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Objective: To evaluate the radiological features of IgG4-related disease (IgG4-RD) in the head and neck region. Methods: In this radiology-based study, radiological features, clinical, laboratory, pathological findings, and prognosis of nine patients with head and neck involvement diagnosed with IgG4-RD were investigated retrospectively. Results: The median age of the patients was 38 years (range: 2.5-79 years), and there were six males and three females. The most common symptoms and clinical findings of the patients were eyelid and lacrimal gland swelling, painless exophthalmos, and ophthalmoplegia. The most common site of involvement on MRI was the orbit. Orbital involvement was followed by branches of the trigeminal nerve, sinonasal cavity, cervical lymph nodes, and dural involvement. The most common and remarkable imaging features were T2 hypointensity and diffuse homogeneous contrast enhancement. Conclusions: Head and neck involvement of the IgG4-RD, has specific imaging features that can help with diagnosis. Thus, early diagnosis and better outcomes can be achieved with increasing awareness of these features of this relatively new pathology. [ABSTRACT FROM AUTHOR]

Byline: Adnan KabaaliogElu (1), Kamil Karaali (1), Ali Apaydin (1), Mustafa MelikogElu (2), Timur Sindel (1), Ersin Luleci (1) Keywords: Key words Echinococcosis; Liver/interventional procedure; Cyst/percutaneous drainage; Children Abstract: To evaluate the efficacy of ultrasound (US) guided percutaneous sclerotherapy in the pediatric population, 14 hydatid liver cysts (HLC) in eight male patients whose ages ranged between 6 and 16 years (mean 9.9 years) were treated. The maximum diameter was 110mm. Albendazole was administered orally to all patients for 1 week before percutaneous treatment and for 3--6 months after the procedure to prevent dissemination of the disease. Cyst puncture was performed with 20G Chiba needles using US guidance. More than one-half of the estimated cyst volume was aspirated, then 20% hypertonic saline (7 cysts) or sterile 96% alcohol (7 cysts) equivalent to one-third of the estimated cyst volume was injected into the cavity and left for 5--15min. Finally, all the fluid in the cavity was reaspirated. Catheterization was not performed. Follow-up US examinations were performed every month during the first 6 months and every 3 months thereafter. The follow-up period ranged between 6 and 51 months (mean 15 months). No major complications were seen during or after the procedures. Two cysts in two patients completely disappeared. Volumes of the 11 cysts in five patients who were followed for 6--21 months were markedly reduced (22%--64% of the initial volume) and thick septations and solid debris-like structures were seen within the cyst cavities. There was no significant change in 1 cyst. US-guided percutaneous sclerotherapy is thus a safe and effective treatment of HLC in children. Author Affiliation: (1) Department of Radiology, Akdeniz Universitesi Tip Fakultesi, Radyoloji ABD, Arapsuyu 07070, Antalya, Turkey, TR (2) Department of Pediatric Surgery, Akdeniz Universitesi Tip Fakultesi, Arapsuyu 07070, Antalya, Turkey, TR Article note: Accepted: 8 November 1999

Tonsillar synovial sarcoma is an extremely rare entity and only 9 adult patients have been reported up to now. Here, we describe the first pediatric tonsillar synovial sarcoma of the literature in a patient who presented with a 2-month history of dysphagia and snoring. Clinical and radiological examinations showed that the tumor arose from the right palatine tonsil and narrowed the parapharyngeal space. An incisional biopsy from the palatine tonsil revealed the diagnosis of synovial sarcoma. The patient has underwent total tonsillectomy and received radiotherapy and chemotherapy because of the positive surgical margins. The patient is clinically in good condition and free of tumor 30 months after the initial diagnosis. We achieved a long-term complete remission with a combination of surgery, radiotherapy and chemotherapy in our case. Tonsillar synovial sarcoma should be kept in mind while dealing with tonsillar masses. We can conclude that a multidisciplinary approach is warranted while treating synovial sarcoma with this localization. [ABSTRACT FROM AUTHOR]

Epithelial–myoepithelial carcinoma (EMC) is an uncommon neoplasm that is predominantly seen in major salivary glands. Although it is considered as low grade, the high recurrence rate is quite common. EMC of the nasal cavity is extremely rare. A case of EMC detected in the nasal cavity is reported. A 44-year-old woman presented with a 1-year history of nasal congestion and bleeding. Magnetic resonance imaging (MRI) revealed a 4×4 cm necrotic expansile lesion involving the bilateral nasal cavity, extending to the nasopharynx, oral cavity, maxillary sinus, and ethmoid cells. The patient was found to be inoperable since complete surgical resection was not possible, and excisional biopsy was performed. Histopathological and immunohistochemical analyses led to a diagnosis of EMC. Definitive radiotherapy (RT) with concomitant cisplatin was applied. After 4 years, the patient is asymptomatic, and MRI showed a stable status with no progression. EMC is rarely seen in the nasal cavity. If possible, the first treatment modality should be surgery. The role of RT is controversial. To the best of our knowledge, this is the only case treated with definitive chemoradiotherapy for EMC in the nasal cavity. [ABSTRACT FROM AUTHOR]