Dysphagia is commonly seen after a cerebral vascular accident. It is rarely caused by lipomas of the retropharyngeal region which are rare benign mesenchymal neoplasms. We report a case of a 53-year-old man who presented with a history of ptyalism and dysphagia occurring after a brain stroke. Flexible nasal endoscopy revealed a pooling of saliva in both pyriform sinuses. Cervical and neurological examinations were unremarkable. Computed tomography (CT) scan suggested the diagnosis of retropharyngeal lipoma. The mass was resected by trans-cervical approach. The histological examination confirmed the diagnosis of a retropharyngeal lipoma. The postoperative course was unremarkable. Although lipomas in the retropharyngeal space are rare, clinicians should evoke this diagnosis when treating a patient presenting with dysphagia, even if there is a medical history of cerebral vascular accident.
Diffuse Idiopathic Skeletal Hyperostosis (DISH) also known as Forestier's disease, is a musculoskeletal disorder characterized by the calcification of ligaments essentially the vertebral longitudinal anterior ligament. Men are generally affected. It is often asymptomatic. The most common extra-spinal clinical manifestation of this disease presents as dysphagia followed by respiratory disturbances such as dyspnea and sleep apnea. In this paper we discuss two cases where the patients have experienced progressive dysphagia. Radiological findings were compatible with DISH. The management was based on diet modification and anti-inflammatory medication.
Desmoid tumor is a proliferation of a mesenchymal, fibroblastic or myofibroblastic tissue. It is a non-capsulated tumor. Despite its benign nature, desmoids tumor have an aggressive behavior.Its localization in the parotid gland has rarely been reported in the literature.The particularity of this location in the head and neck is the proximity of Vascularnervous structures, the facial nerve in the parotid location and the consequence, if affected, on the facial motility especially that this tumor often occurs in young people. The clinical presentation is often about a slow-growing mass characterized by being: painless, ill-defined, firm, non-inflammatory, deeply located, and fixed to the underlying structures. Treatments strategies, always made by a multidisciplinary committee, are based on the natural biological behavior of this deep fibromatosis which is unpredictable and variable. Surgery could be undergone every time it is radical. Radiotherapy could also be played. However, the most relevant point is that actually, most authors highlighted the conservative approach by the "wait and see" policy for primary as well as for recurrence of the disease after surgical resection or radiotherapy.
Background
Pediatric neck masses are a common complaint in children. The most common etiologies include congenital lesions, lymphadenopathy, vascular malformations, inflammatory, and malignant lesions. Spontaneous sternocleidomastoid hematoma is exceptional in infant.
Case presentation
We describe a case of spontaneous cervical hematoma diagnosed in a 4-month-old child. Past history did not reveal a neck trauma, a history of difficult labor, a bleeding disorder or a pertinent family history. The diagnosis was suspected based on the imaging features and confirmed after surgical removal.
Conclusions
Sternocleidomastoid swelling is commonly encountered in infancy.
Ultrasound still remains the initial modality of choice. The management modalities are controversial.
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