASTLE is favorable, the treatment is different from other aggressive thyroid cancers, such as poorly differentiated or anaplastic thyroid carcinoma. [ABSTRACT FROM AUTHOR]

Background: Masson's tumor, commonly referred to as intravascular papillary endothelial hyperplasia (IPEH), is an uncommon growth of endothelial cells within a vessel wall that is frequently assumed to indicate an abnormal resolution of thrombosis. IPEH is most typically found in the extremities however it is rare for IPEH to appear as a neck tumor. The issue with IPEH is that it could clinically, radiologically, and pathologically imitate some malignant neoplasms such as angiosarcomas creating a diagnostic challenge. Case Report: We describe a 21-year-old male patient who presented with right anterolateral neck swelling for 12 months. Ultrasound revealed a 9.0 × 8.0 cm well-defined echogenic hyper-vascular lesion. The contrast computed tomography (CT) scan of the neck revealed an oval, well-defined subcutaneous mass, measuring 9 × 4.5 cm, situated over and separable from the right sternocleidomastoid muscle with no significant enhancement in the post-contract study. T1-weighted and T2-weighted MRI revealed a 10 × 9 × 7 cm well-defined subcutaneous lobulated lesion superficial to the sternocleidomastoid expanding upward to the Rt. side of the cheek and below to the suprasternal region, eliciting an intermediate signal in T1 and a heterogenous bright signal (mostly fluid) in T2 with low signal foci within the mass. The decision had been reached to entirely excise the lesion surgically with safety margins for histological evaluation. Histological examination indicated thrombosed variable-sized ectatic vascular spaces with papillary formations related to the thrombus, covered with a single layer of flat endothelium, and no features suggestive of malignancy. There was no recurrence at 18 months follow-up post-surgery. Conclusion: Masson's tumor is a benign intravascular disease with an unclear origin and no confirmed inheritance pattern. Presentation of Masson's tumor as a neck mass is incredibly uncommon. Masson's tumor lacks a distinct or distinguishing clinical and radiological appearance. Histopathologic examination is the sole definitive way for diagnosing the disease and the only tool for distinguishing it from angiosarcoma. Surgical excision is the best treatment for IPEH. Recurrence is extremely rare. [ABSTRACT FROM AUTHOR]

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Background: Extracranial hypoglossal schwannoma is a rare tumor primarily treated with surgical excision. This article aims to highlight the potential for unexpected complications intraoperatively, such as cerebrospinal fluid leakage from skullbase to neck. Methods: A previously healthy 23‐year‐old male presented with tongue numbness. Magnetic resonance imaging revealed a 17 × 20 mm nodular lesion adjacent to the cervical segment of the internal carotid artery. Surgical excision was scheduled due to suspicion of a neurogenic tumor. Results: Intraoperatively, despite careful handling, cerebrospinal fluid leakage was observed. Manipulation of the mass caused detachment of proximal nerve fibers, potentially indicating avulsion of the hypoglossal nerve from the brainstem or nearby. Clear fluid leakage from the skull base was also noted. Conclusion: Thorough preoperative evaluation and patient education regarding potential complications are crucial. This article presents an unexpected complication encountered during surgical excision of extracranial hypoglossal schwannoma, emphasizing the need for awareness and preparedness in such cases. [ABSTRACT FROM AUTHOR]

In the present case, a 41-year-old male patient had reported a large swelling on the right side of his neck that had been radiographically diagnosed as a carotid body tumor. The tumor extended toward the right thyroid lobe, deep to the parapharyngeal space and cranially to the base of the skull. The clinical and medical imaging findings confirmed the diagnosis. Because of the large size of the tumor (50 mm × 48 mm × 85 mm), extent of involvement, and hypervascularity, surgical excision by midline mandibulotomy was chosen as the treatment approach. Midline mandibulotomy is a very good approach for large tumors with extensive involvement of the surrounding tissues, especially tumors with great medial and cephalic extension.

A highly vascular glomus tumor that develops from the paraganglion cells of the carotid body is called a carotid body tumor (CBT), also known as a chemodectoma or carotid body paraganglioma (CBP). It is situated near the carotid bifurcation, where the external and internal carotid arteries splay out characteristically. We present a case of a 30-year-old woman who had a slightly tender, slightly pulsatile, and slightly ballotable swelling over the lateral aspect of the neck on the right side. The surgical resection of the tumor was done based on the diagnosis made on clinicalradiological investigations as a carotid body tumor further confirmed by a histopathological study. We also provide a summary of the research on carotid body tumors clinical and imaging manifestations, assessment, and therapy. [ABSTRACT FROM AUTHOR]

Point-of-care ultrasound (POCUS) in the head and neck region plays a particularly significant role in the diagnosis and treatment of upper airway stenosis, swelling, and painful diseases in the neck, and in the evaluation of swallowing function. Therefore, it should be performed in various medical settings beyond the boundaries of the clinical department such as general medicine, emergency medicine, anesthesiology, orthopedics, and pediatrics. The target diseases are salivary gland disease, lymph node disease, pharyngeal disease, laryngeal disease, esophageal disease, thyroid disease, and dysphagia and dyspnea due to various causes. Head and neck POCUS is an extremely useful diagnostic method for both patients and doctors, and its use is expected to become more widespread in the future. [ABSTRACT FROM AUTHOR]

A solitary infantile myofibroma tumor arises as a hard, painless cutaneous or subcutaneous nodule and is defined as an uncommon soft tissue neoplasm that is usually seen in childhood. A nine-month-old female infant presented with a solid mass that appeared one month ago. The mass gradually increased in size within the right posterior triangle of the neck, without any local or systemic accompanying symptoms. Laboratory tests were normal. Ultrasonography revealed a homogeneous tissue mass measuring 1.5 × 3 cm, with blood flow within it. Multislice CT scan accurately localized the isolated tumor. The mass was surgically excised and found within the sternocleidomastoid muscle, without any adhesions to adjacent tissues. Histological examination of the tumor and immunohistochemical tests confirmed infantile myofibroma. IM is one of the most common soft tissue tumors in children and mainly consists of myofibroblasts. 90 % of IM cases are diagnosed before the age of two years. Possible therapeutic measures for this tumor include conservative management, surgical resection, chemotherapy, radiation therapy, and steroid injections into the tumor. Surgical removal of the tumor is often performed, and if it is single and completely removed, the prognosis is good with a recurrence rate of less than 10 %. Infantile myofibroma is considered a benign tumor, but it may be fatal in some cases. Each case is treated individually according to the number (single or multicentric), size, location, symptoms, and visceral involvement. Surgical resection remains the therapeutic procedure of choice in most cases. • Infantile myofibroma (IM) is a rare benign tumor that typically occurs before the age of two years. • An isolated myofibroma accounts for 70% of IM cases, and in one-third of cases, it is located in the head, neck, or trunk. • Complete surgical resection is the preferred treatment. • A biphasic growth pattern is the descriptive histological feature of IM. [ABSTRACT FROM AUTHOR]

EWSR1-PATZ1 is a rare gene fusion recently recognized to occur in round and spindle cell sarcomas. To date, fewer than 20 cases have been described in the literature. However, no dedicated case reports have detailed its presentation in the head and neck region. We recently cared for a 52-year-old woman with an isolated, single right level 5A cervical mass. Excisional biopsy at an external hospital revealed pathology results consistent with EWSR1-PATZ1 polyphenotypic round and spindle cell sarcoma. The patient subsequently underwent surgical excision of the tumor and right neck lymph node dissection followed by adjuvant chemoradiation. Laryngoscope, 2020. [ABSTRACT FROM AUTHOR]

Neck lumps can be a symptom of thyroid and parathyroid gland metabolic diseases, and papillary thyroid carcinoma is reported in some cases. It is commonly observed in middle-aged people with a female predominance. Papillary carcinoma of the thyroid is the most common type of thyroid cancer, originating from the thyroid gland cells. It is slow-growing and less aggressive, but it has been reported to have the ability to affect nearby lymph nodes and other organs. It is associated with the RET protooncogene, NTRK1, and MET genes. Early detection is crucial, especially for middle-aged patients. Treatment typically involves thyroidectomy and radioactive iodine therapy, with the need for hormone replacement therapy. Fine-needle aspiration cytology (FNAC) is an efficient and cost-effective tool for diagnosing neck swellings, leading to a conclusive diagnosis of the mass. We present a case of a 60-year-old Indian female with swelling over the neck for the past six years, which was recently accompanied by dyspnea, hand tremors, and palpitations. The ignored neck mass was found to be a hyper-echoic mass with macro calcifications and cystic degeneration on ultrasonography, confirmed as papillary thyroid carcinoma by FNAC, followed by a complete thyroidectomy and uneventful follow-up., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bhargava et al.)

Background: Oral cancer is one of the common malignant tumors of the head and neck. However, current treatments have numerous side effects, and drugs from natural sources may have better therapeutic potential. This research investigated the induction of apoptosis by α-hederin (α-HN), a constituent of Pulsatilla chinensis (Bunge) Regel, in the oral cancer cell line SCC-25 and its underlying mechanism. Results: SCC-25 cells were treated with 50, 100, and 200 µmol/L α-HN. Cell proliferation; extent of apoptosis; activities of caspases-3, 8, and 9; and the expression of Bcl-2, Bax, phosphorylated (p)-phosphoinositide 3-kinase (PI3K), p-Akt, and p-mammalian target of rapamycin (mTOR) proteins were determined using the 3-(4,5)-2-thiazole-(2,5)-diphenyl tetrazolium bromide, flow cytometry, caspase activity detection kits, and western blot assays, respectively. The results showed that the proliferation of SCC-25 cells in the α-HN-treated groups decreased significantly, and the inhibitory effect was time and concentration dependent. Compared with cells in the control group, the extent of apoptosis increased significantly, caspase-3 and -9 activities were significantly enhanced, and the Bcl-2 level was lowered and the Bax level was elevated significantly in SCC-25 cells treated with α-HN for 48 h (P b 0.05). The expression of p-PI3K, p-Akt, and p-mTOR was also significantly lower in SCC-25 cells treated with α-HN than that in the control group (P b 0.05). Conclusion: These results indicate that á-HN can inhibit proliferation and induce apoptosis of SCC-25 cells and may exert these effects by inhibiting the PI3K/Akt/mTOR signaling pathway. [ABSTRACT FROM AUTHOR]

Primary small neuroendocrine carcinoma (SNEC) of the tonsil it's a rarity. We present the case of a 64 year-old Caucasian male patient referred to our hospital due to a neck mass. A fixed non-tender rock hard supraclavicular right mass and ipsilateral cervical lymphadenopathy was palpable. Biopsy was performed and showed poor differentiated neoplasm with features of SNEC. A fludeoxyglucose positron emission tomography (FDG-PET) scan showed intense uptake in the right tonsil. The patient underwent right tonsillectomy and immunochemistry was positive for characteristic features of small cell neuroendocrine carcinoma. Right tonsil SNEC was diagnosed and the patient was proposed to chemotherapy. [ABSTRACT FROM AUTHOR]

Introduction. Metastatic melanoma of unknown primary (MMUP) is already a well described oncologic phenomenon in the literature, whereas tissue defects’ reconstructions on the neck region always present a challenge for the reconstructive surgeon. Two cases of giant metastatic, skin infiltrative neck tumor masses are presented. In both cases MMUP was diagnosed. Both intraoperative tissue defects were reconstructed using pectoralis major (PM) regional flap. Outline of cases. The first patient was admitted with giant tumor mass on the right side of the neck. The fast growing mass appeared two months prior to the admission. Thorough examination showed no signs of primary tumor. Removal surgery was performed and the defect was reconstructed using the PM musculocutaneous flap. The second patient was admitted with large tumor mass on the left side of the neck. Thorough examination displayed no signs of any primary tumor. After the excision, the tumor mass and subsequent neck dissection, reconstruction followed, using the pedicled PM muscle flap and partial thickness skin transplants. There were no major complications in either case. The histopathological examinations presented metastatic melanoma diagnoses. Conclusion. Clinical outcome of MMUP described in literature is rather variable. Different studies have shown that prognosis in patients with MMUP is better than that in patients with diagnosed primary melanoma with metastatic disease. Therefore, the best initial course of action in those cases would be surgery, according to oncological principles, if possible. Neck defects’ reconstructions should fulfill both functional and esthetic demands. Due to the reliability and low cost of the procedure, PM regional flap presents a very good and trustworthy reconstruction modality.

The present study aimed to establish a strategy for parapharyngeal space (PPS) tumor surgery based on preoperative symptoms, clinical signs, imaging and histological examination. A retrospective cohort study was conducted with 29 adult patients who underwent surgery for primary PPS tumors from 2008-2015. The following data was obtained: Preoperative symptoms of the patient, histological type of the tumor, surgical approach and complications. Of the 29 patients who underwent surgery to remove a PPS tumor, 16 presented with neurogenic tumors and 13 with salivary gland tumors. The most common symptom was the presence of a neck mass. Preoperative computed tomography and magnetic resonance imaging were performed to evaluate the size and location of the tumors. The majority of the salivary gland tumors were located in the prestyloid space, whereas all neurogenic tumor cases were poststyloid. A total of 21 of the 29 patients (72.4%) underwent a preoperative fine needle aspiration (FNAC) examination. FNAC contributed to preoperative diagnosis in 9 of these cases (42.9%). In parotid tumors of the prestyloid space, facial nerve palsy was a common postoperative complication. In the case of neurogenic tumors, a common complication was the postoperative palsy of the nerve of tumor origin. The strategy for PPS surgery, from the preoperative diagnosis to the operative method, remains controversial. The data on pre- and postoperative symptoms, imaging and histological diagnosis, and the selection of surgical method depending on a neurogenic or salivary tumor origin in the present study indicated that improving the method of examination, carefully selecting the method of approach and accurately managing surgery leads to complete tumor removal, and that the use of nerve-preserving techniques may reduce the likelihood of complications. [ABSTRACT FROM AUTHOR]

Takayasu arteritis is a rare, idiopathic inflammatory disease of the aorta and its major branches, usually affecting young women of Asian descent. In the course of the disease stenosis, occlusions as well as dilatations and aneurysms of vessels occur. Because of many possible localizations of pathological changes, the symptoms have a wide range, but the most common are a weak pulse or its absence on the brachial artery and a difference in systolic pressure above 10 mm Hg between the upper extremities. Here we present a case report of a young woman with Takayasu arteritis, who presented a palpable mass in the back of her neck, significantly diminished after treatment with glucocorticoids. [ABSTRACT FROM AUTHOR]

Lipomas are the most common subcutaneous soft-tissue tumors. These are benign tumors originating from the adipocytes. They may be located in any part of the body and can be confused clinically with other soft tissue masses. They infrequently occur in the head and neck region. We present a case of solitary lipoma arising in the neck region that was reported to our division of oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Malignant peripheral nerve sheath is a rare neoplasm seen in humans, with a very small percentage of occurrence in the cervical region. It is an aggressive form of sarcoma, usually arising from peripheral nerves. In this case study, we present a 61-year-old male who was reported to the hospital with a chief complaint of swelling on the right side of his neck. Magnetic resonance imaging (MRI) revealed a heterogeneous mass in the cervical region, which is reported as a schwannoma. The patient was posted for surgery for tumor excision. The patient was managed with analgesics, physical therapy, and wound care. The patient's symptoms were relieved, and he was discharged. In conclusion, combined surgical resection and adjuvant treatments like physical and medical therapy improved the functional outcome. However, this literature does not address radiation therapy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Malhotra et al.)

A 56-year-old healthy man noticed a stony-hard mass gradually grown in his neck for more than a 6-year period. Examinations revealed 2 additional calcified masses at the esophageal hiatus and retroperitoneum. The cut-surface of the operative specimens showed fibrous and mucinous appearance with many calcified islands. Microscopically, the lesion showed a gradual transform from the central immature area with fibroblasts and mucinous matrix, to the peripheral mature area with woven bone and osteoclasts (zoning phenomenon), which was compatible with the features of mature myositis ossificans. Myositis ossificans is an isolated, benign, nonneoplastic disease typically found in adolescence, after traumatic episode. Similar lesions have been found in the major musculature of patients with increased bleeding tendency. In the present case, idiopathic thrombocytopenic purpura was found to be associated and was suggested to be involved in initiating myositis ossificans. Still, it is extremely rare to observe lesions in these sites synchronously. [ABSTRACT FROM PUBLISHER]

Cervical teratomas are rarely encountered in adults. We report herein the case of a 21-year-old woman who was admitted to our hospital for surgical treatment of a neck tumor, 7.5×4.5×2.7 cm in size, located in the left lower pole of the thyroid. Ultrasonography (US) and computed tomography (CT) revealed a multicystic tumor. The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19–9 (CA 19-9), and squamous cell carcinoma-related antigen (SCC) in the cystic fluid were extremely elevated in contrast to the normal levels found in the serum. The tumor was completely excised and histological examination revealed it to be composed of elements derived from the three germ layers, confirming a diagnosis of benign cystic teratoma. [ABSTRACT FROM AUTHOR]

Background: This paper reports a case of an 87-year-old female patient who was admitted for an emergency operation due to massive hemorrhage of an ulceration localized on a huge neck tumor. Post-interventional diagnosis indicated hidradenocarcinoma. Hidradenocarcinoma is a rare skin neoplasm. It can coincide with adenoma, may develop through its malignant transformation or develop as a malignant tumor from the beginning. It may be found in all dermal localizations. It may develop metastases or appear in the diffuse form. Material and methods: Surgical excision of the tumor was performed obtaining a surgical margin, completed with excision of local lymph nodes and multiple layer suturing. Due to lack of the patient's consent, she has not been qualified for adjuvant therapy. Results : Control examination 6 and 12 months later showed no signs of local recurrence or lymph node metastasis. Conclusion: Surgical excision of apocrine hidradenocarcinoma with a surgical margin could present a good therapeutic effect in spite of lack of adjuvant therapy. [ABSTRACT FROM AUTHOR]

Abstract: Cervical malignancies are a rare but well-known cause of syncope. Gestural automatisms during syncope have only rarely been reported. We describe a patient presenting with bimanual automatisms during syncopal episodes caused by parapharyngeal carcinoma involving the right laterocervical region. Ictal phenomenology was strongly suggestive of focal seizures and only video-polygraphic recording including EEG and ECG allowed the correct diagnosis to be established. Syncopal episodes ceased after partial removal of the mass. Although gestural automatisms in the context of a sudden spell with loss of consciousness are strongly suggestive of focal (mainly frontal or temporal) seizures, the diagnosis of syncope must be taken in account and confirmed or excluded by appropriate neurophysiological investigations. [Copyright &y& Elsevier]

Background and Objectives: Current management guidelines recognize the impact of hepatic versus peritoneal sided gallbladder cancers (GBC) on survival. However, no data exist regarding the significance of anatomic tumor location within the gallbladder., Methods: We retrospectively analyzed all GBC that underwent surgical resection with curative intent in our health system from 2007 to 2017. We evaluated the effect of anatomic pathologic tumor location (fundus/body, neck, and multifocal) on clinicopathologic, perioperative, and oncologic outcomes., Results: About 97 patients met criteria; 63% fundus/body, 22% multifocal, and 15% neck. Compared with fundus/body, neck tumors more frequently presented with preoperative jaundice (53% vs. 13%, p < .001), were smaller (20 mm vs. 30 mm, p = .068) and had significantly more biliary tree invasion (33% vs. 13%, p = .030) on histopathology. Although tumor characteristics (pTNM stage, liver invasion, lymphovascular invasion, prognostic nutritional index, and grade) were similar, neck tumors had significantly higher rates of R0 resection (53% vs. 11%, p < .001). Rates of adjuvant therapy were similar. Median PFS was similar between cohorts (p = .356). However, median overall survival (OS) was significantly shorter in neck (21 months) than fundus/body tumors (NR > 109 months), p = .015., Conclusions: Neck tumors were rare, small and more likely to result in jaundice secondary to biliary tree invasion. Despite higher R0 resection rates, these tumors had significantly worse OS., (© 2020 Wiley Periodicals LLC.)

Inflammatory myofibroblast tumor (IMT) is a unique intermediate soft tissue tumor, comprising myofibroblasts/fibroblasts, with infiltrating plasma cells, lymphocytes, and/or eosinophils. IMT, first reported in 1939 in the lung or pleura, is most common in children or adolescents and in the lungs; however, it can also occur in other tissues. The exact etiology and pathogenesis of IMT are yet to be clarified. Virus-induced trauma, surgery, autoimmune etiology, inflammation, infection, and abnormal responses to long-standing exogenous stimuli in the body, dominated by myofibroblast proliferation, can lead to IMT development. Most patients with IMT have masses, with or without physical manifestations, including fever, weight loss, and various clinical laboratory abnormalities. Surgical resection is the main treatment. IMT is not common in the head and neck region, and additional thyroid involvement is rare. A male patient presented a rapidly growing neck mass was treated and diagnosed with IMT in the neck and thyroid involvement in our hospital in September 2018 by successful surgical resection. Follow-up for 6 months showed no recurrence or metastasis. We review the etiology, clinical features, pathological features, treatment, and prognosis of IMT, with the aim of improving the diagnosis and treatment of this condition in the head and neck region., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/gs-20-355). The authors have no conflicts of interest to declare., (2020 Gland Surgery. All rights reserved.)

The carotid body is the largest collection of paraganglia in the head and neck and is found on the medial aspect of the carotid bifurcation bilaterally. Carotid body tumors are rare neoplasms arising from the chemoreceptor cells of the carotid bulb. We report a case of carotid body tumor in a 42-year-old female, who presented with painless, pulsatile, gradually progressive lateral neck swelling. The diagnosis is suspected on the basis of history, clinical and radiological examination findings and a successful surgical excision of the tumor is performed. Histopathological examination confirms the diagnosis of carotid body tumor. We also present brief literature about carotid body tumors in terms of its clinical and imaging presentation, evaluation, and management.

Abstract: Laryngomalacia is a common cause of chronic noisy breathing that can present as stridor in infants and neonates. Mild cases of laryngomalacia are usually followed clinically and managed conservatively. However, the evaluation and diagnosis could be challenging in some patients. We present a case of a 3-week-old male infant with persistent and worsening noisy breathing, snoring, and poor weight gain, prompting further evaluation. The patient had an initial diagnosis of laryngomalacia and obstructive sleep apnea with complete resolution of loud breathing with continuous positive airway pressure. A repeated evaluation of the upper airway for further investigation led to the diagnosis of a neck mass compressing the airway. We review the clinical presentation, management, and follow-up of this patient, as well as the literature of possible etiologies. In the case of our patient, timely diagnosis and treatment had significant prognostic implications., (© 2019 American Academy of Sleep Medicine.)

Introduction: Parapharyngeal space (PPS) is the anatomical area lateral to the upper pharynx and clinically important due to PPS tumors. They account for less than 1% of head and neck neoplasms. Both benign and malignant neoplasms may arise there and typical for this localization is diversity of histological origin. Complete surgical excision is still the basis of treatment., Aim of the Study: Evaluation of the results of surgical treatment of PPS tumors in the Department of Otolaryngology at the Medical University over the period 2015-2017., Material and Methods: A retrospective analysis of medical records including complaints, physical examination, results of imaging studies, surgical approach, postoperative complication and histopathological results in 22 patients with a diagnosis of a PPS tumors., Results: The most frequent complaints reported by the patients were: discomfort in the throat, dysphagia, hearing disorders and a palpable tumor on the neck. Asymptomatic course of the disease was demonstrated in 4 cases. All patients were treated surgically: 2 with transoral approach, 9 with transparotid-transcervical approach, 11 with transcervical approach. In most cases the tumor was removed radically. In 2 patients intracapsular tumor resection was performed. Based on histopathological examination the benign lesions dominated (18/22). In 4 cases malignant neoplasms were diagnosed: carcinoma ex pleomorphic adenoma, adenoid cystic carcinoma and two cases of squamous cell carcinoma. The most common origin of PPS tumors was deep lobe of parotid gland and for this group 11 patients had diagnosis of pleomorphic adenoma. Other diagnosis included: paraganglioma, neurofibroma, hemangioma, lymphangioma and rhabdomyoma. Postoperative complications occurred in 9 patients and presented as hoarseness and dysphagia due to paresis of the lower group of cranial nerves (IX, X, XII). Significant intraoperative bleeding during surgery occurred in 2 cases and ligation of the external carotid artery was necessary., Conclusion: Due to the anatomical topography of PPS and its content with the essential vessels and the lower group of cranial nerves, the surgical treatment of pathology of this area is still a challenge for head and neck surgeons. The decrease of voice quality and impaired speech and swallowing should always be considered as complications post the surgical resection in PPS.

The article presents a case study of a 33-year-old man suffering from schizophrenia and had longstanding painless huge anterior neck mass. The computed tomography (CT) of the neck showed lobulated cystic neck mass that extended from the base of the tongue to the floor of the mouth and anterior to the hyoid bone. It also informs that the thyroglossal duct cyst (TGDC) is the congenital neck anomaly in childhood.

A 49-year-old woman was referred to our department for increased schwannoma of the right neck and mediastinum. We chose a robot-assisted endoscopic approach to minimize the operative trauma. After exposure of the thyroid through the right axilla, the neck tumor was resected using the da Vinci Surgical System. A mini-thoracotomy was then made in the left third intercostal space through the axillary incision, robotic instruments were introduced across the thoracic cavity, and the tumor was excised circumferentially using the robot. Histopathological examination of both specimens revealed schwannomas. This procedure has benefited the patient with good cosmetic results and allowed her to rapidly resume her daily activities. [ABSTRACT FROM AUTHOR]

Accessory nerve schwannoma are extremely rare. The preoperative consideration of this diagnosis will lead to appropriate surgical management with preservation of motor nerve function. In this article we review the literature and report a case treated successfully based on preoperative MRI findings. [ABSTRACT FROM AUTHOR]

A patient with recurrent tonsillar carcinoma in his neck presented with cardioinhibitory neurocardiogenic syncope. Ventricular demand pacing was ineffective in preventing recurrent symptoms. The pacemaker was upgraded to a dual chamber device with hysteresis that eliminated further syncopal episodes. [ABSTRACT FROM AUTHOR]

Abstract: Lipoblastoma and lipoblastomatosis are rare tumors of infancy. They originate from embryonic fat and localize in soft tissues. We present the case of a lipoblastoma of the neck with localization in tracheal and esophageal walls that required an extended laryngotracheal and esophageal resection. To our knowledge, this is the first report of such localization of this tumor. [ABSTRACT FROM AUTHOR]